Archives of medical sciences. Atherosclerotic diseases最新文献

{"title":"Clinical outcomes of isolated versus systemic cardiac sarcoidosis: a systematic review and meta-analysis.","authors":"Raheel Ahmed, Areeba Ahsan, Mushood Ahmed, Kamleshun Ramphul, Hritvik Jain, Syed Faisal Ali, Adnan Hasan Afridi, Renju Philip Thomas, Nimra Zuberi, Muhammad Easa Khan, Irfan Rind, Mohammad Saddam Jeelani, Mohsin Zia Sana Ullah, Nitish K Behary Paray","doi":"10.5114/amsad/209036","DOIUrl":"10.5114/amsad/209036","url":null,"abstract":"<p><strong>Introduction: </strong>Isolated cardiac sarcoidosis (ICS) is characterized by a lack of the apparent extra-cardiac involvement seen in systemic cardiac sarcoidosis (SCS) and is being increasingly recognized as a distinct clinical phenotype of cardiac sarcoidosis. This systematic review and meta-analysis pooled data from published literature to assess any differences in outcomes of ICS vs. SCS patients.</p><p><strong>Methods: </strong>Studies were identified from PubMed/Medline, Embase, and the Cochrane Library. Risk ratios were calculated using the Mantel-Haenszel method in a random effects model. Heterogeneity was assessed using the Higgins <i>I</i> ² statistic. Leave-one-out sensitivity analysis was also performed. The primary outcome was a composite of MACE, including cardiac death, ventricular arrhythmias, or hospitalization for heart failure. The secondary outcomes included sudden cardiac death, arrhythmias, and heart-failure-related hospitalizations.</p><p><strong>Results: </strong>The analysis included 7 studies and 918 CS patients (28.9% ICS and 71.1% SCS). Increased risk for arrhythmias (RR = 3.06, 95% CI: 0.98 to 9.55, <i>p</i> = 0.05, <i>I</i> ² = 67%) in patients with ICS compared to SCS was observed. No significant difference was observed for composite outcome (RR = 1.43, 95% CI: 0.93 to 2.18, <i>p</i> = 0.10, <i>I</i> ² = 0%), HF-related hospitalizations (RR = 6.83, 95% CI: 0.47 to 100.33, <i>p</i> = 0.16, <i>I</i> ² = 80%), or cardiac death (RR = 1.85, 95% CI: 0.49 to 7.08, <i>p</i> = 0.37, <i>I</i> ² = 0%) between the two groups.</p><p><strong>Conclusions: </strong>Although ICS patients were more likely to experience arrhythmias, no significant difference was observed between ICS and SCS patients for composite outcome, cardiac death, or hospitalizations due to heart failure.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e96-e103"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12550700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145380486","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":"High-density lipoprotein cholesterol and multiple sclerosis: a systematic review and meta-analysis.","authors":"Anastasios Makris, Nikoletta Palli, Angelos Liontos, Evangelos C Rizos, Constantinos Tsioutis, Dimitrios Papadopoulos, Aris P Agouridis","doi":"10.5114/amsad/204578","DOIUrl":"10.5114/amsad/204578","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by demyelination and axonal degeneration. Evidence has shown that lipid metabolism is associated with MS clinical outcomes. The aim was to systematically investigate the association between high-density lipoprotein cholesterol (HDL-C) and disease activity in MS.</p><p><strong>Material and methods: </strong>Medline via PubMed, the Cochrane Library and Clinicaltrials.gov databases were searched for studies with data on HDL-C in patients with MS. A qualitative synthesis of published prospective and retrospective studies on the role of HDL-C and other lipid profile parameters in MS was performed. Additionally, a meta-analysis on HDL-C mean differences (MD) between relapsing remitting MS (RRMS) cases and healthy controls (HC) was performed.