American Journal of Cardiovascular Drugs最新文献

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Polypill Strategy: A Paradigm Shift in Cardiovascular Disease Prevention 多药片策略:心血管疾病预防的范式转变。
IF 3 4区 医学
American Journal of Cardiovascular Drugs Pub Date : 2025-08-13 DOI: 10.1007/s40256-025-00758-5
Makhzan Ali Akbar, Asia Batool, Muneeb Khawar, Abdul Manan Dero, Javed Iqbal
{"title":"Polypill Strategy: A Paradigm Shift in Cardiovascular Disease Prevention","authors":"Makhzan Ali Akbar, Asia Batool, Muneeb Khawar, Abdul Manan Dero, Javed Iqbal","doi":"10.1007/s40256-025-00758-5","DOIUrl":"10.1007/s40256-025-00758-5","url":null,"abstract":"","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 6","pages":"735 - 737"},"PeriodicalIF":3.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833734","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
Should We Use Renin–Angiotensin-System Inhibitors As a First-Line Therapy for the Management of Hypertension in Patients Receiving Hemodialysis? 我们是否应该使用肾素-血管紧张素系统抑制剂作为血液透析患者高血压管理的一线治疗?
IF 3 4区 医学
American Journal of Cardiovascular Drugs Pub Date : 2025-08-07 DOI: 10.1007/s40256-025-00756-7
Panagiotis I. Georgianos, Ioannis Kontogiorgos, Vasilios Vaios, Konstantinos Leivaditis, Vassilios Liakopoulos
{"title":"Should We Use Renin–Angiotensin-System Inhibitors As a First-Line Therapy for the Management of Hypertension in Patients Receiving Hemodialysis?","authors":"Panagiotis I. Georgianos, Ioannis Kontogiorgos, Vasilios Vaios, Konstantinos Leivaditis, Vassilios Liakopoulos","doi":"10.1007/s40256-025-00756-7","DOIUrl":"10.1007/s40256-025-00756-7","url":null,"abstract":"","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 1","pages":"1 - 5"},"PeriodicalIF":3.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793232","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
Contemporary Oral Medication Use and Frequency in Patients with Transthyretin Amyloid Cardiomyopathy 转甲状腺素淀粉样心肌病患者的当代口服药物使用和频率。
IF 3 4区 医学
American Journal of Cardiovascular Drugs Pub Date : 2025-08-01 DOI: 10.1007/s40256-025-00752-x
Noel Dasgupta, Steen Hvitfeldt Poulsen, Michele Emdin, Amrut V. Ambardekar, Keyur B. Shah, Liana Hennum, Rohit Marwah, Melissa Allison, Pruthviraj Shivanna, Suresh Siddhanti, Jean-François Tamby, Heather Falvey, Justin L. Grodin
{"title":"Contemporary Oral Medication Use and Frequency in Patients with Transthyretin Amyloid Cardiomyopathy","authors":"Noel Dasgupta, Steen Hvitfeldt Poulsen, Michele Emdin, Amrut V. Ambardekar, Keyur B. Shah, Liana Hennum, Rohit Marwah, Melissa Allison, Pruthviraj Shivanna, Suresh Siddhanti, Jean-François Tamby, Heather Falvey, Justin L. Grodin","doi":"10.1007/s40256-025-00752-x","DOIUrl":"10.1007/s40256-025-00752-x","url":null,"abstract":"<div><h3>Introduction</h3><p>Transthyretin amyloid cardiomyopathy (ATTR-CM) is an increasingly recognized cause of heart failure (HF), with a higher prevalence in older patients with comorbidities requiring concomitant medical therapy. Acoramidis is a next-generation transthyretin stabilizer with near-complete protein stabilization (≥ 90%) administered orally twice daily (BID) for treatment of ATTR-CM. We report on oral medication use in patients with ATTR-CM using two complementary sources: the ATTRibute-CM trial and real-world claims data.</p><h3>Methods</h3><p>In the ATTRibute-CM study, participants with ATTR-CM were randomly assigned 2:1 to receive 800 mg of acoramidis hydrochloride or matching placebo BID for 30 months. Participants from acoramidis and placebo groups were pooled for this analysis. Baseline oral medication use was collected upon enrollment in the study. Real-world data were obtained from patients with ATTR-CM in Optum’s deidentified Clinformatics Data Mart Database (Optum CDM) who met the stability criteria. Patients meeting the stability criteria had: (1) ≥ 2 years of continuous enrollment with ≥ 3-months look-back and a 12-month look-forward from index diagnosis, during the study period of 2018–2021 and (2) ≥ 28 days of continuous treatment for a given dosing frequency within the 12-month look-forward period.