Current Opinion in Cardiology最新文献_第5页

Recent updates on therapeutic targeting of lipoprotein(a) with RNA interference. 利用 RNA 干扰对脂蛋白（a）进行靶向治疗的最新进展。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-03-26 DOI: 10.1097/HCO.0000000000001144

Aravind Sekhar, Ashani Kuttan, Richard A Lange

{"title":"Recent updates on therapeutic targeting of lipoprotein(a) with RNA interference.","authors":"Aravind Sekhar, Ashani Kuttan, Richard A Lange","doi":"10.1097/HCO.0000000000001144","DOIUrl":"10.1097/HCO.0000000000001144","url":null,"abstract":"Purpose of review: RNA interference (RNAi)-based therapies that target specific gene products have impacted clinical medicine with 16 FDA approved drugs. RNAi therapy focused on reducing plasma lipoprotein(a) [Lp(a)] levels are under evaluation.Recent findings: RNAi-based therapies have made significant progress over the past 2 decades and currently consist of antisense oligonucleotides (ASO) and small interfering RNA (siRNA). Chemical modification of the RNA backbone and conjugation of siRNA enables efficient gene silencing in hepatocytes allowing development of effective cholesterol lowering therapies. Multiple lines of evidence suggest a causative role for Lp(a) in atherosclerotic cardiovascular disease, and recent analyses indicate that Lp(a) is more atherogenic than low density lipoprotein- cholesterol (LDL-C). These findings have led to the 'Lp(a) hypothesis' that lowering Lp(a) may significantly improve cardiovascular outcomes. Four RNAi-based drugs have completed early phase clinical trials demonstrating >80% reduction in plasma Lp(a) levels. Phase 3 clinical trials examining clinical outcomes with these agents are currently underway.Summary: Currently, four RNAi-based drugs have been shown to be effective in significantly lowering plasma Lp(a) levels. Clinical outcome data from phase 3 trials will evaluate the Lp(a) hypothesis.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"292-299"},"PeriodicalIF":2.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bad behavior in healthcare: an insidious threat to patients, staff, and organizations. 医疗保健领域的不良行为：对患者、员工和机构的隐性威胁。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-03-20 DOI: 10.1097/HCO.0000000000001139

Liz Crowe, Christine M Riley

{"title":"Bad behavior in healthcare: an insidious threat to patients, staff, and organizations.","authors":"Liz Crowe, Christine M Riley","doi":"10.1097/HCO.0000000000001139","DOIUrl":"10.1097/HCO.0000000000001139","url":null,"abstract":"Purpose of review: 'Bad' or unprofessional behavior (UPB) destroys communication, teamwork, and professional wellbeing, presenting a significant threat to patients and staff. Understanding what constitutes 'bad' or UPB and creating broad accountability for its cessation is imperative to patient-centered care and the survival of the multidisciplinary health workforce.Recent findings: Despite organizational and legislative commitments to provide well tolerated work environments, UPB is endemic in healthcare and continues to harm patients, staff, and organizations. Historically, categories of UPB have been researched separately which dilutes the problem. Typically, these behaviors cluster, are interchangeable, and are committed by same perpetrators. Women, junior staff, and minority groups remain the most prevalent targets. Even low intensity UPBs among health staff dramatically impacts risk to patient lives, limits quality care, and destroys staff wellbeing. Targeted interventions must address all five roles impacted by UPBs: the target, patients, bystanders, the perpetrator, and the organization to effectively eliminate UPBs. Organizational leaders must demonstrate and uphold organizational values and be swift in addressing UPB to limit the impact on teams and patients.Summary: UPB in the healthcare setting presents a multifactorial threat to patients, staff, and organizations. To ensure the delivery of high-quality patient care, and the wellbeing of the health workforce it is crucial to understand the insidious impact of UPB and target interventions across all five roles.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"331-337"},"PeriodicalIF":2.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resistant hypertension. 抵抗性高血压。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-03-04 DOI: 10.1097/HCO.0000000000001134

Farnoosh Shariati, Nitin Tandan, Carl J Lavie

引用次数: 0

From remnant cholesterol to lipoprotein(a) - emerging risk factors for cardiovascular diseases beyond low density lipoprotein. 从残余胆固醇到脂蛋白（a）--低密度脂蛋白之外新出现的心血管疾病风险因素。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-06-06 DOI: 10.1097/HCO.0000000000001142

Debabrata Mukherjee, Dimitri P Mikhailidis

引用次数: 0

Predictive utility of remnant cholesterol in atherosclerotic cardiovascular disease. 残余胆固醇对动脉粥样硬化性心血管疾病的预测作用。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-03-08 DOI: 10.1097/HCO.0000000000001140

