American Journal of Cardiovascular Drugs最新文献

{"title":"Correction: Impact of Aspirin on Primary Prevention of Cardiovascular Events in Patients with Elevated Lipoprotein(a): A Systematic Review and Meta-analysis","authors":"Daniel Caldeira, Mariana Alves, Rita Avó-Baião, Andreia Lopes, Luisa Prada, Fausto J. Pinto","doi":"10.1007/s40256-026-00805-9","DOIUrl":"10.1007/s40256-026-00805-9","url":null,"abstract":"","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 5","pages":"571 - 571"},"PeriodicalIF":3.2,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40256-026-00805-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148275215","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}

{"title":"Comment on “Polypill Strategy: A Paradigm Shift in Cardiovascular Disease Prevention”","authors":"Frank A. Snyder, Daniel T. Gregory Jr., Roy A. Stimits, Stephan D. Glenn","doi":"10.1007/s40256-026-00804-w","DOIUrl":"10.1007/s40256-026-00804-w","url":null,"abstract":"","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 5","pages":"667 - 668"},"PeriodicalIF":3.2,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155034","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}

{"title":"Spironolactone or Finerenone for Cardiovascular and Kidney Protection in Patients with Moderate CKD?","authors":"Panagiotis I. Georgianos,&nbsp;Eirini Leptokaridou-Mourtzila,&nbsp;Christodoula Kourtidou,&nbsp;Ioannis Kontogiorgos,&nbsp;Athanasios Roumeliotis,&nbsp;Vasilios Vaios,&nbsp;Vassilios Liakopoulos","doi":"10.1007/s40256-026-00802-y","DOIUrl":"10.1007/s40256-026-00802-y","url":null,"abstract":"<div><p>In clinical states of relative aldosterone excess, such as in patients with chronic kidney disease (CKD), blockade of the overactivated mineralocorticoid receptor (MR) is a mechanistically plausible target of therapy in order to improve long-term cardiovascular and kidney outcomes. However, in the recently completed Benefits of Aldosterone Receptor Antagonism in Chronic Kidney Disease (BARACK-D) trial, the addition of spironolactone to standard care was not superior to standard care alone in improving cardiovascular outcomes in high-risk patients with moderate CKD. The use of spironolactone over the course of the BARACK-D trial was commonly restricted by hyperkalemia and other side effects. In sharp contrast, finerenone is a novel, selective, non-steroidal MR antagonist with proven cardiorenal protective effects and a more favorable side-effect profile. In a prespecified, individual patient-level data synthesis of 3 large clinical trials, as compared with placebo, finerenone significantly reduced the risks of all-cause death, hospitalization for heart failure and progression of CKD in a broad spectrum of patients with cardio-kidney-metabolic diseases. Although the risk of hyperkalemia with finerenone is real, the permanent discontinuation of treatment due to hyperkalemia occurs rarely. Accordingly, finerenone appears to be a safer therapeutic option with well-documented benefits on cardiovascular and kidney outcomes. In this article, we provide a comparative evaluation of safety and efficacy of spironolactone with that of finerenone. We discuss differences in pharmacodynamic and pharmacokinetic properties as well as data for the safety and efficacy of these 2 MR antagonists. We conclude with a call for a trial aiming to provide a direct and head-to-head comparison between spironolactone and finerenone in high-risk patients with cardio-kidney-metabolic diseases in the future.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 4","pages":"391 - 396"},"PeriodicalIF":3.0,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40256-026-00802-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980250","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}

{"title":"Author’s Reply to: “Comment on: Colchicine for the Secondary Prevention of Cardiovascular Diseases: A Cumulative-Dose Meta-analysis of Randomized Controlled Trials Including 31,397 Subjects Worldwide”","authors":"Hoi-Ying Li,&nbsp;Joseph Cheriyan,&nbsp;Tsz-Kwan Chan,&nbsp;Kai-Hang Yiu,&nbsp;Hung-Fat Tse,&nbsp;Ian B. Wilkinson,&nbsp;Yap-Hang Chan","doi":"10.1007/s40256-026-00800-0","DOIUrl":"10.1007/s40256-026-00800-0","url":null,"abstract":"","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 4","pages":"511 - 512"},"PeriodicalIF":3.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969658","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}

