Current Problems in Cardiology最新文献

{"title":"SGLT2 inhibitor therapy in patients with advanced heart failure and reduced ejection fraction","authors":"Vincenzo Nuzzi MD ,&nbsp;Paolo Manca MD ,&nbsp;Francesca Parisi MD ,&nbsp;Cristina Madaudo MD ,&nbsp;Sergio Sciacca MD ,&nbsp;Noemi Cannizzo MD ,&nbsp;Massimiliano Mulè MD, PhD ,&nbsp;Manlio G. Cipriani MD","doi":"10.1016/j.cpcardiol.2024.102823","DOIUrl":"10.1016/j.cpcardiol.2024.102823","url":null,"abstract":"<div><h3>Aims</h3><p>Sodium-glucose cotransporter inhibitors (SGLT2-i) improve outcomes in patients with heart failure (HF) and reduced ejection fraction (HFrEF). However, evidence in patients with advanced HF is lacking. We aimed to determine the effect of SGLT2-i in advanced HFrEF compared to their effect on a non-advanced population.</p></div><div><h3>Methods</h3><p>Consecutive HFrEF outpatients who started SGLT2-i were observed for 6-months. Patients were categorized as having advanced or non-advanced HFrEF. The primary outcome was the trend of NTproBNP in the two groups. Secondary outcomes included changes in New York Heart Association (NYHA) class, glomerular filtration rate (GFR), and ejection fraction (LVEF). The association between advanced HF diagnosis and including N-terminal pro-brain natriuretic peptide (NTproBNP) reduction was tested using multivariate analysis.</p></div><div><h3>Results</h3><p>Overall, 105 patients (45 advanced, 60 non-advanced) were included. Mean age was 56 ± 10 years, 22 % were female, and 35 % had ischemic heart disease. Median NTproBNP at baseline for advanced and non-advanced patients was 1672pg/ml (IQR 520-3320) vs. 481 pg/ml (IQR 173-917), respectively (<em>p</em> &lt; 0.001). At follow-up, only non-advanced patients reduced their NTproBNP (-32 % (95 % CI -51 to -3), <em>p</em> &lt; 0.001), while advanced patients had an increase in NTproBNP. LVEF and NYHA class improved only in non-advanced patients. GFR was stable in both subgroups. At multivariate analysis a diagnosis of advanced HF was independently associated with a reduced probability of NTproBNP reduction (OR 0.041 (95 % CI 0.002-0.752), <em>p</em> = 0.031). Only one patient discontinued the drug due to side effects.</p></div><div><h3>Conclusion</h3><p>In advanced HFrEF, SGLT2-i do not impact on NTproBNP, LVEF or NYHA class but are well tolerated.</p></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 11","pages":"Article 102823"},"PeriodicalIF":3.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Tai Chi exercise in patients with hypertension: systematic review and meta-analysis","authors":"Wenxuan Zhang,&nbsp;Hong Wang,&nbsp;Zheng Xiong,&nbsp;Chunmu Li","doi":"10.1016/j.cpcardiol.2024.102798","DOIUrl":"10.1016/j.cpcardiol.2024.102798","url":null,"abstract":"<div><h3>Background</h3><p>An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries. Pharmachological approaches have side effect, prompting exploration of Non-pharmacological approaches, like Tai Chi. Although early evidence suggests a potential favourable benefit with Tai Chi, it remains unclear whether the method can significantly reduced SBP and DBP. We aimed to assess by a systematic review and meta-analysis the effectiveness of Tai Chi in alleviating SBP and DBP on hypertension patients.</p></div><div><h3>Methods</h3><p>Our study adhered to the PRISMA method and was registered in PROSPERO under the code CRD42024496192. The search was carried out in the PubMed, Web of Science, Embase, and the Cochrane Library databases in December 2023. Five randomized controlled trials were included (a total of 568 patients). Risk of bias was employed to assess the quality of individual studies, and a random-effects model was utilized to examine the overall effect.