American Journal of Cardiovascular Drugs最新文献

{"title":"Stem Cell Therapy in Ischemic Heart Failure","authors":"Quanchi Guo,&nbsp;Yang Hua","doi":"10.1007/s40256-025-00741-0","DOIUrl":"10.1007/s40256-025-00741-0","url":null,"abstract":"<p>Stem cells have emerged as a promising therapeutic approach for ischemic heart failure, with multiple preclinical and clinical trials demonstrating encouraging outcomes. However, limitations and challenges encountered during clinical trials or follow-up periods hinder stem cell therapy's clinical translation for heart failure. In this review, we will elaborate on the applications of stem cell–based therapy, the main subtypes and fundamental properties of stem cells, and the mechanisms by which stem cells exert their effects in ischemic heart failure, such as remuscularization, paracrine effects, autocrine effects, and endocrine-like effects. We will also demonstrate and explain the extensive clinical trials of stem cell therapy in ischemic heart failure, focusing on safety, efficacy, and primary and secondary outcome measures. To improve transplanted stem cells' viability and retention rates, we will discuss various delivery routes and advanced biomaterials used to encapsulate stem cells, such as injectable hydrogels, cardiac patches, and cell sheets. Several challenges severely obstruct the clinical translation of stem cell therapy for ischemic heart failure, including immunological rejection, post-transplantation hypoxia, inflammatory reactions, the maturity of transplanted stem cells, and cost. Finally, we will focus on the prospects of stem cell–based therapy for ischemic heart failure, emphasizing the ongoing need for further research to address existing challenges and establish clearer avenues toward clinical application.</p>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"601 - 632"},"PeriodicalIF":3.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504509","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":"A Drug–Drug Interaction Study Evaluating the Pharmacokinetic Consequences of Obicetrapib Therapy on Atorvastatin or Rosuvastatin Levels in Healthy Volunteers","authors":"John J. P. Kastelein,&nbsp;Marc Ditmarsch,&nbsp;Andrew Hsieh,&nbsp;Douglas Kling,&nbsp;Ashley Walker,&nbsp;Mary R. Dicklin,&nbsp;Zia Tayab,&nbsp;Mohammed Bouhajib,&nbsp;Michael H. Davidson","doi":"10.1007/s40256-025-00740-1","DOIUrl":"10.1007/s40256-025-00740-1","url":null,"abstract":"<div><h3>Objective</h3><p>Obicetrapib, a selective cholesteryl ester transfer protein inhibitor in development for the treatment of dyslipidemia and cardiovascular risk, is expected to be administered with high-intensity statins in clinical practice. This study was performed to assess the effect of obicetrapib on the pharmacokinetics (PK) of atorvastatin and rosuvastatin. </p><h3>Methods</h3><p>An open-label study was conducted to evaluate the PK of atorvastatin 80 mg (cohort 1, <i>n</i> = 42) or rosuvastatin 40 mg (cohort 2, <i>n</i> = 32, non-Asians) with and without co-administration of 10 mg obicetrapib in healthy adult males and females. Study participants received statin on day − 4, obicetrapib on days 1–11, statin co-administered with obicetrapib on day 12, and obicetrapib on days 13–17. Blood samples were collected throughout the dosing period and analyzed for plasma obicetrapib (both cohorts); atorvastatin, ortho-hydroxy atorvastatin, and para-hydroxy atorvastatin (cohort 1), and rosuvastatin (cohort 2). Safety and tolerability were also assessed.</p><h3>Results</h3><p>The 90% confidence intervals of the geometric mean ratios for the log-transformed maximum plasma concentration and area under the curve from time 0 to the time of the last measurable concentration (AUC_<i>t</i>) and from time 0 to infinity (AUC_inf) for atorvastatin and rosuvastatin were all within the range pre-specified for bioequivalence (80.00–125.00%) of statin plus obicetrapib versus statin alone. Although there were significant treatment effects for atorvastatin AUC_<i>t</i> (<i>p</i> = 0.0026) and AUC_inf (<i>p</i> = 0.0012), the differences were small (9–10%) and not deemed clinically important. Overall, all study drugs were safe and well tolerated.</p><h3>Conclusions</h3><p>No clinically significant PK interaction occurred between multiple daily doses of obicetrapib on the single-dose PK of either atorvastatin or rosuvastatin in healthy volunteers.</p><h3>Clinical Trial Registration</h3><p>NCT06081166.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"693 - 702"},"PeriodicalIF":3.