</p><p><strong>Results: </strong>Literature search identified 13 eligible studies evaluating the HDL-C levels of RRMS patients. In total, 1692 participants were included, 859 of which were RRMS patients, and 833 were HC. The pooled analysis demonstrated that RRMS patients had significantly lower HDL-C levels compared with HC (MD: -3.35 mg/dl, 95% CI (-5.69, -1.01), <i>p</i> = 0.005). Regarding triglycerides (TG) and total cholesterol (TC), the pooled analysis from 11 and 13 studies, respectively, showed significantly higher TG (MD = 26.33, 95% CI (15.03, 37.62), <i>p</i> < 0.00001) and TC levels (MD = 11.03, 95% CI (0.45, 21.60), <i>p</i> = 0.04) in RRMS versus HC. No significant differences were observed in low-density lipoprotein cholesterol levels between RRMS and HC.</p><p><strong>Conclusions: </strong>HDL-C levels were significantly decreased in RRMS patients compared with HC. HDL-C and other lipid profile parameters should be considered in the assessment of patients with RRMS.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e69-e77"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577542","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":"Spontaneous avulsion of the inferior mesenteric artery in a neurofibromatosis type 1 patient: a case-based review.","authors":"Spyros Papadoulas, Melina Stathopoulou, Emmanouil Barmparessos, Andreas Tsimpoukis, Chrysanthi Papageorgopoulou, Konstantinos Nikolakopoulos, Nikolaos Krinos, Elias Liolis, Konstantinos Tasios, Dimitrios Litsas, Vasileios Leivaditis, Petros Zampakis, Nikolaos Giannikas, Anastasia Zotou, John Ellul, Helen Kourea, Francesk Mulita","doi":"10.5114/amsad/205022","DOIUrl":"10.5114/amsad/205022","url":null,"abstract":"<p><p>We present the case of successful endovascular abdominal aortic aneurysm repair (EVAR) in a 55-year-old male who presented with a ruptured infrarenal aortic pseudoaneurysm, formed after spontaneous avulsion of the inferior mesenteric artery. The avulsion occurred after lifting a heavy object. Although aortic endografting is not the first option in patients with hereditary disorders due to aortic friability and concerns about long-term durability, it is valuable in urgent cases due to lower morbidity and mortality, even as a bridging procedure. This policy is further supported by the fact that the alternative open reconstruction has been invariably associated with hemostasis issues and poor outcomes due to arterial fragility and inability to construct safe anastomoses. Finally, we present a current literature review regarding abdominal aortic and iliac pathology in patients with neurofibromatosis type 1 focusing on the type of the vascular lesion, method of repair and outcome.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e48-e68"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577547","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 and safety of direct oral anticoagulants versus warfarin in patients with atrial fibrillation and liver disease: an updated systematic review and meta-analysis.","authors":"Riya Bhagwan, Rushaan Ahmed, Saad Ahmed Idrees, Saad Javaid, Roha Mazhar, Rahima Tauqeer, Mushood Ahmed, Satesh Kumar, Mahima Khatri, Ashish Gupta, Ramachandra Ramkumar, Mudassar Baig, Peter Collins, Raheel Ahmed","doi":"10.5114/amsad/205549","DOIUrl":"10.5114/amsad/205549","url":null,"abstract":"<p><strong>Introduction: </strong>Although previous meta-analyses have explored the efficacy and safety of direct oral anticoagulants (DOAC) compared to warfarin in patients with atrial fibrillation (AFib) and liver disease, recent studies and emerging data necessitate a re-evaluation of the topic. Therefore, we conducted an updated meta-analysis to incorporate the latest evidence and provide a more comprehensive understanding of the literature. This meta-analysis aimed to assess the safety and efficacy of DOAC in patients diagnosed with AFib and liver disease.</p><p><strong>Methods: </strong>Following PRISMA guidelines, this meta-analysis is registered with PROSPERO (2024 CRD42024584964). A detailed search up to August 2024 was conducted for the studies comparing DOAC with warfarin. The quality of the included observational studies was evaluated using the Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool.</p><p><strong>Results: </strong>This meta-analysis included 53,224 participants with AFib and liver disease. The use of DOAC, in comparison to warfarin, was significantly linked to a lower risk of all-cause mortality (HR = 0.77; 95% CI: 0.60-0.98; <i>p</i> = 0.04) and a decreased occurrence of intracranial haemorrhage (HR = 0.49; 95% CI: 0.40-0.59; <i>p</i> < 0.00001). However, other outcomes did not demonstrate statistically significant differences.</p><p><strong>Conclusions: </strong>Recent studies indicate that DOAC are at least non-inferior to warfarin concerning efficacy and safety of patients with AFib and liver disease.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e78-e88"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577541","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":"Unraveling the mystery of pleural calcifications: a diagnostic challenge in pleural disease.","authors":"Vasileios Leivaditis, Francesk Mulita, Elias Liolis, Konstantinos Nikolakopoulos, Konstantinos Tasios, Dimitrios Litsas, Nikolaos Krinos, Andreas Antzoulas, Levan Tchabashvili, Konstantinos Grapatsas, Efstratios Koletsis, Spyros Papadoulas, Manfred Dahm","doi":"10.5114/amsad/205019","DOIUrl":"10.5114/amsad/205019","url":null,"abstract":"","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e35-e40"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577548","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":"A troubleshooting technique in endovascular abdominal aortic aneurysm repair.","authors":"Spyros Papadoulas, Chrysanthi Papageorgopoulou, Konstantinos Nikolakopoulos, Andreas Tsimpoukis, Melina Stathopoulou, Elias Liolis, Konstantinos Tasios, Dimitrios Litsas, Nikolaos Krinos, Andreas Antzoulas, Levan Tchabashvili, Vasileios Leivaditis, Francesk Mulita","doi":"10.5114/amsad/205020","DOIUrl":"10.5114/amsad/205020","url":null,"abstract":"","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e41-e42"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577540","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":"Restoring the failing heart: successful complex ventricular reconstruction with Dor procedure in severe ischemic cardiomyopathy.","authors":"Vasileios Leivaditis, Francesk Mulita, Ece Özsoy, Athanasios Papatriantafyllou, Tamas Büki, Nikolaos G Baikoussis, Ioannis Panagiotopoulos, Konstantinos Nikolakopoulos, Nikolaos Krinos, Elias Liolis, Efstratios Koletsis, Manfred Dahm","doi":"10.5114/amsad/205021","DOIUrl":"10.5114/amsad/205021","url":null,"abstract":"","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e28-e34"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577546","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":"Omecamtiv mecarbil, a cardiac myosin activator with potential efficacy in heart failure.","authors":"Mohammed Kallash, William H Frishman, Wilbert S Aronow","doi":"10.5114/amsad/205547","DOIUrl":"10.5114/amsad/205547","url":null,"abstract":"<p><p>Heart failure (HF) is a growing global epidemic resulting in significant morbidity and mortality. The pathophysiology of HF with reduced ejection fraction (HFrEF) is characterized by impaired systolic function resulting in diminished cardiac output. A new class of inotropes, cardiac myosin activators were developed to directly augment cardiac sarcomere function and improve myocardial activity in HFrEF. The first drug in this class, omecamtiv mecarbil selectively activates cardiac myosin and improves cardiac contractility by increasing the efficiency of the actin-myosin cross-bridge cycle, increasing the duration of systolic ejection without raising myocardial oxygen demand. The first major trial investigating omecamtiv mecarbil use in HFrEF demonstrated a statistically significant decrease in the composite endpoint of the first HF event or death from cardiovascular causes. A post hoc analysis demonstrated that omecamtiv mecarbil produced a statistically significant reduction in the composite endpoint of time to the first HF event or cardiovascular death among patients with severe HFrEF.