</p></div><div><h3>Results</h3><p>The results showed that Tai Chi, when compared to routine care, had a statistically significant impact on anxiety ((MD = 5.49, 95 % CI: 3.44 to 7.54, p = 0.001), with a heterogeneity I² = 54%. Tai Chi did not show a significant difference in terms of DBP when compared to standard care (MD =3.18, 95 % CI: 1.89 to −4.48, p = 0.31). The included trials exhibited small sample sizes, substantial heterogeneity.</p></div><div><h3>Conclusions</h3><p>Tai Chi effectively lowers SBP levels in hypertension patients, however, did not show a statistically significant difference on DBP.</p></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 11","pages":"Article 102798"},"PeriodicalIF":3.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S014628062400433X/pdfft?md5=154511807ff2dbe049a163a47af3f60f&pid=1-s2.0-S014628062400433X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in trend, clinical characteristics and outcomes in Takotsubo syndrome","authors":"Song Peng Ang MD ,&nbsp;Jia Ee Chia MD ,&nbsp;Chayakrit Krittanawong MD, FACC ,&nbsp;Tharangini Vummadi DO ,&nbsp;Abhishek Deshmukh MBBS ,&nbsp;Muhammed Haris Usman MD, FACC ,&nbsp;Carl J Lavie MD FACC ,&nbsp;Debabrata Mukherjee MD, FACC, MSCAI","doi":"10.1016/j.cpcardiol.2024.102826","DOIUrl":"10.1016/j.cpcardiol.2024.102826","url":null,"abstract":"<div><h3>Introduction</h3><p>Takotsubo syndrome (TTS) is an acute transient nonischemic cardiomyopathy often characterized by its hallmark feature of left ventricular apical ballooning. The correlation between racial backgrounds and the prognosis of individuals with TTS remains poorly defined. Our study aimed to explore the influence of race on the trends, clinical presentations, and outcomes in patients diagnosed with TTS.</p></div><div><h3>Methods</h3><p>We queried the National Inpatient Sample (NIS) database from 2016 to 2020 and identified hospitalizations with TTS. We compared the clinical features and outcomes across three different races - non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic population. The primary outcome was in-hospital mortality.</p></div><div><h3>Results</h3><p>76,505 weighted hospitalizations for TTS were identified, of which 65,495 (85.6%) were non-Hispanic White, 5,830 (7.6%) were non-Hispanic Black, and 5,180 (6.8%) were Hispanics. After propensity-score matching, NHB patients had higher odds of acute kidney injury (OR: 1.49, 95% CI: 1.21-1.84, <em>p</em> &lt; 0.001) and mechanical ventilation (OR: 1.33, 95% CI: 1.04-1.68, <em>p</em> = 0.02). Hispanic patients had a higher incidence of acute kidney injury requiring dialysis when compared to NHW patients (OR: 2.53, 95% CI: 1.11-5.77, <em>p</em> = 0.027). There was no significant difference in terms of in-hospital mortality between NHB and Hispanic patients when compared to NHW patients. Notably, Hispanic populations experienced a higher mortality rate during the COVID-19 period.</p></div><div><h3>Conclusion</h3><p>Our study suggested significant differences in the outcomes of TTS across different racial groups. Hispanic populations experienced a higher mortality rate with TTS during the COVID-19 era. Further research should emphasize discovering the factors contributing to the observed disparities.</p></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 11","pages":"Article 102826"},"PeriodicalIF":3.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0146280624004614/pdfft?md5=16fdc6230ca6d534bb21e569e08e5861&pid=1-s2.0-S0146280624004614-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to “Outcomes after septal myectomy in a cohort of patients with hypertrophic cardiomyopathy”","authors":"Syeda Zuha Sami","doi":"10.1016/j.cpcardiol.2024.102822","DOIUrl":"10.1016/j.cpcardiol.2024.102822","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 11","pages":"Article 102822"},"PeriodicalIF":3.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Rising mortality related to cardiovascular disease and prostate cancer amongst older men across the United States","authors":"Umer Bin Shahzad MBBS,&nbsp;Ume Aiman MBBS","doi":"10.1016/j.cpcardiol.2024.102828","DOIUrl":"10.1016/j.cpcardiol.2024.102828","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 11","pages":"Article 102828"},"PeriodicalIF":3.