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40256-025-00740-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493452","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":"One-Year Prognostic Differences and Management Strategies between ST-Elevation and Non-ST-Elevation Myocardial Infarction: Insights from the PRAISE Registry","authors":"Luigi Spadafora,&nbsp;Paola Pastena,&nbsp;Stefano Cacciatore,&nbsp;Matteo Betti,&nbsp;Giuseppe Biondi-Zoccai,&nbsp;Fabrizio D’Ascenzo,&nbsp;Gaetano Maria De Ferrari,&nbsp;Ovidio De Filippo,&nbsp;Francesco Versaci,&nbsp;Sebastiano Sciarretta,&nbsp;Giacomo Frati,&nbsp;Francesco Fiorentino,&nbsp;Marco Borgi,&nbsp;Nicola Pierucci,&nbsp;Pierre Sabouret,&nbsp;Francesco Ajmone,&nbsp;Attilio Lauretti,&nbsp;Federico Russo,&nbsp;Alberto Polimeni,&nbsp;Maciej Banach,&nbsp;Giorgia Panichella,&nbsp;Marco Bernardi","doi":"10.1007/s40256-025-00739-8","DOIUrl":"10.1007/s40256-025-00739-8","url":null,"abstract":"<div><h3>Introduction</h3><p>Whether ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) carry distinct prognoses after discharge remains a matter of debate. This study aimed to compare 1-year clinical outcomes between patients with STEMI and NSTEMI in a large, real-world cohort.</p><h3>Methods</h3><p>Among 23,270 patients with acute coronary syndrome enrolled in the international PRAISE registry between 2003 and 2019, we included 21,789 patients with a diagnosis of either STEMI or NSTEMI. Clinical characteristics, discharge medications, and outcomes at 1 year were analyzed. The primary outcomes were all-cause mortality, re-infarction, and major bleeding. Multivariable logistic regression and propensity score matching were used to adjust for confounding. Subgroup and interaction analyses were also performed.</p><h3>Results</h3><p>The cohort included 12,365 patients with STEMI and 9424 patients with NSTEMI. At baseline, patients with NSTEMI had more comorbidities, cardiovascular risk factors (except diabetes), and prior revascularization. Patients with STEMI were more frequently treated with statins, beta-blockers, and renin-angiotensin-aldosterone system inhibitors at discharge. At 1-year follow-up, overall outcomes were comparable between groups. Nonfatal reinfarction occurred more frequently in patients with NSTEMI (3.4% versus 2.8%, <i>p</i> = 0.022), but this association was not significant after adjustment (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.65–1.24, <i>p</i> = 0.519). Results from propensity score-matched analyses confirmed the absence of prognostic differences. Subgroup analyses revealed significant interactions for diabetes mellitus and completeness of revascularization.</p><h3>Conclusions</h3><p>After accounting for clinical and therapeutic variables, 1-year outcomes were largely similar in patients with STEMI and NSTEMI. Differences in reinfarction risk appear to be driven by baseline characteristics and treatment patterns, rather than infarct type itself.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"681 - 691"},"PeriodicalIF":3.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482848","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":"Meta-analysis of the Effect of Semaglutide on Blood Pressure in Obese Populations","authors":"Yihan Li,&nbsp;Kefan Xue,&nbsp;Rui Hu,&nbsp;Xiao Hu,&nbsp;Ran Guo,&nbsp;Hongxia Guo,&nbsp;Gang Li","doi":"10.1007/s40256-025-00738-9","DOIUrl":"10.1007/s40256-025-00738-9","url":null,"abstract":"<div><h3>Objective</h3><p>The aim was to systematically evaluate the effect of semaglutide on blood pressure in obese populations using meta-analysis methods.</p><h3>Methods</h3><p>Randomized controlled trials on the effect of semaglutide on blood pressure regulation published from the inception of the databases to October 2024 were searched for in PubMed, Embase, the Cochrane Library, and Web of Science. Stata software was used for statistical analysis of the outcome measures in all included studies. Egger’s test was applied to assess the risk of publication bias.</p><h3>Results</h3><p>A total of 22 studies involving 15,347 participants were included in this meta-analysis. The results showed that, compared to the control group, the semaglutide group significantly reduced systolic blood pressure (SBP) (mean difference [MD] − 2.90, 95% confidence interval [CI] − 3.70 to − 2.11; <i>P</i> &lt; 0.01) and diastolic blood pressure (DBP) (MD − 0.86, 95% CI − 1.34 to − 0.38; <i>P</i> &lt; 0.01). Further subgroup analysis revealed that, compared to diabetic populations, semaglutide had a more significant reduction in SBP (− 1.87, 95% CI − 2.67 to − 1.06, vs − 5.02, 95% CI − 6.10 to − 3.94) and DBP (− 0.43, 95% CI − 0.89 to 0.02, vs − 1.96, 95% CI − 3.12 to − 0.80) in non-diabetic populations. The higher dose of semaglutide (2.4 mg) was found to significantly lower SBP (MD − 4.31, 95% CI − 5.18 to − 3.44) and DBP (MD − 1.84, 95% CI − 2.70 to − 0.98), although mild heterogeneity was present. Sensitivity analysis showed that the exclusion of any single study did not significantly affect the final results.