Cardiovascular & hematological disorders drug targets最新文献

{"title":"Venous Congestion in Metabolic Heart Disease: Potential Indirect Role of Dual Incretin Agonists.","authors":"Sidhartha Gautam Senapati","doi":"10.2174/011871529X502187260803101832","DOIUrl":"https://doi.org/10.2174/011871529X502187260803101832","url":null,"abstract":"<p><strong>Introduction: </strong>Venous congestion is responsible for symptoms, organ dysfunction, and negative outcomes in heart failure. In obesity-related Heart Failure (HF) with preserved ejection fraction (HFpEF), metabolic dysfunction, inflammation, endothelial damage, and sodium retention might exacerbate venous congestion.</p><p><strong>Method: </strong>This structured narrative review provides an overview of the association between metabolic dysfunction, venous congestion, and incretin-based treatment in heart failure. Relevant literature was reviewed with special focus on original clinical trials, mechanism-of-action studies, and studies with venous congestion-related endpoints or surrogates.</p><p><strong>Results: </strong>Beneficial effects of GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists in obesity-related HFpEF patients have been shown in weight loss, symptom improvement, improvement in exercise tolerance, and reduced cardiovascular and heart failure outcomes. Nevertheless, there is still no evidence showing the direct effect of these agents in reducing venous pressure, preload, and systemic venous congestion.</p><p><strong>Discussion: </strong>The current available literature can explain the indirect mechanism by which weight loss, hypotensive action, improved insulin resistance, reduction of ectopic fat, and antiinflammatory properties improve the cardiometabolic physiology of HFpEF patients.</p><p><strong>Conclusion: </strong>Although the use of dual incretin agonists represents a novel therapeutic approach for obesity-related HFpEF, the ability of these drugs to decongest the venous system directly is not yet proven. Further studies are required to evaluate venous congestion endpoints such as right-sided filling pressures, venous Doppler indices, natriuretic peptides, need for diuretics, and VExUS score.</p>","PeriodicalId":93925,"journal":{"name":"Cardiovascular & hematological disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating AI in Cardiovascular Systems: Innovations in Diagnosis, Risk Prediction, and Management.","authors":"Srushti Bhupesh Patil, Yash Pramod Patil, Kunal Sharad Patil, Nagaraju Bandaru, Makarand Suresh Gambhire","doi":"10.2174/011871529X414660251209135356","DOIUrl":"https://doi.org/10.2174/011871529X414660251209135356","url":null,"abstract":"<p><p>Worldwide, cardiovascular diseases remain the leading contributors to illness and death, which hinders rapid diagnosis and efficient treatment. Recent developments in artificial intelligence (AI) have transformed cardiovascular medicine by enabling the integration and analysis of large and complex data sets from portable sensors, electronic health records, and medical images. AI algorithms, such as machine learning and deep learning models, excel in detecting detailed patterns and forecasting disease progression, improving risk assessment and diagnostic accuracy. These technologies enable the early diagnosis of disorders such as heart failure, arrhythmias, and coronary artery disease, resulting in more personalized treatment approaches and better patient outcomes. Automated image processing reduces human error and simplifies procedures, while continuous cardiac function can be monitored remotely. As AI systems advance further, they have the potential to revolutionize clinical decision-making by providing real-time information and predictive analyses that anticipate adverse cardiac events. Despite ongoing challenges with data quality, model transparency, and ethical considerations, the use of AI in cardiovascular care is expected to optimize resource allocation, reduce healthcare costs, and ultimately improve survival rates. Adopting this cutting-edge technology represents a crucial step toward a more precise, proactive, and patient-centered strategy with significant potential.</p>","PeriodicalId":93925,"journal":{"name":"Cardiovascular & hematological disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macrophage Polarization and Endothelial Dysfunction in Response to Cigarette Smoke and Ketone Body Administration.","authors":"Meity Ardiana, Inna Maya Sufiyah, Fita Triastuti, Alivia Retra Kusumowardani","doi":"10.2174/011871529X437571251214200529","DOIUrl":"https://doi.org/10.2174/011871529X437571251214200529","url":null,"abstract":"<p><strong>Introduction: </strong>Cigarette smoking promotes endothelial dysfunction through inflammation and macrophage polarization toward a pro-inflammatory M1 phenotype. Ketone bodies have been reported to have vascular benefits and may represent a therapeutic approach by modulating macrophage responses. This study investigated the impact of cigarette smoke on macrophage polarization and whether ketone body administration could alter these effects in an animal model.</p><p><strong>Methods: </strong>A randomized post-test-only control group design was conducted in 20 male Wistar rats assigned to four groups: control, smoke-exposed without intervention, and smoke-exposed treated with ketone bodies at low (1.5 g/kg/day) or high (6 g/kg/day) doses. Wistar rats were exposed to cigarette smoke (40 cigarettes/day) for 4 weeks, followed by ketone body administration. Macrophage polarization was assessed by calculating the M1/M2 ratio.</p><p><strong>Results: </strong>Cigarette smoke exposure increased M1 macrophage expression and produced an M1- dominant phenotype compared with controls (K⁷ 14.11 ± 10.15 vs. K- 7.00 ± 9.93, p = 0.109). Ketone body administration showed a trend toward reduced M1 and M2 macrophage counts and lowered the M1/M2 ratio, with the lowest ratio observed at the highest ketone dose (K⁷ 6.96 ± 8.55 vs P2 2.88 ± 2.86, p = 0.348).</p><p><strong>Discussion: </strong>Cigarette smoke promoted M1-dominant polarization, supporting its proinflammatory role in endothelial dysfunction. Ketone body administration could shift the balance toward a more anti-inflammatory profile, with higher doses favoring M2 activity.