IJC Heart and Vasculature最新文献

{"title":"Prognostic value of preoperative high-sensitivity C-reactive protein to albumin ratio in patients with dilated cardiomyopathy receiving pacemaker therapy: A retrospective two-center study in China","authors":"Jiaqi Pan ,&nbsp;Enrui Zhang ,&nbsp;Jie Han ,&nbsp;Haiyu Zou ,&nbsp;Liangrong Zheng","doi":"10.1016/j.ijcha.2024.101554","DOIUrl":"10.1016/j.ijcha.2024.101554","url":null,"abstract":"<div><h3>Background</h3><div>Despite receiving pacemaker therapy, patients with heart failure with reduced ejection fraction (HFrEF) due to dilated cardiomyopathy (DCM) remain at an increased risk of adverse cardiovascular events. The high-sensitivity C-reactive protein (hs-CRP)-to-albumin ratio (CAR) is a novel indicator. This study aimed to assess the prognostic value of preoperative CAR in this population.</div></div><div><h3>Methods</h3><div>Patients with DCM who underwent cardiac resynchronization therapy (CRT) or implantable cardiac defibrillator (ICD) implantation for HFrEF between 2018 and 2023 were involved. The primary endpoint was major adverse cardiac events (MACE). Cox regression models were used to investigate predictors for MACE. Receiver operating characteristic (ROC) curve analysis was utilized to evaluate the diagnostic efficacy and identify the optimal cutoff point.</div></div><div><h3>Results</h3><div>We enrolled 250 patients, of whom 78 experienced MACE. Patients who experienced MACE had a significantly higher CAR than those without MACE (<em>p</em> &lt; 0.001). Multivariate Cox regression analysis indicated CAR as an independent predictor for MACE (hazard ratio = 4.301, 95 % confidence interval [CI] 1.833–10.091, <em>p</em> &lt; 0.001). ROC curve analysis demonstrated the discriminatory ability of CAR in predicting MACE (area under the curve [AUC] = 0.732, 95 % CI 0.666–0.792, <em>p</em> &lt; 0.001), with an optimal threshold of 0.08. Furthermore, the incidence of MACE was significantly higher in the high-CAR (&gt; 0.08) group compared to the low-CAR (≤ 0.08) group (48.8 % vs. 13.6 %, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Among patients with DCM and HFrEF treated with CRT or ICD, CAR can serve as an independent risk predictor, with higher levels associated with poorer outcomes.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"55 ","pages":"Article 101554"},"PeriodicalIF":2.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659348","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":"Association between Proenkephalin A and cardiovascular outcomes in ambulatory Veterans","authors":"Shreya Banerjee ,&nbsp;Pranav S. Garimella ,&nbsp;Kimberly N. Hong ,&nbsp;Alexander L. Bullen ,&nbsp;Lori B. Daniels ,&nbsp;Nicholas Wettersten","doi":"10.1016/j.ijcha.2024.101557","DOIUrl":"10.1016/j.ijcha.2024.101557","url":null,"abstract":"<div><div>Proenkephalin (PENK) is a novel biomarker of kidney function associated with cardiovascular risk in patients with cardiovascular disease. Its association with cardiovascular outcomes in ambulatory individuals is less described. In an observational study of 199 ambulatory Veterans enrolled from April to September 2010, we assessed PENK’s association with major adverse cardiac events (MACE − cardiovascular death, heart failure [HF] hospitalization, myocardial infarction [MI], or stroke) and individual outcomes of all-cause mortality, incident HF, and cardiovascular death using Cox regression. We also assessed the association of PENK with left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), and left ventricular mass index (LVMi) with linear regression. The mean age was 66 ± 12 years, 99 % were men, and 76 % were White, with median follow-up of 12.7 years. Each two-fold higher PENK was associated with a 73 % higher risk of MACE in unadjusted analysis (HR 1.73; 95 % CI 1.00, 2.99; p = 0.043), though this association lost significance after adjusting for confounders (HR 1.69; 95 % CI 0.90–3.15; p = 0.098). PENK was not associated with all-cause mortality, incident HF or cardiovascular death, although risk estimates were elevated with wide confidence intervals for incident HF and cardiovascular death. PENK was not associated with LVMi or LVEDd but had a non-linear relationship with LVEF with low and high PENK associated with lower LVEF. In conclusion, PENK may be associated with a higher risk of MACE in ambulatory Veterans with diverse health statuses; however, further studies are needed.