Spencer D Proctor, Maggie Wang, Donna F Vine, Paolo Raggi

{"title":"Predictive utility of remnant cholesterol in atherosclerotic cardiovascular disease.","authors":"Spencer D Proctor, Maggie Wang, Donna F Vine, Paolo Raggi","doi":"10.1097/HCO.0000000000001140","DOIUrl":"10.1097/HCO.0000000000001140","url":null,"abstract":"Purpose of review: Remnant cholesterol (RC) is the cholesterol carried in lipoproteins derived from the catabolism of chylomicrons and very low-density lipoproteins. Evidence supporting the causal relationship of RC with atherosclerotic cardiovascular disease (ASVD) is accumulating rapidly. The number of impactful contributions to this field are increasing and provide a pathophysiological insight into the current residual cardiovascular risk beyond low-density cholesterol (LDL)-cholesterol (LDL-C). They also raise the question of whether RC should be used in prediction models and become the target of new therapeutic interventions. The intent of this review is to highlight the recent advances on the role of RC in atherogenesis and the validation of RC as a predictor of ASVD.Recent findings: Numerous prospective and retrospective cohorts helped validate a significant causal relationship of RC with various forms of ASVD, independent of LDL-C. A recent large Mendelian randomization study reinforced the existence of this relationship and showed that the risk of atherosclerotic events was driven nearly entirely by a direct effect of RC.Summary: Both available and accumulating evidence suggest that a lifelong reduction in RC could translate into a substantial reduction in ASVD risk. The data support a revision of current guidelines to incorporate RC as an independent risk factor for ASVD. We propose that early screening of RC should be implemented and that RC lowering should become the target of future drug developments.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"300-307"},"PeriodicalIF":2.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Short and long-term complications of hypertensive disorders of pregnancy: lifelong cardiovascular risks we cannot ignore. 妊娠高血压疾病的短期和长期并发症：我们不能忽视的终生心血管风险。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-02-21 DOI: 10.1097/HCO.0000000000001122

Cara E Saxon, Julia Bast, Josephine C Chou

{"title":"Short and long-term complications of hypertensive disorders of pregnancy: lifelong cardiovascular risks we cannot ignore.","authors":"Cara E Saxon, Julia Bast, Josephine C Chou","doi":"10.1097/HCO.0000000000001122","DOIUrl":"10.1097/HCO.0000000000001122","url":null,"abstract":"Purpose of review: Hypertensive disorders of pregnancy (HDP) pose a significant threat to maternal cardiovascular health, with emerging research shedding light on the enduring risks beyond the gestational period. This review highlights updates regarding cardiovascular risks associated with HDP and their implications for long-term health.Recent findings: Patients with a history of HDP are at an elevated risk of developing chronic hypertension, ischemic heart disease, stroke, valvular heart disease, and heart failure.Not surprisingly, patients with HDP experience higher rates of maternal and fetal adverse events in the antepartum and immediate postpartum periods, with high readmission rates for cardiovascular complications. The high risk of chronic hypertension after a HDP then leads to the development of subclinical disease over 5-10 years with overt cardiovascular disease becoming most prevalent in the decades following pregnancy. Early hypertension management in the antepartum and postpartum periods has lifelong health benefits and highlights the need for seamless postpartum transitions with close blood pressure monitoring and cardiovascular risk mitigation.Summary: HDP significantly increases the risk of short and long-term adverse cardiovascular events. Integrated healthcare models that assess and address postpartum cardiovascular risk are necessary to improve the cardiovascular health and longevity of those effected by HDP.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"259-265"},"PeriodicalIF":2.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updates in the management of cancer therapy-related hypertension. 癌症治疗相关高血压的最新管理方法。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-02-23 DOI: 10.1097/HCO.0000000000001127

Prerna Gupta, Mario Enrico Canonico, Christian Faaborg-Andersen, Nicole Prabhu, Lavanya Kondapalli, Raymundo A Quintana

{"title":"Updates in the management of cancer therapy-related hypertension.","authors":"Prerna Gupta, Mario Enrico Canonico, Christian Faaborg-Andersen, Nicole Prabhu, Lavanya Kondapalli, Raymundo A Quintana","doi":"10.1097/HCO.0000000000001127","DOIUrl":"10.1097/HCO.0000000000001127","url":null,"abstract":"Purpose of review: To provide a comprehensive review of hypertension among patients with cancer. Several cancer therapies cause hypertension which has resulted in a growing and vulnerable population of patients with difficult to control hypertension which has significant downstream effects.Recent findings: Hypertension affects up to 50% of cancer patients and higher comorbidity when compared to the general population. Many anticancer therapies can cause hypertension through their treatment effect. Antihypertensive treatment is crucial given cardiovascular mortality is a leading cause of death among cancer patients. It is already known that hypertension is poorly controlled in the general population, and there are additional challenges in management among patients with cancer. Patients with cancer suffer from multimorbidity, are on multiple medications creating concern for drug interactions, and often have blood pressure lability, which can worsen clinical inertia among patients and their providers. It is crucial to effectively treat hypertension in cancer patients to mitigate downstream adverse cardiovascular events.Summary: In recent years, there have been significant changes in management guidelines of hypertension and simultaneously as influx of new cancer therapeutics. We provide an update on hypertension treatment among patients with cancer on different chemotherapeutic agents.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"235-243"},"PeriodicalIF":2.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Metabolic basis of cardiac dysfunction in cancer patients. 癌症患者心脏功能障碍的代谢基础。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-05-01 Epub Date: 2024-02-21 DOI: 10.1097/HCO.0000000000001118