</p><h3>Results</h3><p>The ATTRibute-CM study randomly assigned 632 participants with ATTR-CM (mean [± SD] age: 77.3 [6.6] years). At entry to the study, 407 (64.4%) participants were using a medication that was administered BID, three times daily (TID), or four times daily (QID), and 392 (62.0%) participants were using at least one medication administered BID. The most frequent BID medications were apixaban, furosemide, metformin, metoprolol, and carvedilol. In ATTRibute-CM, accountability to acoramidis was high (97.1%).</p><p>From a pool of 2.46 million patients with HF and cardiomyopathy identified in the Optum CDM, 12,116 patients (mean [± SD] age: 76.3 [9.4] years) met the criteria for ATTR-CM, and 5601 patients met the stability criteria. Analysis from this real-world database demonstrated that 4351 (92.1%) patients were prescribed a medication that was administered BID, TID, or QID and 4166 (88.2%) patients were prescribed at least one BID medication. The most frequent medications regardless of dosing frequency included furosemide, atorvastatin, metoprolol, apixaban, and carvedilol. The most frequent BID medications were apixaban, carvedilol, furosemide, metoprolol, and potassium chloride.</p><h3>Conclusions</h3><p>Patients with ATTR-CM take oral medications administered multiple times a day for the treatment of HF and other comorbidities. As a BID medication, acoramidis does not appear to deviate from non-ATTR-CM pharmacotherapy strategies, and is therefore not expected to impose additional burden in a real-world setting. These data suggest that acoramidis may align with and could possibly be incorporated into p","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 6","pages":"829 - 839"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s40256-025-00752-x.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764376","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
Authors’ Reply to Umińska and Fabiszak: ‘Morphine and P2Y12 inhibitors in ST-Elevation Myocardial Infarction: An Updated Meta-Analysis’ 作者回复Umińska和Fabiszak:“吗啡和P2Y12抑制剂治疗st段抬高型心肌梗死:最新荟萃分析”。
IF 3 4区 医学
American Journal of Cardiovascular Drugs Pub Date : 2025-07-30 DOI: 10.1007/s40256-025-00747-8
Ryan Berry, Alaa Roto, Jawad Basit, Zohaib Khan, M. Chadi Alraies
{"title":"Authors’ Reply to Umińska and Fabiszak: ‘Morphine and P2Y12 inhibitors in ST-Elevation Myocardial Infarction: An Updated Meta-Analysis’","authors":"Ryan Berry, Alaa Roto, Jawad Basit, Zohaib Khan, M. Chadi Alraies","doi":"10.1007/s40256-025-00747-8","DOIUrl":"10.1007/s40256-025-00747-8","url":null,"abstract":"","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"729 - 730"},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752053","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
Comment on: “Morphine and P2Y12 Inhibitors in ST-Elevation Myocardial Infarction: An Updated Meta-Analysis” 评论:“吗啡和P2Y12抑制剂治疗st段抬高型心肌梗死:最新荟萃分析”。
IF 3 4区 医学
American Journal of Cardiovascular Drugs Pub Date : 2025-07-30 DOI: 10.1007/s40256-025-00746-9
Julia M. Umińska, Tomasz Fabiszak
{"title":"Comment on: “Morphine and P2Y12 Inhibitors in ST-Elevation Myocardial Infarction: An Updated Meta-Analysis”","authors":"Julia M. Umińska, Tomasz Fabiszak","doi":"10.1007/s40256-025-00746-9","DOIUrl":"10.1007/s40256-025-00746-9","url":null,"abstract":"","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 5","pages":"727 - 728"},"PeriodicalIF":3.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752054","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