</div><div>Abbreviations: PENK: Proenkephalin A; MACE: Major Adverse Cardiac Events.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"55 ","pages":"Article 101557"},"PeriodicalIF":2.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659349","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 3-level Wells score combined with D-dimer can accurately diagnose acute pulmonary embolism in hospitalized patients with acute exacerbation of COPD: A multicentre cohort study","authors":"Xiaojing Jiao ,&nbsp;Yixiao zhang ,&nbsp;Tuguang Kuang ,&nbsp;Juanni Gong ,&nbsp;Yadong Yuan ,&nbsp;Guohua Zhen ,&nbsp;Jifeng Li ,&nbsp;Suqiao Yang ,&nbsp;Jianguo He ,&nbsp;Yuanhua Yang","doi":"10.1016/j.ijcha.2024.101533","DOIUrl":"10.1016/j.ijcha.2024.101533","url":null,"abstract":"<div><h3>Background</h3><div>Identification of acute pulmonary embolism (APE) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is challenging. Wells score and Revised Geneva score have been developed to diagnose APE. We aim to investigate the predictive accuracy of two clinical scoring systems combined with D-dimer for APE in patients with AECOPD.</div></div><div><h3>Methods</h3><div>A multicentre cross-sectional study was conducted in 13 China hospitals. A total of 731 patients were enrolled. Computed tomography pulmonary angiography (CTPA) was performed within 48 hours of admission. The performance of the clinical scoring systems was compared by calculating the area under the receiver operating characteristic curves (AUROC), sensitivities, and specificities.</div></div><div><h3>Results</h3><div>731 patients were included with an average age of 68.9 years, with a male proportion of 585 (80.0 %). 112 (15.3 %) were diagnosed with APE. The optimal D-dimer cut-off value for identifying APE in AECOPD was 690.12 ng/mL. Analysis for assessing the clinical probability of APE using the 3-level Wells and Revised Geneva scores showed the AUC were 0.74 and 0.60, sensitivity were 61.61 % and 77.68 %, and specificity were 85.46 % and 38.29 %, respectively. Analysis using the 3-level Wells and Revised Geneva scores combined with a D-dimer cut-off value of 690.12 ng/mL showed the AUC were 0.909 and 0.869, sensitivity were 73.21 % and 91.96 %, specificity were 92.08 %and 72.70 %. The performance of the 3-level Wells score with D-dimer was significantly better than the performance of the 3-level Revised Geneva score with D-dimer (<em>P</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>The 3-level Wells score combined with a D-dimer cut-off value of 690.12 ng/mL performed better than other clinical scoring algorithms for assessing clinical probability of APE in patients with AECOPD.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"55 ","pages":"Article 101533"},"PeriodicalIF":2.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659343","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":"Efficacy of finerenone in reducing heart failure outcomes in patients with history of heart failure: A meta-analysis of randomized controlled trials","authors":"Vikash Jaiswal ,&nbsp;Fakhar Latif ,&nbsp;Sidra Naz ,&nbsp;Pragathi Munnangi ,&nbsp;Novonil Deb ,&nbsp;Jishanth Mattupuram","doi":"10.1016/j.ijcha.2024.101548","DOIUrl":"10.1016/j.ijcha.2024.101548","url":null,"abstract":"","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"55 ","pages":"Article 101548"},"PeriodicalIF":2.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659442","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":"Exploring risk Indicators of atrial fibrillation in severe Obesity: Left atrial cardiomyopathy and premature atrial contractions","authors":"J.F. Chin ,&nbsp;Y.S. Aga ,&nbsp;S. Abou Kamar ,&nbsp;S.M. Snelder ,&nbsp;I. Kardys ,&nbsp;R.A. de Boer ,&nbsp;J.J. Brugts ,&nbsp;B.M. van Dalen","doi":"10.1016/j.ijcha.2024.101555","DOIUrl":"10.1016/j.ijcha.2024.101555","url":null,"abstract":"<div><h3>Background</h3><div>Although obesity is a major risk factor for atrial fibrillation (AF), its mechanisms and the diagnostic yield of AF screening in severe obesity is unclear. This study aims to enhance our comprehension of AF susceptibility in severe obesity by investigating associations between left atrial (LA) cardiomyopathy and premature atrial contractions (PACs) and to explore the diagnostic yield of AF screening.