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of definite vs probable/presumed cardiac sarcoidosis: a systematic review and meta-analysis","authors":"Raheel Ahmed ,&nbsp;Areeba Ahsan ,&nbsp;Mushood Ahmed ,&nbsp;Margaux Dragon ,&nbsp;Rigoberto Rafael Hernñandez Caballero ,&nbsp;Shehroze Tabassum ,&nbsp;Hritvik Jain ,&nbsp;Mohsin Zia Sana Ullah ,&nbsp;Debankur Dey ,&nbsp;Kamleshun Ramphul ,&nbsp;Peter Collins ,&nbsp;Anwar Chahal ,&nbsp;Vasilis Kouranos ,&nbsp;Nitish Behary Paray ,&nbsp;Rakesh Sharma","doi":"10.1016/j.cpcardiol.2024.102820","DOIUrl":"10.1016/j.cpcardiol.2024.102820","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosing cardiac sarcoidosis (CS), which can be associated with arrhythmias and heart failure, remains challenging despite multiple advances over time. The 2014 Heart Rhythm Society (HRS) consensus statement recommends an endomyocardial biopsy (EMB) to establish a definite diagnosis of CS. In the absence of a positive EMB, a diagnosis of probable or presumed CS is made on the basis of clinical and imaging criteria.</div></div><div><h3>Objective</h3><div>To investigate whether there is any difference in outcomes between definite vs probable/presumed CS.</div></div><div><h3>Methods</h3><div>PubMed/MEDLINE, Embase, and the Cochrane Library databases were searched for relevant studies published after 2014. Risk ratios (RR) with 95% confidence intervals (CI) were calculated using the random effects model and presented in forest plots.</div></div><div><h3>Results</h3><div>6 studies involving 2,204 patients were identified. The cohort had a mean age of 56.8 years (SD: ±13.6 years). The median duration of follow-up was 40.5 months. No statistically significant difference was observed between definite and probable/presumed CS for reduced risk of the composite endpoint (RR: 1.80, 95% CI: 0.93 to 3.49), and all-cause death (RR: 1.01, 95% CI: 0.48 to 2.10).</div></div><div><h3>Conclusion</h3><div>This meta-analysis demonstrated the equivalence of clinical course and prognosis between definite and probable/presumed CS. This highlights the importance of a multi-disciplinary approach to CS care and emphasizes that histological confirmation should not be a prerequisite to diagnose or manage this condition.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 12","pages":"Article 102820"},"PeriodicalIF":3.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to “Rising mortality related to cardiovascular disease and prostate cancer amongst older men across the United States”","authors":"Muzna Murtaza,&nbsp;Syeda Zuha Sami,&nbsp;FNU Venjhraj,&nbsp;Zainab Muhammad Hanif","doi":"10.1016/j.cpcardiol.2024.102824","DOIUrl":"10.1016/j.cpcardiol.2024.102824","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 11","pages":"Article 102824"},"PeriodicalIF":3.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspirin use in patients with elevated lipoprotein(a): Impact on cardiovascular events and bleeding","authors":"Walter Masson ,&nbsp;Leandro Barbagelata ,&nbsp;Juan Patricio Nogueira","doi":"10.1016/j.cpcardiol.2024.102827","DOIUrl":"10.1016/j.cpcardiol.2024.102827","url":null,"abstract":"<div><p>The role of aspirin in cardiovascular primary prevention remains controversial. There are physiological reasons to explore its potential benefits in patients with high levels of lipoprotein(a) [Lp(a)], mainly due to its antifibrinolytic properties and interactions with platelets. The primary objective of this systematic review was to evaluate the cardiovascular benefits and bleeding risks associated with aspirin use in patients who have elevated Lp(a) levels but no history of cardiovascular disease. This systematic review was conducted following PRISMA guidelines. We performed a literature search to identify studies assessing the