Overview of Systematic Reviews on Treatments for Pulmonary Arterial Hypertension: Assessing Methodological Quality and Mapping Evidence Gaps 肺动脉高压治疗的系统综述:评估方法质量和绘制证据差距。
IF 3 4区 医学
American Journal of Cardiovascular Drugs Pub Date : 2025-07-27 DOI: 10.1007/s40256-025-00744-x
Ana Paula Oliveira Vilela, Flávia Deffert, Fernanda S. Tonin, Roberto Pontarolo
{"title":"Overview of Systematic Reviews on Treatments for Pulmonary Arterial Hypertension: Assessing Methodological Quality and Mapping Evidence Gaps","authors":"Ana Paula Oliveira Vilela,&nbsp;Flávia Deffert,&nbsp;Fernanda S. Tonin,&nbsp;Roberto Pontarolo","doi":"10.1007/s40256-025-00744-x","DOIUrl":"10.1007/s40256-025-00744-x","url":null,"abstract":"<div><h3>Background</h3><p>Higher quality scaled-up evidence on pulmonary arterial hypertension (PAH), a rare and life-threatening disease, is needed to support informed decision-making. We aimed to map the current knowledge of PAH treatments and evaluate the methodological quality of published systematic reviews.</p><h3>Methods</h3><p>An overview with literature searches in PubMed and Embase (May 2025) was performed (CRD42023414469). The methodological and reporting quality of the eligible records was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR 2) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist, respectively. Association analyses between tools’ scores with key variables (article publication date, journal impact factor, country/region) were performed (SPSS v.28). An evidence map summarizing the most reported treatments and outcomes was also built.</p><h3>Results</h3><p>Overall, 57 systematic reviews (<i>n</i> = 52; 91.2% with meta-analysis) published between 1997 and 2025 (median year 2017), authored mostly by countries from Asia (<i>n</i> = 35; 61.4%) and North America (<i>n</i> = 12; 21.1%), were included. The classes of phosphodiesterase type-5 inhibitors, endothelin receptor antagonists, and prostanoids and combination therapies were each assessed in one-third of the studies each. Over 20 different outcomes were reported, with the most common surrogate endpoints being 6-min walking distance (<i>n</i> = 42; 73.7%) and mean pulmonary arterial pressure (<i>n</i> = 33; 57.9%). Most studies were classified as having critically low methodological quality (<i>n</i> = 48; 84.2%), with only three presenting high-quality methodology according to AMSTAR 2. The mean PRISMA score was 21.3 ± 2.9, indicating an adherence rate of 78.9% to the checklist among authors. Although there was an improvement over time in the quality of the reviews (<i>p</i> = 0.016 for AMSTAR; <i>p</i> = 0.002 for PRISMA), no correlations were found based on country nor journal impact factor.</p><h3>Conclusions</h3><p>Methodological weaknesses remain common in systematic reviews of PAH; therefore, enforcing compliance with guidelines and standardizing outcome measurements through a core outcome set is crucial for improving data comparability and clinical application.</p><h3>Registration</h3><p>PROSPERO identifier no. CRD42023414469.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 6","pages":"779 - 802"},"PeriodicalIF":3.0,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717313","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
Cardiovascular Outcomes Associated with Cholinesterase Inhibitor Use in Individuals at High Cardiovascular Risk 高危心血管患者使用胆碱酯酶抑制剂与心血管结局相关
IF 3 4区 医学
American Journal of Cardiovascular Drugs Pub Date : 2025-07-25 DOI: 10.1007/s40256-025-00755-8
Jiann-Der Lee, Chuan-Pin Lee, Yen-Chu Huang, Meng Lee, Ya-Wen Kuo