</div></div><div><h3>Methods</h3><div>This cross-sectional study included a total of 192 subjects aged 35–65 years with a BMI ≥ 35 kg/m², alongside 50 non-obese controls, both without known cardiac disease. Prolonged heart rhythm registration was done with either 24-hours (n = 147) or 7-day Holter monitoring (n = 75) or an implantable loop recorder (ILR) (n = 10). Furthermore, we performed conventional transthoracic echocardiography and strain analyses.</div></div><div><h3>Results</h3><div>In the obese cohort, LA enlargement was independently associated with PAC frequency. Each SD increment (10 ml/m²) of LA volume index corresponded with a 46 % increase in PACs. An increase of each SD (10 %) LA reservoir strain was associated with a decrease of 16 % in PAC frequency. There was no association found between LA cardiomyopathy and PACs in the control group. AF was not detected in any subject.</div></div><div><h3>Conclusion</h3><div>LA enlargement was independently associated with more frequent PACs in severe obesity, a well-known AF precursor. There was a noticeable trend suggesting a relation between impaired LA function and PACs. Considering our observed low diagnostic yield of AF screening within this population, further investigation is needed to determine whether incorporating LA cardiomyopathy as an additional risk measure could improve AF screening strategies for individuals with severe obesity.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"55 ","pages":"Article 101555"},"PeriodicalIF":2.5,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659345","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":"Different patterns of pre-excitation in a large Italian cohort of asymptomatic non-competitive athletes evaluated by telecardiology screening: Prevalence and ECG features","authors":"Martina Molinari ,&nbsp;Sergio Setti ,&nbsp;Natale Daniele Brunetti ,&nbsp;Nicola Di Nunno ,&nbsp;Maria Alberta Cattabiani ,&nbsp;Giuseppe Molinari","doi":"10.1016/j.ijcha.2024.101553","DOIUrl":"10.1016/j.ijcha.2024.101553","url":null,"abstract":"<div><h3>Background</h3><div>Telecardiology has proven to be a useful and cost-effective tool for ECG screening in several contexts, allowing the evaluation of large cohorts of subjects in a short time, even for non-competitive athletes (NCA).</div></div><div><h3>Aim of the study</h3><div>To evaluate and detail the prevalence of the Wolff-Parkinson-White (WPW) syndrome in a large Italian cohort of young NCA.</div></div><div><h3>Methods</h3><div>In a 4-year period 216,424 consecutive NCA (118,851 males; 55%) underwent preparticipation ECG screening through a Telecardiology System. ECGs were recorded and sent by a network of ‘spoke’ centers located all over Italy; a ‘hub’ center, located in Genoa, received and reported back on ECGs, digitally stored and analyzed. Only asymptomatic NCA were included in the study.</div></div><div><h3>Results</h3><div>Out of 216,424 NCA 88 (mean age: 14 ± 8) presented a WPW pre-excitation at ECG analysis (55 males, 62.5 %); the prevalence of WPW pre-excitation in this population was 4.1 per 10,000 NCA. No significant sex-related differences were found. The highest incidence (29 WPW patterns) was observed in the 10–15 year group with an equal sex ratio (M/F:16/13).</div><div>Intermittent pre-excitation was found in 8 NCAs. The most frequent accessory pathway locations were right antero-septal (25.0%), mid-septal (21.6%) and postero-septal (13.6%).</div></div><div><h3>Conclusions</h3><div>In a large population of young NCA the prevalence of ECG pre-excitation at telemedicine remote screening was 4.1 per 10,000; intermittent pre-excitation was found in 9% of NCA with ECG pre-excitation.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"55 ","pages":"Article 101553"},"PeriodicalIF":2.