</p><h3>Conclusion</h3><p>Current evidence suggests that semaglutide can lower SBP and DBP, and increasing the dosage can enhance the blood pressure-lowering effect.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"655 - 665"},"PeriodicalIF":3.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257138","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":"Efficacy of Landiolol for Treatment of Sepsis-Related Tachyarrhythmia: Lost in Translation","authors":"Athanasios Chalkias,&nbsp;Konstantina Katsifa,&nbsp;Athanasios Prekates,&nbsp;Paraskevi Tselioti","doi":"10.1007/s40256-025-00736-x","DOIUrl":"10.1007/s40256-025-00736-x","url":null,"abstract":"","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"571 - 575"},"PeriodicalIF":3.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245914","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":"Emerging Role of Weight-Loss Medications in the Management of Heart Failure: Current Evidence and Future Perspectives","authors":"Maryam,&nbsp;Treesa P. Varghese,&nbsp;B. Tazneem,&nbsp;Gurrala Rajshekhar Reddy","doi":"10.1007/s40256-025-00735-y","DOIUrl":"10.1007/s40256-025-00735-y","url":null,"abstract":"<div><p>Heart failure is a major global health concern as it contributes to high rates of mortality and morbidity, with high rates of hospitalizations. The most prevalent risk factor or comorbidity of heart failure is obesity, which not only worsens and exacerbates disease progression and the course of illness, it also reduces its prognosis. Weight management is still not well addressed, even with major advancements in heart failure pharmacotherapies. Recent advances in weight-loss medications such as glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, and other novel anti-obesity drugs have sparked interest in their potential to improve clinical outcomes for patients with heart failure, especially those who also have obesity-related cardiac dysfunction. Weight-loss medications benefit heart failure by reducing adiposity-related inflammation, myocardial stress, and remodeling. These effects are auspicious in heart failure with preserved ejection fraction, where obesity-driven mechanisms play a critical role. These medications have been demonstrated to help with weight reduction, improve heart failure symptoms, and reduce hospitalization rates. However, questions about their long-term safety, particularly in patients with severe heart failure, are still being researched. The purpose of this review is to summarize the current evidence on the safety and effectiveness of weight-loss medications in the treatment of heart failure, describe their mechanisms of action, and highlight knowledge gaps that require further research. </p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"593 - 600"},"PeriodicalIF":3.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155467","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":"Appraisal of β-Blocker Use in Patients with Cardiovascular Disease and Chronic Obstructive Pulmonary Disease","authors":"Ruicong Xue,&nbsp;Chen Liu,&nbsp;Qian Yu,&nbsp;Yugang Dong,&nbsp;Jingjing Zhao","doi":"10.1007/s40256-025-00732-1","DOIUrl":"10.1007/s40256-025-00732-1","url":null,"abstract":"<div><p>β-blockers are a fundamental component of cardiovascular disease (CVD) management, while β₂-agonists are used to treat chronic obstructive pulmonary disease (COPD). Current guidelines recommend that these conditions be treated as usual, even when they coexist. However, there have been concerns over COPD exacerbation risk with β-blockers and attenuation of the beneficial effects of β₂-agonists in this comorbid population, leading to β-blocker underuse. Recent evidence suggests that β-blockers, particularly cardioselective β-blockers, do not increase COPD exacerbations, demonstrate good efficacy and safety, and improve survival in patients with COPD after first-time myocardial infarction. In atrial fibrillation with COPD, both cardioselective and nonselective β-blockers may be associated with a lower COPD exacerbation risk than calcium channel blockers, as well as improving outcomes and reducing mortality risk. In this review, we summarize the β-blocker prescribing patterns in patients with CVD and COPD; describe the reasons for β-blocker underuse in patients with CVD with COPD; collate up-to-date evidence on the effects of β-blockers on symptoms and outcomes in each of these comorbid populations; and review the current treatment guidelines for coexisting COPD and CVD to support the rational prescribing of β-blockers. Finally, we provide recommendations for future research needed to demonstrate the clinical rationale of prescribing β-blockers and to encourage the generation of more robust evidence-based guidelines for β-blockers use. Future large-scale, prospective, randomized controlled trials are needed to expand the body of evidence and better understand the effects of β-blockers in CVD with comorbid COPD.