{"title":"Cardiovascular Outcomes Associated with Cholinesterase Inhibitor Use in Individuals at High Cardiovascular Risk","authors":"Jiann-Der Lee,&nbsp;Chuan-Pin Lee,&nbsp;Yen-Chu Huang,&nbsp;Meng Lee,&nbsp;Ya-Wen Kuo","doi":"10.1007/s40256-025-00755-8","DOIUrl":"10.1007/s40256-025-00755-8","url":null,"abstract":"<div><h3>Background</h3><p>Cholinesterase inhibitors (ChEIs) are widely prescribed for dementia, but their effects on cardiovascular outcomes in high-risk populations remain unclear.</p><h3>Objectives</h3><p>Our objective was to evaluate the association between ChEI use and the risk of major adverse cardiovascular events (MACE) and all-cause mortality among individuals with high cardiovascular risk.</p><h3>Methods</h3><p>We conducted a retrospective cohort study using data from the Chang Gung Research Database in Taiwan from 2001 to 2022. Individuals aged ≥ 50 years with cardiovascular risk factors who received ChEIs were matched 1:1 with non-users based on birth year, sex, history of dementia, and cardiovascular comorbidities. The primary outcome was time to first MACE, defined as hospitalization for acute ischemic stroke, acute myocardial infarction, or cardiovascular death. Secondary outcomes included individual cardiovascular events, heart failure, and all-cause mortality. Competing risk and survival analyses were performed using Fine and Gray subdistribution hazard models and Cox proportional hazards models, respectively.</p><h3>Results</h3><p>Among 21,598 matched patients (mean age 77.7 years; 61.1% female), ChEI use was associated with a significantly reduced risk of MACE (adjusted subdistribution hazard ratio 0.79; 95% confidence interval 0.74–0.84; <i>P</i> &lt; 0.001) and acute myocardial infarction (adjusted subdistribution hazard ratio 0.70; 95% confidence interval 0.55–0.90; <i>P</i> = 0.006). ChEI users also had significantly improved overall survival (log-rank <i>P</i> &lt; 0.001).</p><h3>Conclusions</h3><p>ChEI use is associated with a lower risk of major cardiovascular events and improved survival in patients at high cardiovascular risk. These findings suggest potential cardiovascular benefits of ChEIs beyond cognitive symptom management.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 6","pages":"817 - 828"},"PeriodicalIF":3.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706046","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
Long-Term Cardiovascular Safety of Testosterone-Replacement Therapy in Middle-Aged and Older Men: A Meta-analysis of Randomized Controlled Trials 中老年男性睾酮替代疗法的长期心血管安全性:随机对照试验的荟萃分析
IF 3 4区 医学
American Journal of Cardiovascular Drugs Pub Date : 2025-07-22 DOI: 10.1007/s40256-025-00737-w
Marcelo A. P. Braga, André Rivera, Gabriel Marinheiro, Nicole Felix, Pedro E. P. Carvalho, Douglas Mesadri Gewehr, Larissa Teixeira, Mariana R. C. Clemente, Pedro C. Abrahão Reis, Lucas G. C. R. de Amorim, Alice Deberaldini Marinho, Thiago Bosco Mendes, Francesco Costantini Mesquita, Edoardo Pozzi, Ranjith Ramasamy
{"title":"Long-Term Cardiovascular Safety of Testosterone-Replacement Therapy in Middle-Aged and Older Men: A Meta-analysis of Randomized Controlled Trials","authors":"Marcelo A. P. Braga,&nbsp;André Rivera,&nbsp;Gabriel Marinheiro,&nbsp;Nicole Felix,&nbsp;Pedro E. P. Carvalho,&nbsp;Douglas Mesadri Gewehr,&nbsp;Larissa Teixeira,&nbsp;Mariana R. C. Clemente,&nbsp;Pedro C. Abrahão Reis,&nbsp;Lucas G. C. R. de Amorim,&nbsp;Alice Deberaldini Marinho,&nbsp;Thiago Bosco Mendes,&nbsp;Francesco Costantini Mesquita,&nbsp;Edoardo Pozzi,&nbsp;Ranjith Ramasamy","doi":"10.1007/s40256-025-00737-w","DOIUrl":"10.1007/s40256-025-00737-w","url":null,"abstract":"<div><h3>Introduction</h3><p>The cardiovascular safety of testosterone-replacement therapy (TRT) for middle-aged and older men with low to low-normal levels of testosterone remains unclear.