Current Opinion in Cardiology最新文献_第9页

Effects of bempedoic acid on markers of inflammation and Lp(a). 鱼贝多酸对炎症指标和脂蛋白（a）的影响

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-03-04 DOI: 10.1097/HCO.0000000000001137

Sukhila Reddy, Abhizith Deoker

{"title":"Effects of bempedoic acid on markers of inflammation and Lp(a).","authors":"Sukhila Reddy, Abhizith Deoker","doi":"10.1097/HCO.0000000000001137","DOIUrl":"10.1097/HCO.0000000000001137","url":null,"abstract":"Purpose of review: To study the effect of bempedoic acid on markers of inflammation and lipoprotein (a) to help determine if the drug would be useful to treat patients with elevated cardiovascular risks and residual cardiovascular risk despite optimal low-density lipoprotein cholesterol (LDL-C) levels.Recent findings: Bempedoic acid is found to cause significant reduction in LDL-C and high-sensitivity C-reactive protein (hs-CRP) in various randomized clinical trials. Multiple meta-analyses have also found that bempedoic acid therapy leads to reduction in non-high-density lipoprotein cholesterol (non-HDL-C), total cholesterol (TC) and apolipoprotein B (ApoB) levels. However, it has minimal effect on lipoprotein (a) (Lp(a)) level.Summary: Bempedoic acid is a new lipid-lowering agent that inhibits enzyme ATP-citrate lyase in the cholesterol biosynthesis pathway. Major risk of cardiovascular events and its associated morbidity and mortality are proportional to LDL-C and inflammatory markers levels. It was found that bempedoic acid significantly lowers LDL-C, hs-CRP and other inflammatory markers levels. This drug could potentially be used in patients with elevated cardiovascular risk, in patients with residual cardiovascular risk despite attaining LDL-C goal and in statin intolerant patients.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"280-285"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061290","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

Leaders need to look in the mirror. 领导者需要照照镜子。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-03-11 DOI: 10.1097/HCO.0000000000001138

Josh Koch

引用次数: 0

Pemafibrate and other triglyceride-lowering therapies to reduce risk of cardiovascular and metabolic disease. 培马贝特和其他降低甘油三酯的疗法，以降低心血管疾病和代谢疾病的风险。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-03-11 DOI: 10.1097/HCO.0000000000001136

Michael Miller

{"title":"Pemafibrate and other triglyceride-lowering therapies to reduce risk of cardiovascular and metabolic disease.","authors":"Michael Miller","doi":"10.1097/HCO.0000000000001136","DOIUrl":"10.1097/HCO.0000000000001136","url":null,"abstract":"Purpose of review: Although high triglycerides are consistently associated with elevated risk of cardiovascular disease (CVD), therapies that reduce triglyceride levels have inconsistently translated into reduced CVD risk.Recent findings: To date, three clinical trials have tested triglyceride-lowering therapies in patients with hypertriglyceridemia (HTG) and elevated risk of incident/recurrent CVD. In REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial), assignment to IPE, a highly purified eicosapentanoic acid (EPA), resulted in a 25% reduction in nonfatal myocardial infarction), nonfatal stroke, cardiovascular death, coronary revascularization and hospitalization for unstable angina. By contrast, the combination of EPA and docosahexanoic acid (DHA) carboxylic fatty acids used in the STRENGTH trial (Statin Residual Risk With Epanova in High Cardiovascular Risk Patients With Hypertriglyceridemia) failed to reduce CVD risk. Most recently, PROMINENT (Pemafibrate to Reduce Cardiovascular Outcomes by Reducing Triglycerides in Patients with Diabetes) also failed to demonstrate reduction in CVD events despite use of a potent triglyceride-lowering, fibric-acid derivative. However, improvement in HTG-associated metabolic complications (e.g. nonalcoholic fatty liver disease) was observed with pemafibrate as well as with another potent triglyceride-lowering therapy (i.e. pegozafermin). Moreover, trials are underway evaluating whether the most fatal metabolic complication of HTG, pancreatitis, may be reduced with highly potent triglyceride-lowering therapies (e.g. apolipoprotein C3 inhibitors).Summary: Taken together, HTG is associated with increased risk of CVD and attendant adverse metabolic sequalae. To this end, a potentially promising and evidence-based landscape is emerging for treating a clinical phenotype that in the past has been insufficiently addressed.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"286-291"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11150088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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 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":2.0,"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

Management of hypertension in heart transplant recipients: an ongoing conundrum. 心脏移植受者的高血压管理：一个持续的难题。

IF 2 4区医学

Current Opinion in Cardiology Pub Date : 2024-07-01 Epub Date: 2024-03-27 DOI: 10.1097/HCO.0000000000001145

Juan Duarte Torres, Selim R Krim

{"title":"Management of hypertension in heart transplant recipients: an ongoing conundrum.","authors":"Juan Duarte Torres, Selim R Krim","doi":"10.1097/HCO.0000000000001145","DOIUrl":"10.1097/HCO.0000000000001145","url":null,"abstract":"Purpose of review: Hypertension remains one of the most common clinical problems leading to significant posttransplant complications. This study reviews the pathophysiology of hypertension in the postcardiac transplant phase and provides an update on currently available antihypertensive therapies for heart transplant patients.Recent findings: The true prevalence of hypertension in the heart transplant population remains unknown. Effective blood pressure (BP) control is key to prevent left ventricular remodeling, diastolic dysfunction and stroke. Calcium channel blockers (CCBs) are the most commonly and preferred agents in the early posttransplant phase and may have renal protective effects. Angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs) can all be used as second line antihypertensive agents and may have a role in preventing other long-term complications such as calcineurin-inhibitor induced nephropathy. Although more data are needed, sodium-glucose co-transporter 2 inhibitors (SGLT2i) appeared to be well tolerated and could be considered especially in the presence of type diabetes and chronic kidney disease. Conversely, angiotensin receptor-neprilysin inhibition (ARNI) have not been studied in the heart transplant population therefore cannot be recommended at this time.Summary: Hypertension is very common after heart transplant. Early steroid wean and traditional risk factor modification play an important part in the management of post-heart transplant hypertension. CCB, ACEI, ARB are the preferred antihypertensive agents to improve postcardiac transplant complications. Novel therapies such as SGLT2i appear well tolerated and may have benefits in both BP and glycemic control in heart transplant; however, larger trials are needed.","PeriodicalId":55197,"journal":{"name":"Current Opinion in Cardiology","volume":" ","pages":"273-278"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319950","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 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

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 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":2.0,"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

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 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":2.0,"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

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 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

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 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":2.0,"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