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"577 - 592"},"PeriodicalIF":3.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40256-025-00732-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966899","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":"Chronotherapy for Hypertension: A Meta-Analysis and Systematic Review of RCTs","authors":"Hongyu Kuang,&nbsp;Qiang Li,&nbsp;Qijian Yi,&nbsp;Huaan Du","doi":"10.1007/s40256-025-00731-2","DOIUrl":"10.1007/s40256-025-00731-2","url":null,"abstract":"<div><h3>Aim</h3><p>The aim of this study was to evaluate the efficacy of chronotherapy for patients with essential hypertension with a range of clinical characteristics.</p><h3>Methods</h3><p>We searched the PubMed, EMBASE, and Cochrane Library databases for randomized controlled trials of antihypertensive therapies in which patients were randomized to morning or evening administration. The primary outcomes of the included studies were ambulatory blood pressure (BP) parameters and patient characteristics, including age, body mass index, percentage of female participants, and drug ingestion, which were described in subgroup analyses.</p><h3>Results</h3><p>In total, 56 studies were included in the analyses. Meta-analyses and subgroup analyses revealed that specific populations of patients benefited more from bedtime dosing than from morning dosing in both 24-h or 48-h ambulatory systolic BP (SBP) and nighttime SBP, including (1) groups aged &lt; 60 years, (2) those with body mass index ≥ 30 kg/m², (3) studies with ≥ 50% female participants, and (4) patients receiving antihypertensive calcium channel blockers. However, when controversial data by Hermida et al. were omitted, the effects of BP controls were observed in patients with overweight, particularly obesity. Furthermore, calcium channel blockers contributed to an obvious reduction in nighttime SBP with chronotherapy.</p><h3>Conclusions</h3><p>Chronotherapy for hypertension may not be completely ineffective, and the clinical program and timing of medication administration can be selected according to the patient’s clinical characteristics.</p><p>Registration PROSPERO identifier number CRD42021292795.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"633 - 654"},"PeriodicalIF":3.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956596","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":"The Efficacy and Safety of GLP-1 RAs in the Modification of Cardiovascular Morbidity in Patients with Obesity Without Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Controlled Trials Involving 32,884 Patients","authors":"Mohammad Tanashat,&nbsp;Yazan A. Al-Ajlouni,&nbsp;Mohamed Abuelazm,&nbsp;Obieda Altobaishat,&nbsp;Almothana Manasrah,&nbsp;Mustafa Turkmani,&nbsp;Ubaid Khan,&nbsp;Mohamed Abouzid","doi":"10.1007/s40256-025-00726-z","DOIUrl":"10.1007/s40256-025-00726-z","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Although the cardioprotective effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are well documented in patients with diabetes mellitus, their impact on cardiovascular outcomes in patients with obesity without diabetes remains under debate. Therefore, we conducted this systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the effects of GLP-1 RAs on cardiovascular outcomes in patients with obesity without diabetes.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;We systematically searched PubMed, Web of Science, SCOPUS, and Cochrane databases through December 26, 2023. We pooled dichotomous data using risk ratios (RRs) and continuous data using mean differences with 95% confidence intervals (CIs). We evaluated the quality of each study using the Cochrane RoB2 method, and the study protocol was registered on PROSPERO ID: CRD42024498538.