</p><h3>Methods</h3><p>We systematically searched PubMed, Embase, Cochrane Library, and ClinicalTrials.gov for randomized controlled trials (RCTs) comparing TRT versus placebo for men aged ≥ 40 years old with hypogonadism or low to low-normal testosterone levels (≤ 14 nmol/L), and at least 12 months of follow-up. We pooled risk ratios (RRs) with 95% confidence intervals (CIs) applying a random-effects model and using R version 4.3.1 for statistical analyses.</p><h3>Results</h3><p>We included 23 RCTs comprising 9280 men with testosterone deficiency, of whom 4800 (51.7%) were randomized to TRT. The mean age was 64.6 years, and the baseline total testosterone was 9.17 nmol/L. Placebo and TRT had similar rates of all-cause mortality (RR 0.85; 95% CI 0.60–1.19; <i>p</i> = 0.33). There was a significant increase in the incidence of cardiac arrhythmias (RR 1.53; 95% CI 1.20–1.97; <i>p</i> &lt; 0.01). There was no significant difference between groups in cardiovascular mortality (RR 0.85; 95% CI 0.65–1.12; <i>p</i> = 0.25), stroke (RR 1.00; 95% CI 0.67–1.50; <i>p</i> = 0.99), and myocardial infarction (RR 0.94; 95% CI 0.69–1.28; <i>p</i> = 0.70).</p><h3>Conclusion</h3><p>In men with low to low-normal testosterone, aged 40 and above, TRT did not increase all-cause mortality, cardiovascular mortality, stroke, or myocardial infarction, but increased the incidence of cardiac arrhythmias.</p><h3>Registration</h3><p>PROSPERO identifier number CRD42024502421.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 6","pages":"767 - 777"},"PeriodicalIF":3.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688669","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
Association of Glucagon-Like Peptide-1 Receptor Agonist with Incident Atrial Fibrillation 胰高血糖素样肽-1受体激动剂与房颤发生的关系。
IF 3 4区 医学
American Journal of Cardiovascular Drugs Pub Date : 2025-07-19 DOI: 10.1007/s40256-025-00751-y
Suzan Khalil, William Hicks, Floyd W. Burke, Ishak A. Mansi
{"title":"Association of Glucagon-Like Peptide-1 Receptor Agonist with Incident Atrial Fibrillation","authors":"Suzan Khalil,&nbsp;William Hicks,&nbsp;Floyd W. Burke,&nbsp;Ishak A. Mansi","doi":"10.1007/s40256-025-00751-y","DOIUrl":"10.1007/s40256-025-00751-y","url":null,"abstract":"<div><h3>Background</h3><p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown efficacy in reducing cardiovascular events in patients with diabetes mellitus (DM), but conflicting evidence exists regarding their impact on cardiac arrhythmias. Whereas some studies associated GLP-1RAs with arrhythmogenesis, other studies suggested a decreased association with atrial fibrillation (AF).</p><h3>Objective</h3><p>The aim was to compare the risk of incident AF after initiation of GLP-1RAs versus dipeptidyl peptidase-4 inhibitors (DPP4is), as active comparators, in patients with DM.</p><h3>Design</h3><p>A retrospective propensity score-matched cohort study was conducted.</p><h3>Setting</h3><p>The national data of Veterans Health Administration during fiscal years 2006–2021 were used for the study.</p><h3>Patients</h3><p>Adults who initiated either GLP-1RA or DPP4i medications were included.</p><h3>Measurements</h3><p>The primary outcome was a composite outcome of AF (diagnosis of AF/flutter or undergoing an AF procedure).</p><h3>Results</h3><p>Out of 116,235 GLP-1RA users and 217,668 DPP4i users, we propensity score-matched 80,948 pairs, on 88 characteristics. The composite outcome of AF was similar in the GLP-1RA group (4.1%) and DPP4i group (4.3%); odds ratio (OR) 0.96, 95% confidence interval (CI) 0.92–1.01. Secondary analyses stratified by medication use duration showed no significant differences in composite AF risk (<i>p</i> &gt; 0.05). Individuals achieving 5% weight loss from baseline body weight had significantly lower AF incidence (OR 0.83, 95% CI 0.78–0.89), whereas no significant differences were observed in those with no weight loss or weight gain (OR 1.05, 95% CI 0.97–1.12).