{"title":"Comment on: “Colchicine for the Secondary Prevention of Cardiovascular Diseases: A Cumulative-Dose Meta-analysis of Randomized Controlled Trials including 31,397 Subjects Worldwide”","authors":"Sunil Konipineni,&nbsp;Jayesh Valecha,&nbsp;Caroline Ducatti Meme,&nbsp;Amanda Cyntia Lima Fonseca Rodrigues","doi":"10.1007/s40256-026-00801-z","DOIUrl":"10.1007/s40256-026-00801-z","url":null,"abstract":"","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 4","pages":"507 - 509"},"PeriodicalIF":3.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969648","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}

{"title":"Factors Influencing Physician Adherence to Venous Thromboembolism Risk Assessment Model Recommendations: A Best–Worst Scaling","authors":"Nicola B. Campoamor,&nbsp;Benjamin G. Mittman,&nbsp;Stephanie Moss,&nbsp;Michael B. Rothberg,&nbsp;John F. P. Bridges","doi":"10.1007/s40256-026-00799-4","DOIUrl":"10.1007/s40256-026-00799-4","url":null,"abstract":"<div><h3>Purpose</h3><p>Risk assessment models (RAM) use predictive algorithms to support physicians in personalizing care. For example, a RAM to determine the risk of venous thromboembolism (VTE-RAM) in hospitalized patients offered treatment recommendations that physicians adhered to at varying rates. We sought to investigate which factors influenced physician adherence to prophylaxis recommendations from a VTE-RAM implemented in an inpatient setting.</p><h3>Methods</h3><p>We assessed adherence to treatment recommendations for a VTE-RAM in the inpatient setting using both survey and real-world data sources. Inclusion criteria included being a hospitalist or resident in the inpatient setting, using a VTE-RAM at least 50 times, and having complete data from both sources available. Variation in treatment adherence from the two data sources was compared, and physicians were inductively segmented into high- and low-adherence groups. Seven possible factors influencing adherence were identified using prior research and prioritized using best–worst scaling (BWS). Results were stratified by adherence group, and differences in priorities were tested using Wald tests.</p><h3>Results</h3><p>We obtained data for 188 physicians, most of whom (56%) were unable to accurately state their rate of adherence. Two groups were identified: those with relatively high adherence (≥ 70%; <i>n</i> = 58) and those with relatively low adherence (&lt; 70%; <i>n</i> = 130). High-adherence physicians prioritized that the VTE-RAM increases decision-making confidence (<i>p</i> &lt; 0.001), reduces overtreatment of low-risk patients (<i>p</i> &lt; 0.001), and facilitates documentation of low-risk patients (<i>p</i> = 0.029). Low-adherence physicians were more likely to prioritize that important risk factors are missing from the algorithm (<i>p</i> &lt; 0.001), that the VTE-RAM disrupts workflow (<i>p</i> &lt; 0.001), and that it is used owing to institutional policy requirements (<i>p</i> = 0.021).</p><h3>Conclusions</h3><p>Observed physician adherence to VTE-RAM recommendations often differs from self-reported behavior. We found that several factors associated with high- and low-adherence physicians. High adherence was linked to confidence, reduced overtreatment, and documentation support, while low adherence reflected concerns about missing factors, workflow disruption, and institutional requirements. Aligning RAM design with physician priorities may improve adherence and clinical utility.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 4","pages":"497 - 506"},"PeriodicalIF":3.0,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40256-026-00799-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959642","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}

{"title":"Efficacy and Safety of Ongericimab in Chinese Patients with Hypercholesterolemia: A Meta-analysis of Randomized Controlled Trials","authors":"Muhammad Imaz Bhatti,&nbsp;Muhammad Safiullah,&nbsp;Maria Qadri,&nbsp;Anam Aamir Butt,&nbsp;Raheel Ahmed","doi":"10.1007/s40256-026-00797-6","DOIUrl":"10.1007/s40256-026-00797-6","url":null,"abstract":"<div><h3>Background</h3><p>Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition has emerged as an effective lipid-lowering strategy, particularly for patients with hypercholesterolemia not adequately managed with statins. Ongericimab is a novel monoclonal antibody targeting PCSK9. In this meta-analysis, we aim to evaluate the efficacy and safety of ongericimab in Chinese patients with hypercholesterolemia.</p><h3>Methods</h3><p>A comprehensive literature search was conducted on PubMed, Embase, Scopus, and ClinicalTrials.gov from inception to November 2025, to identify studies assessing the lipid-lowering effects of ongericimab. Effect estimates and 95% confidence intervals (CIs) were calculated using a random-effects model.</p><h3>Results</h3><p>Five RCTs (<i>n</i> = 1415; mean age 57.65 ± 10.94 years; 55.7% male) were included. Ongericimab significantly reduced LDL-C by approximately 71%, Lp(a) by 48%, ApoB by 60%, total cholesterol by 47%, and non-HDL-C by 65%. Subgroup analysis revealed dose-dependent effects for LDL-C, ApoB, TC, and non-HDL-C (<i>p</i> &lt; 0.05), while Lp(a) reduction remained consistent across doses (<i>p</i> = 0.75). At the 150 mg dose, ongericimab also increased HDL-C by 10% and ApoA1 by 8%, and reduced triglycerides (TGs) by 23%. Adverse events were comparable between ongericimab and placebo groups.</p><h3>Conclusions</h3><p>Ongericimab reduces LDL-C and other atherogenic lipoproteins in Chinese patients with hypercholesterolemia, with a tolerability profile comparable to placebo. These findings support its potential role as an adjunct therapy for patients who do not meet LDL-C targets with statins.</p><h3>Registration</h3><p>PROSPERO identifier no. CRD420251086724.</p><h3>Graphical Abstract</h3><div><figure><div><div><picture><source><img></source></picture><span>The alternative text for this image may have been generated using AI.</span></div></div></figure></div></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 4","pages":"467 - 484"},"PeriodicalIF":3.0,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863385","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}

