American Journal of Cardiovascular Drugs最新文献

{"title":"GLP-1 Receptor Agonists and Cardiovascular Outcomes in Patients with Type 2 Diabetes Across Myocardial Infarction-Defined Populations: A Systematic Review and Meta-Analysis","authors":"Pedro Gomes Batista, Railla Raquel Albino dos Santos Silva, Marcela Vasconcelos Montenegro, Mushrin Malik, Mrunalini Dandamudi, Juan Peres de Oliveira, Maria Eduarda Molinari, Larissa Araujo de Lucena, Ramon Huntermann, Juliana Giorgi, Caroline O. Fischer Bacca","doi":"10.1007/s40256-026-00809-5","DOIUrl":"10.1007/s40256-026-00809-5","url":null,"abstract":"<div><h3>Background</h3><p>Patients with type 2 diabetes mellitus (T2DM) who survive myocardial infarction (MI) remain at high risk for recurrent cardiovascular events and heart failure (HF). Although glucagon-like peptide-1 receptor agonist (GLP-1 RA) reduces cardiovascular events in stable atherosclerotic disease, its impact among patients with established MI has not been comprehensively synthesized.</p><h3>Objectives</h3><p>To evaluate the association between GLP-1 RA use and cardiovascular outcomes in patients with T2DM across MI-defined cohorts.</p><h3>Methods</h3><p>We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Heterogeneity was evaluated using the I<sup>2</sup> statistic, and 95% prediction intervals (PIs) were calculated to estimate the expected range of true effects in future clinical settings. Outcomes included all-cause mortality, cardiovascular death, study-defined major adverse cardiovascular events (MACE), MI, stroke, and HF or hospitalization for HF. A sensitivity analysis using the Hartung–Knapp–Sidik–Jonkman (HKSJ) adjustment was performed to account for the small number of included studies and substantial heterogeneity. Statistical analysis was performed using R software version 4.5.0.</p><h3>Results</h3><p>Seven studies, including 37,393 patients with T2DM from MI-defined populations (9556 receiving GLP-1 RA), were analyzed. GLP-1 RA use was associated with lower all-cause mortality (HR, 0.67; 95% CI, 0.49–0.90; <i>I</i><sup>2</sup> = 87.3%; PI, 0.27–1.63; <i>P</i> = 0.0085), reduced study-defined MACE (HR, 0.69; 95% CI, 0.56–0.84; <i>I</i><sup>2</sup> = 55.6%; PI, 0.44–1.06; <i>P</i> = 0.0002), and fewer HF events or hospitalizations for HF (HR, 0.78; 95% CI, 0.62–0.98; <i>I</i><sup>2</sup> = 77.6%; PI, 0.42–1.45; <i>P</i> = 0.0306). No significant associations were observed for cardiovascular death (HR, 0.85; 95% CI, 0.67–1.06; <i>I</i><sup>2</sup> = 0%; PI, 0.42–1.69; <i>P</i> = 0.15), recurrent MI (HR, 0.82; 95% CI, 0.62–1.09; <i>I</i><sup>2</sup> = 63%; PI, 0.41–1.63; <i>P</i> = 0.1753), or stroke (HR, 0.91; 95% CI, 0.68–1.22; <i>I</i><sup>2</sup> = 61.2%; PI, 0.40–2.05; <i>P</i> = 0.5237). In the sensitivity analysis using the HKSJ adjustment, statistical significance was lost for all endpoints, including all-cause mortality (<i>P</i> = 0.05), study-defined MACE (<i>P</i> = 0.13), and HF or hospitalization for HF (<i>P</i> = 0.06).</p><h3>Conclusions</h3><p>In patients with T2DM across MI-defined populations, GLP-1 RA use showed signals toward lower all-cause mortality, study-defined MACE, and HF-related events; however, these findings remain exploratory because of substantial heterogeneity, wide PIs, and attenuation of statistical significance under HKSJ adjustment.</p><h3>Registration</h3><p>PROSPERO identifier no. CRD420251270326.</p><h3>Graphical Abstract</h3><div><figure><div><div><pictu","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 5","pages":"573 - 587"},"PeriodicalIF":3.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366751","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":"Clinical Pharmacology of Plozasiran","authors":"Jessica Huston,&nbsp;Dontia Orey,&nbsp;Kelli Corona,&nbsp;Andrew Ashchi,&nbsp;Andrea Ashchi Lachapelle,&nbsp;Elias Deeb,&nbsp;Alexander Deeb,&nbsp;Rambod Rouhbakhsh,&nbsp;Jason Berner,&nbsp;David Sutton,&nbsp;Wasim Deeb,&nbsp;Majdi Ashchi,&nbsp;Amir Azarbal,&nbsp;Rebecca F. Goldfaden","doi":"10.1007/s40256-026-00808-6","DOIUrl":"10.1007/s40256-026-00808-6","url":null,"abstract":"<div><p>Hypertriglyceridemia can increase the risk of acute pancreatitis and atherosclerotic cardiovascular disease (ASCVD). Patients with familial chylomicronemia syndrome are at an even higher risk of developing pancreatitis due to elevated triglycerides. A pathway involving small interfering RNA that selectively inhibits apolipoprotein C-III (APOC3) messenger RNA through RNA interference is currently being studied to reduce levels of apoC-III and thus, triglycerides. This review presents and discusses the current pharmacokinetic, pharmacodynamics, and clinical and scientific evidence pertaining to plozasiran, a small interfering RNA medicine.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 5","pages":"513 - 522"},"PeriodicalIF":3.2,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148306610","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":"De-risking Atrial Fibrillation: Refining Anticoagulation Decision-Making","authors":"Navid Radfar,&nbsp;Dhir Gala,&nbsp;Harsh Singh,&nbsp;Juan Bello,&nbsp;Joseph Allencherril","doi":"10.1007/s40256-026-00806-8","DOIUrl":"10.1007/s40256-026-00806-8","url":null,"abstract":"<div><p>Traditional stroke risk assessment in atrial fibrillation relies on clinical scoring tools such as CHA₂DS₂-VASc, which do not capture the full spectrum of individual thromboembolic risk. Contemporary trials have further challenged this traditional approach, highlighting the importance of atrial fibrillation burden and patient-specific factors in guiding therapy. Advanced echocardiographic markers, including left atrial volume index, strain, and appendage morphology, correlate with atrial remodeling, while biomarkers reflecting cardiac stress and inflammation may further refine risk stratification. These multimodal tools offer a path toward more precise “de-risking” strategies and may help identify patients in whom the net benefit of anticoagulation warrants further individualized assessment. Integrating structural, functional, biomarker, and AI-enabled data into stroke prevention models represents a meaningful step toward personalized care in atrial fibrillation management.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 5","pages":"523 - 536"},"PeriodicalIF":3.2,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40256-026-00806-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148306571","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":"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,&nbsp;Mariana Alves,&nbsp;Rita Avó-Baião,&nbsp;Andreia Lopes,&nbsp;Luisa Prada,&nbsp;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,&nbsp;Daniel T. Gregory Jr.,&nbsp;Roy A. Stimits,&nbsp;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}