</p><h3>Conclusions</h3><p>GLP-1RA use was not associated with a decreased or increased risk of AF compared to DPP4i use. In subgroup analysis, lower AF risk was seen in GLP-1RA versus DPP4i users who achieved weight loss, which suggests weight loss as a potential modifier of response to GLP-1RAs.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"25 6","pages":"803 - 816"},"PeriodicalIF":3.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666867","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
A Retrospective Cohort Study on Long-Term Outcomes of Ticagrelor Versus Clopidogrel After Retrograde Percutaneous Coronary Intervention for Chronic Total Occlusion 慢性全闭塞逆行经皮冠状动脉介入治疗后替格瑞洛与氯吡格雷长期疗效的回顾性队列研究。
IF 3 4区 医学
American Journal of Cardiovascular Drugs Pub Date : 2025-07-12 DOI: 10.1007/s40256-025-00750-z
Feihuang Han, Dunliang Ma, Song Wen, Qiheng Wan, Yuqing Huang, Feng Wang, Zehan Huang, Bin Zhang
{"title":"A Retrospective Cohort Study on Long-Term Outcomes of Ticagrelor Versus Clopidogrel After Retrograde Percutaneous Coronary Intervention for Chronic Total Occlusion","authors":"Feihuang Han,&nbsp;Dunliang Ma,&nbsp;Song Wen,&nbsp;Qiheng Wan,&nbsp;Yuqing Huang,&nbsp;Feng Wang,&nbsp;Zehan Huang,&nbsp;Bin Zhang","doi":"10.1007/s40256-025-00750-z","DOIUrl":"10.1007/s40256-025-00750-z","url":null,"abstract":"<div><h3>Background</h3><p>Chronic total occlusion (CTO) affects 15–25% of patients undergoing coronary angiography, and successful percutaneous coronary intervention (PCI) can improve ischemia, angina symptoms, and overall quality of life. However, CTO-PCI is a complex procedure with higher risks of acute thrombosis, restenosis, and long-term thrombosis due to factors such as longer lesion length, calcification, and the need for more stents. Dual antiplatelet therapy (DAPT) is essential after PCI, but the optimal regimen for CTO, particularly in patients with chronic coronary syndrome, remains under debate. Although more potent P2Y12 inhibitors such as ticagrelor may offer benefits in some cases, recent studies have shown mixed results.</p><h3>Objective</h3><p>This study aimed to assess the effect of potent DAPT on long-term outcomes in patients with CTO undergoing retrograde PCI.</p><h3>Method</h3><p>We conducted a retrospective analysis of 836 consecutive patients who underwent elective retrograde CTO-PCI at a single center between January 2011 and April 2023. We compared patient and lesion characteristics, procedural details and results, and long-term outcomes between patients who received ticagrelor and those who received clopidogrel after retrograde CTO-PCI.</p><h3>Result</h3><p>Clinical follow-up was available in 767 (91.2%) patients, with a median follow-up of 1041 days (range 531–1511). The risk of major adverse cardiovascular events was significantly lower in patients receiving ticagrelor than in those receiving clopidogrel (8.8% vs. 18.5%, <i>p</i> = 0.005), primarily due to reductions in all-cause mortality (1.9% vs. 8.1%, <i>p</i> = 0.009) and cardiac death (0.6% vs. 5.8%, <i>p</i> = 0.012).</p><h3>Conclusion</h3><p>DAPT with ticagrelor may represent a safe and efficient management strategy for patients undergoing retrograde CTO-PCI.</p></div>","PeriodicalId":7652,"journal":{"name":"American Journal of Cardiovascular Drugs","volume":"26 1","pages":"71 - 82"},"PeriodicalIF":3.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615820","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}
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