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659344","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":"Underrepresentation of women in cardiovascular disease clinical Trials—What’s in a Name?","authors":"A.E. Spiering ,&nbsp;A.M.L.N. van Ommen ,&nbsp;J.E. Roeters van Lennep ,&nbsp;Y. Appelman ,&nbsp;K. Reue ,&nbsp;N.C. Onland-Moret ,&nbsp;H.M. den Ruijter","doi":"10.1016/j.ijcha.2024.101547","DOIUrl":"10.1016/j.ijcha.2024.101547","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease is the leading cause of death in women worldwide. Yet, women are often underrepresented in cardiovascular clinical trials. Trial characteristics may influence the participation of women. For instance, trials are often entitled with an acronym, which might be perceived as gendered. We aimed to investigate if the perceived gender of the acronym and other trial characteristics affect the representation of female patients in cardiovascular trials.</div></div><div><h3>Methods</h3><div>We searched ClinicalTrials.gov for randomized controlled trials in cardiovascular disease named with an acronym. Cardiovascular patients (n = 148) scored the perceived gender of the acronym of 148 identified trials. Prevalence ratios (PR) were calculated with Poisson regression to link trial characteristics to representation of female patients in the trials.</div></div><div><h3>Results</h3><div>In 62 % of trials, female patients were underrepresented relative to the disease population. There was no improvement over time in proportion of trials with adequate representation. A third of acronyms was classified as gendered. The perceived gender did not affect representation of female patients (PR 1.01; 95% CI 0.95 – 1.08; P = 0.68). A woman as first and/or last author (PR 1.22; 95% CI 1.07 – 1.38; P = 0.002) and recruitment in an outpatient setting (PR 1.15; 95% CI 1.02 – 1.29; P = 0.01) were associated with a higher prevalence of adequate representation of female patients.</div></div><div><h3>Conclusions</h3><div>Representation of female patients in cardiovascular trials does not depend on the perceived gender of the trial acronym but is improved in trials under female leadership in out-patient settings. Our findings may direct efforts towards increasing representation of female patients in cardiovascular trials.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"55 ","pages":"Article 101547"},"PeriodicalIF":2.5,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659401","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":"Ten-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients: The OBSERVANT study","authors":"Fausto Biancari ,&nbsp;Paola D’Errigo ,&nbsp;Marco Barbanti ,&nbsp;Gabriella Badoni ,&nbsp;Corrado Tamburino ,&nbsp;Gianluca Polvani ,&nbsp;Giuliano Costa ,&nbsp;Giovanni Baglio ,&nbsp;Stefano Rosato","doi":"10.1016/j.ijcha.2024.101545","DOIUrl":"10.1016/j.ijcha.2024.101545","url":null,"abstract":"<div><h3>Background</h3><div>The evidence of the long-term advantages of transcatheter aortic valve replacement (TAVR) over surgical aortic valve replacement (SAVR) for aortic stenosis (AS) remains scarce.</div></div><div><h3>Methods</h3><div>Patients with EuroSCORE II &lt; 4 % who underwent TAVR or SAVR for AS from the prospective observational OBSERVANT study were included in this analysis. Ten-year survival was the primary outcome of this analysis. Secondary outcome was repeat procedure on the aortic valve prosthesis.</div></div><div><h3>Results</h3><div>Propensity score matching resulted in 355 matched pairs of patients who underwent TAVR or SAVR. The mean age of SAVR patients was 80.0 ± 5.1 years and that of TAVR patients 80.1 ± 6.4 years (p = 0.81) and the mean EuroSCORE II was 2.5 ± 0.8 % and 2.6 ± 0.8 % (p = 0.60), respectively. Thirty-day mortality was 2.8 % after SAVR and 2.5 % after TAVR (p = 0.82). At 10-year, survival was 37.0 % (95 %CI 32.2–42.5 %) after SAVR and 18.2 % (95 %CI 14.5–22.8 %) after TAVR (Log-rank test, p &lt; 0.001; HR 1.70, 95 %CI 1.42–2.03). Difference in terms of survival between the propensity matched cohorts became significant 3 years after the procedures. Ten-year cumulative incidences of repeat aortic valve procedure were 2.6 % (95 %CI 1.4–5.0 %) after SAVR and 1.1 % (95 %CI 0.4–3.0 %) after TAVR (p = 0.153; SHR 0.43, 95 %CI 0.13–1.41).