cardiovascular benefits and bleeding risks of aspirin use in patients with elevated Lp(a) levels (or a related genetic variant) who have no history of cardiovascular disease. Five studies (49,871 individuals) were considered for this systematic review. Three studies assessed the impact of aspirin use in relation to genetic variants associated with elevated Lp(a) levels (SNP rs379822), while the remaining two studies directly measured plasma levels of Lp(a). The endpoints evaluated varied among the studies. Overall, the findings consistently show that carriers of the apolipoprotein(a) variant or patients with Lp(a) levels &gt; 50 mg/dL experience a reduction in cardiovascular risk with aspirin use. No significant bleeding issues were observed, although such events were reported in only two studies. This systematic review suggests that aspirin use in patients with elevated Lp(a) levels and no prior cardiovascular history may reduce cardiovascular risk. The available data on bleeding risk is insufficient.</p></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 11","pages":"Article 102827"},"PeriodicalIF":3.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for Authors","authors":"","doi":"10.1016/S0146-2806(24)00447-X","DOIUrl":"10.1016/S0146-2806(24)00447-X","url":null,"abstract":"","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 10","pages":"Article 102812"},"PeriodicalIF":3.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative pharmacological approaches to hypertrophic cardiomyopathy: The emerging role of Aficamten","authors":"Emmanuel Kokori ,&nbsp;Ravi Patel ,&nbsp;Gbolahan Olatunji ,&nbsp;Abdulbasit Opeyemi Muili ,&nbsp;Victor Oluwatomiwa Ajekiigbe ,&nbsp;Abdulrahmon Moradeyo ,&nbsp;Adetola Emmanuel Babalola ,&nbsp;Julia Mimi Kwape ,&nbsp;Oluwatobi Omoworare ,&nbsp;Nicholas Aderinto","doi":"10.1016/j.cpcardiol.2024.102802","DOIUrl":"10.1016/j.cpcardiol.2024.102802","url":null,"abstract":"<div><p>Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by left ventricular hypertrophy (LVH), which can lead to left ventricular outflow tract (LVOT) obstruction. Traditional treatments often provide limited symptom relief and may not adequately reduce the LVOT gradient. Myosin inhibitors, such as Aficamten , offer a new therapeutic approach by modulating myocardial contractility and improving symptoms. This paper evaluated the efficacy and safety of Aficamten in patients with symptomatic HCM. We conducted a comprehensive literature review of studies evaluating Aficamten for symptomatic HCM, including clinical trials and observational studies up to July 2024. Data on efficacy, safety, and patient outcomes were extracted and analyzed from a total of 10 studies involving 1,067 patients. Aficamten demonstrated substantial efficacy in reducing the LVOT gradient, with dose-dependent reductions ranging from 3.6 % to 48.6 %. It also improved symptoms, with 82.3 % of patients experiencing reduced left ventricular ejection fraction (LVEF) and notable improvements in New York Heart Association (NYHA) functional class. Exercise capacity was enhanced, as indicated by increased peak oxygen uptake. Safety profiles were generally favorable, though some serious adverse events, such as atrial fibrillation and cardiac dysfunction, were reported. Aficamten was well-tolerated overall, with manageable dose-dependent adverse effects. Aficamten represents a promising advance in the management of symptomatic HCM, offering significant reductions in LVOT gradient and improvement in symptoms and exercise capacity. Its safety profile is generally favorable, although ongoing monitoring is necessary to manage potential adverse effects. Future research should focus on long-term outcomes, comparative effectiveness, and real-world evidence.</p></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"49 11","pages":"Article 102802"},"PeriodicalIF":3.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}