Jane C Figueiredo, Neil Adri Bhowmick, Anja Karlstaedt

引用次数: 0

Clinical impact of genetic testing for lipid disorders. 血脂紊乱基因检测的临床影响。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-05-01 Epub Date: 2024-02-29 DOI: 10.1097/HCO.0000000000001133

Emir Muzurović, Sanja Borozan, Manfredi Rizzo

{"title":"Clinical impact of genetic testing for lipid disorders.","authors":"Emir Muzurović, Sanja Borozan, Manfredi Rizzo","doi":"10.1097/HCO.0000000000001133","DOIUrl":"10.1097/HCO.0000000000001133","url":null,"abstract":"Purpose of review: Genetic testing is increasingly becoming a common consideration in the clinical approach of dyslipidemia patients. Advances in research in last decade and increased recognition of genetics in biological pathways modulating blood lipid levels created a gap between theoretical knowledge and its applicability in clinical practice. Therefore, it is very important to define the clinical justification of genetic testing in dyslipidemia patients.Recent findings: Clinical indications for genetic testing for most dyslipidemias are not precisely defined and there are no clearly established guideline recommendations. In patients with severe low-density lipoprotein cholesterol (LDL-C) levels, the genetic analysis can be used to guide diagnostic and therapeutic approach, while in severe hypertriglyceridemia (HTG), clinicians can rely on triglyceride level rather than a genotype along the treatment pathway. Genetic testing increases diagnostic accuracy and risk stratification, access and adherence to specialty therapies, and cost-effectiveness of cascade testing. A shared decision-making model between the provider and the patient is essential as patient values, preferences and clinical characteristics play a very strong role.Summary: Genetic testing for lipid disorders is currently underutilized in clinical practice. However, it should be selectively used, according to the type of dyslipidemia and when the benefits overcome costs.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"154-161"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetic causes of lymphatic disorders: recent updates on the clinical and molecular aspects of lymphatic disease. 淋巴疾病的遗传原因：淋巴疾病临床和分子方面的最新进展。

IF 2.3 4区医学

Current Opinion in Cardiology Pub Date : 2024-05-01 Epub Date: 2024-03-13 DOI: 10.1097/HCO.0000000000001116

Catharine Bowman, Stanley G Rockson

{"title":"Genetic causes of lymphatic disorders: recent updates on the clinical and molecular aspects of lymphatic disease.","authors":"Catharine Bowman, Stanley G Rockson","doi":"10.1097/HCO.0000000000001116","DOIUrl":"10.1097/HCO.0000000000001116","url":null,"abstract":"Purpose of review: The lymphatic system facilitates several key functions that limit significant morbidity and mortality. Despite the impact and burden of lymphatic disorders, there are many remaining disorders whose genetic substrate remains unknown. The purpose of this review is to provide an update on the genetic causes of lymphatic disorders, while reporting on newly proposed clinical classifications of lymphatic disease.Recent findings: We reviewed several new mutations in genes that have been identified as potential causes of lymphatic disorders including: MDFIC, EPHB 4 , and ANGPT2. Furthermore, the traditional St. George's Classification system for primary lymphatic anomalies has been updated to reflect the use of genetic testing, both as a tool for the clinical identification of lymphatic disease and as a method through which new sub-classifications of lymphatic disorders have been established within this framework. Finally, we highlighted recent clinical studies that have explored the impact of therapies such as sirolimus, ketoprofen, and acebilustat on lymphatic disorders.Summary: Despite a growing body of evidence, current literature demonstrates a persistent gap in the number of known genes responsible for lymphatic disease entities. Recent clinical classification tools have been introduced in order to integrate traditional symptom- and time-based diagnostic approaches with modern genetic classifications, as highlighted in the updated St. George's classification system. With the introduction of this novel approach, clinicians may be better equipped to recognize established disease and, potentially, to identify novel causal mutations. Further research is needed to identify additional genetic causes of disease and to optimize current clinical tools for diagnosis and treatment.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"170-177"},"PeriodicalIF":2.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0