</div></div><div><h3>Conclusions</h3><div>The results of this prospective observational, non-randomized study showed that 10-year survival of low-risk patients who underwent TAVR with early generation prosthesis devices was lower than SAVR.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"55 ","pages":"Article 101545"},"PeriodicalIF":2.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571403","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":"Postoperative delirium in patients undergoing TAVI versus SAVR – A systematic review and meta-analysis","authors":"Dimitrios Stavridis ,&nbsp;Angelique Runkel ,&nbsp;Anna Starvridou ,&nbsp;Johannes Fischer ,&nbsp;Luca Fazzini ,&nbsp;Hristo Kirov ,&nbsp;Max Wacker ,&nbsp;Jens Wippermann ,&nbsp;Torsten Doenst ,&nbsp;Tulio Caldonazo","doi":"10.1016/j.ijcha.2024.101544","DOIUrl":"10.1016/j.ijcha.2024.101544","url":null,"abstract":"<div><h3>Background</h3><div>Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR) have different levels of invasiveness which can result in different levels of functional status after the procedure.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis to detect studies showing direct comparison between TAVI and SAVR regarding postoperative functional status. The primary endpoint was the incidence of postoperative delirium (POD) after TAVI or SAVR, assessed using the Confusion Assessment Method (CAM). Secondary endpoints included 30-day mortality, stroke, major bleeding, and hospital length of stay (LOS).</div></div><div><h3>Results</h3><div>We identified 1,161 manuscripts, of which 10 studies (12,015 patients) were analyzed. TAVI patients had a significantly lower incidence of POD (OR: 0.35, 95 % CI, 0.26–0.48, p &lt; 0.01) compared to SAVR patients. No significant differences were found in secondary outcomes between the groups.</div></div><div><h3>Conclusions</h3><div>TAVI is associated with a lower incidence of postoperative delirium compared to SAVR without compromising length of stay or other major clinical outcomes. Further research is needed to understand the impact of postoperative delirium on short and long-term outcomes.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"55 ","pages":"Article 101544"},"PeriodicalIF":2.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560800","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":"Role of Lipoprotein (A) in aortic valve stenosis: Novel disease mechanisms and emerging pharmacotherapeutic approaches","authors":"Mohammad Ishrak Khan ,&nbsp;Raisa Subaita Zahir ,&nbsp;Abel Casso Dominguez ,&nbsp;Francisco José Romeo","doi":"10.1016/j.ijcha.2024.101543","DOIUrl":"10.1016/j.ijcha.2024.101543","url":null,"abstract":"<div><div>Lipoprotein(a) (Lp(a)) has garnered increasing attention as a significant contributor to the pathogenesis of aortic stenosis (AS), prompting a focused investigation into innovative pharmacological strategies to target this lipoprotein and its associated risks. Despite its recognized role in AS progression, Lp(a) often remains overlooked in clinical assessments, mirroring the broader challenges observed in holistic disease management. This review delves into the mechanistic intricacies of Lp(a) involvement in AS pathophysiology and its potential as a therapeutic target. Drawing parallels with the imperative for healthcare providers to proactively engage with patients regarding treatment regimens, this review underscores the essential role of cardiologists and physicians in recognizing and addressing Lp(a) as a modifiable risk factor in AS management. Furthermore, it explores promising avenues of novel drug approaches, including emerging pharmacotherapies and targeted interventions, aimed at modulating Lp(a) levels and attenuating AS progression. By navigating the complexities of Lp(a) modulation and its implications for AS management, this review aims to bridge critical gaps in understanding and clinical practice, ultimately optimizing treatment strategies and improving patient outcomes in the realm of AS therapeutics.</div></div>","PeriodicalId":38026,"journal":{"name":"IJC Heart and Vasculature","volume":"55 ","pages":"Article 101543"},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552413","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}