{"title":"Formulation-Specific Cardiovascular Outcomes with High-Dose Eicosapentaenoic Acid: A Systematic Review and Meta-analysis","authors":"Muhammad Anas Faheem,&nbsp;Bazil Azeem,&nbsp;Talha Ali,&nbsp;Rabia Asim,&nbsp;Tazheen Saleh Muhammad,&nbsp;Mata-e-Alla Dogar,&nbsp;Muhammad Abdullah Naveed","doi":"10.1007/s40256-026-00798-5","DOIUrl":"10.1007/s40256-026-00798-5","url":null,"abstract":"<div><h3>Background/Objective</h3><p>Residual cardiovascular risk persists despite intensive statin therapy in patients with established atherosclerotic cardiovascular disease (CVD). Omega-3 fatty acids, particularly high-dose eicosapentaenoic acid (EPA), have been proposed as adjunctive therapy, yet trial results conflict, likely due to formulation differences. We conducted a formulation-focused meta-analysis to determine whether high-dose EPA-dominant supplementation reduces cardiovascular events and to quantify the impact of mixed EPA/docosahexaenoic acid (DHA) regimens on efficacy.</p><h3>Methods</h3><p>Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, we searched MEDLINE, Embase, CENTRAL, and trial registries through May 2025 for randomized controlled trials, including placebo-controlled and open-label designs, of high-dose EPA-dominant omega-3 (≥ 1.8 g/day; ≥ 50% EPA) in adults with established CVD or other high-risk settings. Six trials (<i>n</i> = 42,738; 31–85% male) were eligible. Random-effects models generated pooled risk ratios (RRs), with <i>I</i>² assessing heterogeneity; sensitivity analyses excluded mixed EPA/DHA formulations. Imaging surrogate outcomes were summarized narratively when study modalities were not directly comparable.</p><h3>Results</h3><p>EPA-based therapy significantly reduced hospitalizations for unstable angina (RR 0.75, 95% CI 0.66–0.87; <i>I</i>² = 0%). Overall effects on recurrent myocardial infarction and revascularization were not statistically significant, but both became significant after exclusion of STRENGTH, the only mixed EPA/DHA cardiovascular outcomes trial. No significant effect was observed for ischemic stroke, cardiovascular death, or high-sensitivity C-reactive protein (hs-CRP). CHERRY and EVAPORATE both suggested attenuation of plaque progression, but these imaging studies were not pooled because intravascular ultrasound and coronary computed tomography angiography-derived measures were not directly comparable.</p><h3>Conclusion</h3><p>High-dose EPA-dominant therapy was associated with fewer unstable angina hospitalizations, and formulation appeared to modify clinical benefit. Among blinded, placebo-controlled, cardiovascular outcomes trials, 4 g/day icosapent ethyl is the only formulation independently associated with reduced cardiovascular events. Larger formulation-specific trials are needed to clarify the roles of purified EPA, mixed EPA/DHA regimens, and patient selection.</p><h3>Registration</h3><p>PROSPERO identifier number: CRD420251063069.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 4","pages":"453 - 465"},"PeriodicalIF":3.0,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809546","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}