&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;We included 19 RCTs with a total of 32,884 patients. Of these, 15 had a low overall risk of bias, two raised concerns, and two had a high risk of bias. There was no difference between GLP-1 RAs and placebo regarding cardiovascular mortality (RR 0.85; 95% CI 0.71–1.01; &lt;i&gt;p&lt;/i&gt; = 0.07). However, compared with placebo, GLP-1 RAs significantly decreased the incidence of all-cause mortality (RR 0.82; 95% CI 0.72–0.93; &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), non-cardiovascular mortality (RR 0.77; 95% CI 0.63–0.95; &lt;i&gt;p&lt;/i&gt; = 0.01), and myocardial infarction (RR 0.73; 95% CI 0.62–0.86; &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). Additionally, patients receiving GLP-1 RAs experienced significant overall weight loss (− 8.53 kg; 95% CI − 12.38 to − 4.68; &lt;i&gt;p&lt;/i&gt; &lt; 0.0001) and improvements in lipid profiles, including lower levels of total cholesterol (− 0.77 %; 95% CI − 1.03 to − 0.50; p &lt; 0.0001), triglycerides (− 6.78 %; 95% CI − 8.11 to − 5.46; &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), low-density lipoproteins (− 2.85 %; 95% CI − 3.74 to − 1.96; &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), and very low-density lipoproteins (− 4.47 %; 95% CI − 5.56 to − 3.38; &lt;i&gt;p&lt;/i&gt; &lt; 0.0001). GLP-1 RAs also significantly increased the incidence of any adverse events (RR 1.11; 95% CI 1.05–1.16; &lt;i&gt;p&lt;/i&gt; &lt; 0.0001), with no difference regarding the incidence of serious adverse events. However, gastrointestinal adverse events were significantly more frequent in patients receiving GLP-1 RAs, with a higher risk of any gastrointestinal adverse events (RR 2.83; 95% CI 1.86–4.3; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), nausea (RR 2.70; 95% CI 2.18–3.33; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), diarrhea (RR 1.97; 95% CI 1.68–2.31; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), vomiting (RR 3.85; 95% CI 3.32–4.48; &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and constipation (RR 2.35; 95% CI 1.94–2.85; &lt;i&gt;p&lt;/i&gt; &lt; 0.001) than in those receiving placebo.&lt;/p&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;In obese patients without diabetes, GLP-1 RAs demonstrated substantial benefits in reducing cardiovascular risks, including all-cause mortality and myocardial infarction, and effectively promoted weight loss and improved lipid profiles and blood pr","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 4","pages":"491 - 518"},"PeriodicalIF":3.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957571","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":"Geographic and Racial Variation in Oral Anticoagulant (OAC) Treatment Among Commercially Insured Patients with Non-valvular Atrial Fibrillation (NVAF) in the United States","authors":"Brett D. Atwater,&nbsp;Risho Singh,&nbsp;Shashi Parmar,&nbsp;Augustina Ogbonnaya,&nbsp;Amiee Kang,&nbsp;Nipun Atreja,&nbsp;Cristina Russ,&nbsp;Dong Cheng,&nbsp;Melissa Hagan,&nbsp;Serina Deeba,&nbsp;Dionne M. Hines","doi":"10.1007/s40256-025-00728-x","DOIUrl":"10.1007/s40256-025-00728-x","url":null,"abstract":"<div><h3>Background</h3><p>Oral anticoagulants (OACs) are recommended for stroke reduction in non-valvular atrial fibrillation (NVAF). OAC use has been studied in Medicare populations, but data for younger, commercially insured populations are limited.</p><h3>Objective</h3><p>This retrospective study aimed to describe the geographic variation of OAC use among commercially insured patients with NVAF at high risk of stroke (CHA₂DS₂-VASc score ≥ 2) in the USA.</p><h3>Methods</h3><p>Geographic variation was assessed by 3-digit zip code and race among patients identified from the Komodo Health commercial database with a diagnosis of NVAF between January 1, 2016, and August 31, 2021. Continuous health plan enrollment for ≥ 12 months before and 12 months after the NVAF diagnosis was required.</p><h3>Results</h3><p>A total of 619,111 patients with NVAF at high risk for stroke were identified, of whom approximately 50% were not treated with OACs. Of the half who received OACs, almost 85% received direct OACs (DOACs) and 15% received warfarin therapy. Overall, the highest untreated rates were observed in the South and West US regions, followed by the Midwest, then the Northeast. The highest DOAC treatment rates were in the Northeast for White patients and in the North and South for Black patients. The highest warfarin treatment rates were in the upper Midwest for White patients and the Midwest for Black patients.</p><h3>Conclusions</h3><p>This study may help guide the identification of areas to target interventions to improve treatment rates and confirm prior findings of geographic and racial variations of OAC use in NVAF.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"667 - 679"},"PeriodicalIF":3.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40256-025-00728-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770920","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}