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e43-e47"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577543","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":"Optimal dual antiplatelet therapy for coronary artery bypass grafting: a systematic review and meta-analysis.","authors":"Ali Salman, Saad Ahmed Waqas, Jazza Aamir, Ruqiat Masooma Batool, Muhammad Khalid Afridi, Fatima Aman Makda, Ifrah Ansari, Haiqa Aamer, Sadaf Iftikhar, Faraz Arshad, Usama Hussain Kamal, Rizwana Noor, Mudassar Baig, Ashish Gupta, Ali Hasan, Farhan Shahid, Raheel Ahmed","doi":"10.5114/amsad/202297","DOIUrl":"10.5114/amsad/202297","url":null,"abstract":"<p><strong>Introduction: </strong>This meta-analysis evaluated the efficacy and safety of dual antiplatelet therapy (DAPT) with aspirin combined with ticagrelor, clopidogrel, or prasugrel in coronary artery bypass grafting (CABG) patients.</p><p><strong>Methods: </strong>Nineteen studies involving 9,585 patients were included.</p><p><strong>Results: </strong>Post-CABG administration of ticagrelor significantly reduced all-cause mortality (OR = 0.49 [0.33, 0.73]; <i>p</i> < 0.01) and minimized major bleeding when discontinued more than 3 days before surgery (OR = 0.62 [0.47, 0.83]; <i>p</i> < 0.01). Ticagrelor exhibited a non-significant trend toward reducing both re-bleeding and the need for platelet transfusions. Prasugrel was associated with a higher requirement for platelet transfusions (OR = 1.88; 95% CI: 1.24-2.87; <i>p</i> < 0.01). No significant associations were found for myocardial infarction, stroke, or RBC transfusion.</p><p><strong>Conclusions: </strong>In CABG patients, DAPT with aspirin and ticagrelor offers the best balance between efficacy and safety, improving key outcomes while managing bleeding risk. Prasugrel's increased bleeding risk requires caution in its use.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e16-e27"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577544","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":"Pioglitazone with SGLT2 inhibitors or GLP-1 receptor agonists in patients with type 2 diabetes and non-alcoholic fatty liver disease: could the combinations of an old friend with new players yield better outcomes?","authors":"Georgios S Papaetis, Michalis K Picolos, Anastasia Sacharidou","doi":"10.5114/amsad/202298","DOIUrl":"10.5114/amsad/202298","url":null,"abstract":"<p><p>More than 25% of the adult population worldwide and approximately 50-75% of patients with type 2 diabetes are diagnosed with non-alcoholic fatty liver disease. Insulin resistance is one of the most crucial factors underlying its pathogenesis and a significant determinant of its progression to non-alcoholic steatohepatitis. The complex pathophysiology of non-alcoholic fatty liver disease emphasizes the need for combination treatment strategies with drug classes that target different cellular pathways, since no single agent can control all the mechanisms contributing to its development and evolution. Pioglitazone, the main thiazolidinedione in clinical practice, is the only true insulin sensitizing antidiabetic drug in our therapeutic armamentarium for the treatment of patients with type 2 diabetes. Current international practice guidelines recommend PIO as a promising therapy for patients who experience NASH and type 2 diabetes. GLP-1 receptor agonists and SGLT2 inhibitors have shown salutary cardiometabolic and renal effects in patients with type 2 diabetes, as well as beneficial liver activities in those with non-alcoholic fatty liver disease. This review discusses the pathophysiological background for the use of these three drug categories in patients with type 2 diabetes and non-alcoholic fatty liver disease. It also explores thoroughly the combinations of pioglitazone with either GLP-1 receptor agonists or SGLT2 inhibitors, as well as their future role in this setting.</p>","PeriodicalId":516556,"journal":{"name":"Archives of medical sciences. Atherosclerotic diseases","volume":"10 ","pages":"e1-e15"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577545","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}