{"title":"Rapid Access Atrial Fibrillation Clinics in Australia – Modelling Outcomes and Cost–Effectiveness","authors":"Adam C. Livori,&nbsp;Ansu Alex,&nbsp;Tamrat Abebe,&nbsp;J. Simon Bell,&nbsp;Zanfina Ademi,&nbsp;Jedidiah I. Morton","doi":"10.1007/s40256-026-00796-7","DOIUrl":"10.1007/s40256-026-00796-7","url":null,"abstract":"<div><h3>Aims</h3><p>Stroke prevention in patients with atrial fibrillation (AF) requires both estimation of risk and the initiation of anticoagulation treatment where indicated. Rapid access atrial fibrillation (RAAF) clinics are an accepted model of multidisciplinary care to reduce time at risk of stroke, but their clinical outcomes and cost–effectiveness are uncertain. This study aimed to perform a cost–effectiveness evaluation, from a healthcare system perspective, of an RAAF clinic within a large regional health service in Australia.</p><h3>Methods</h3><p>We developed a microsimulation model using a cohort of 274 individuals referred to the RAAF clinic between 2022 and 2023. Clinic data were used to determine risk of stroke, major bleeding and death from the GARFIELD equation. A comparator was designed by duplicating the cohort and changing the time from referral to consultation to a general cardiology clinic within the same health service (i.e. standard of care). The model ran in daily cycles over a 2-year time horizon, with individuals replicated 1000 times from an initial cohort of 274. The outcomes were strokes, bleeding events, quality-adjusted life years (QALYs) and healthcare costs for the RAAF compared with standard of care, which were used to determine incremental cost–effectiveness ratios (ICER), with 5% annual discounting.</p><h3>Results</h3><p>The RAAF clinic participants experienced fewer strokes (5198 versus 5303), bleeding events (5369 versus 5491) and deaths (14,158 versus 14,413). There were marginal increases in QALYs gained (1.67 versus 1.66 QALYs/person), and cost savings of AUD$74 per person (AUD$14,187 versus AUD$14,261), resulting in a dominant ICER. The ICER remained dominant across one-way and probabilistic sensitivity analyses.</p><h3>Conclusions</h3><p>RAAF clinics are likely to prevent strokes and bleeding, are cost-saving and could lead to returns on investment. Adoption of this model of care by policy-makers can ensure the delivery of safe, effective and cost-saving care that reduces stroke, bleeding and death in people with atrial fibrillation.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 4","pages":"485 - 495"},"PeriodicalIF":3.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40256-026-00796-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760050","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}

{"title":"A Comprehensive, Updated Review of Ezetimibe: Evidence-Based Clinical Use for Atherosclerotic Cardiovascular Disease","authors":"Hui-Hui Liu,&nbsp;Zhao-Hong Liu,&nbsp;Si-Si Chen,&nbsp;Cheng-Gang Zhu,&nbsp;Jian-Jun Li","doi":"10.1007/s40256-026-00793-w","DOIUrl":"10.1007/s40256-026-00793-w","url":null,"abstract":"<div><p>Elevated low-density lipoprotein cholesterol (LDL-C) is a key modifiable risk factor in atherosclerotic cardiovascular diseases. While statins are the first-line therapy for LDL-C management, challenges such as limited additional benefits with dose escalation and an increased risk of adverse drug reactions at higher doses remain. Ezetimibe is widely recommended in clinical guidelines and has become an essential component of lipid-lowering therapy, particularly for patients requiring additional LDL-C reduction beyond what statins alone can achieve. Ezetimibe monotherapy reduces LDL-C levels by approximately 17.1–25.9% and significantly lowers the risk of major adverse cardiovascular events compared with placebo. For patients whose LDL-C levels remain uncontrolled with statin therapy, adding ezetimibe not only achieves greater LDL-C reduction but also improves goal attainment, reduces plaque burden, enhances plaque stability, and lowers the incidence of cardiovascular events. Furthermore, combining ezetimibe with statins into one tablet offers advantages in medication management, improving patient compliance and convenience. In addition, combining ezetimibe with nonstatin lipid-lowering agents also offers a comprehensive approach to lipid management, especially in complex cases of dyslipidemia or cardiovascular risk management. Despite robust clinical evidence and good tolerability, the adoption of ezetimibe combination therapy in real-world practice remains limited, likely owing to insufficient awareness among clinicians and patients. In this review, we summarize the current evidence to support clinical decision-making and promote the optimal use of ezetimibe in the management of atherosclerotic cardiovascular diseases.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 4","pages":"397 - 418"},"PeriodicalIF":3.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40256-026-00793-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760023","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}