</p><p><strong>Conclusion: </strong>These findings provide initial evidence that ketone bodies may affect macrophage polarization under cigarette smoke exposure, supporting their potential as modulators of vascular inflammation.</p>","PeriodicalId":93925,"journal":{"name":"Cardiovascular & hematological disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanotechnology - Driven Innovations in Anticoagulant Delivery and Antidote Development for Hemostasis Regulation.","authors":"Jitendra Maity, Sushil Kumar Singh, Sovan Lal Pal, Amlan Bishal","doi":"10.2174/011871529X423173251208100541","DOIUrl":"https://doi.org/10.2174/011871529X423173251208100541","url":null,"abstract":"<p><strong>Introduction: </strong>Hemostasis is a complex physiological mechanism that maintains normal blood flow and prevents excessive bleeding after vascular injury. Anticoagulant drugs are widely used to prevent systemic embolism, stroke, and recurrent venous thromboembolism (VTE). Conventional therapies such as heparins and vitamin K antagonists (VKAs) face challenges including parenteral administration, toxicity, and poor patient compliance, leading to an increased need for innovative delivery systems and reversal strategies.</p><p><strong>Methods: </strong>This review synthesises current evidence on nanotechnology-driven drug delivery systems (DDS) and antidote development for anticoagulants, drawing from recent preclinical and clinical studies. The focus is on liposomes, ethosomes, cubosomes, hydrogels, solid lipid nanoparticles (SLnPs), self-nanoemulsifying drug delivery systems (SNEDDS), and emerging antidotes such as idarucizumab, andexanet alfa, and ciraparantag.</p><p><strong>Results: </strong>Nanocarrier systems enhance anticoagulant therapy by improving solubility, stability, targeted delivery, and sustained release. Oral DDS approaches, including solid dispersions, fastdissolving platforms, and SNEDDS, show potential to replace invasive parenteral regimens. Antidote development has advanced rapidly, with idarucizumab approved for dabigatran reversal, andexanet alfa for factor Xa inhibitors, and ciraparantag demonstrating broad-spectrum activity in development.</p><p><strong>Discussion: </strong>Nanotechnology-based DDS address long-standing limitations of conventional anticoagulants, improving patient compliance and therapeutic safety. However, cost, immunogenicity, clearance pathways, and regulatory challenges remain barriers to widespread adoption. Antidotes, while effective, raise concerns about accessibility and affordability in low-resource settings.</p><p><strong>Conclusion: </strong>This review highlights the novelty of integrating nanotechnology-based delivery systems with targeted antidote strategies. Such convergence offers a patient-centred, safer, and more effective framework for anticoagulant therapy, while underscoring the need for future research in clinical translation, cost-effectiveness, and long-term safety.</p>","PeriodicalId":93925,"journal":{"name":"Cardiovascular & hematological disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marine Products as Therapeutics for Atherosclerosis Through Modulation of Gut-heart Axis.","authors":"Fatima Khan, Kalyani Barve","doi":"10.2174/011871529X473049260710110225","DOIUrl":"https://doi.org/10.2174/011871529X473049260710110225","url":null,"abstract":"<p><strong>Introduction: </strong>A bidirectional relationship between cardiovascular health and gut microbiota, established by the gut-heart axis, is a major contributor to the development or prevention of atherosclerosis. Chronic immune-inflammatory and fibro-proliferative atherosclerosis remains a significant global cause of morbidity and death. Bile acids, Short-Chain Fatty Acids (SCFAs), and trimethylamine-N-oxide (TMAO) are examples of gut-derived metabolites that majorly impact inflammation, endothelial dysfunction, and plaque formation.</p><p><strong>Methods: </strong>Data were collected using keywords like 'marine', 'atherosclerosis', 'gut dysbiosis', 'short-chain fatty acids', and 'gut-heart axis' from databases such as PubMed, ScienceDirect, and Scopus. Relevant studies were analysed to evaluate mechanisms linking gut dysbiosis, metabolite modulation, and prevention of atherosclerosis.</p><p><strong>Results: </strong>Marine-derived bioactive compounds include peptides, carotenoids (Fucoxanthin), polysaccharides (Fucoidan, Alginate), and sterols (Fucosterol), which have anti-inflammatory, lipidlowering, and microbiome-balancing properties, making them promising therapeutic options. These bioactive compounds prevent the progression of atherosclerosis by lowering TMAO levels, increasing SCFA synthesis, improving lipid metabolism, and regulating genes associated with cholesterol metabolism.</p><p><strong>Discussion: </strong>The gut-heart axis is a critical contributor to the development and progression of atherosclerosis. Marine natural products have therapeutic potential in the management of atherosclerosis since they act as modulators of gut microbiota and cardiovascular health.</p><p><strong>Conclusion: </strong>Marine-derived natural products offer a novel therapeutic strategy for prevention and management of atherosclerosis by targeting the gut-heart axis.</p>","PeriodicalId":93925,"journal":{"name":"Cardiovascular & hematological disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Ticagrelor with Aspirin DAPT vs. Aspirin Alone in Patients Undergoing CABG Following ACS: A Systematic Review and Meta-Analysis.","authors":"Kunal Mahajan, Deep Dutta, A B M Kamrul-Hasan, Nitin Mahajan, Jaibharat Sharma, Surender Himral, Shekhar Vohra, Akshyaya Pradhan","doi":"10.2174/011871529X488257260710041631","DOIUrl":"https://doi.org/10.2174/011871529X488257260710041631","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;It remains uncertain whether Dual Antiplatelet Therapy (DAPT) or aspirin alone is better for patients following Coronary Artery Bypass Grafting (CABG) post-Acute Coronary Syndrome (ACS). Currently available Systematic Reviews and Meta-Analyses (SRMA) are limited to the analysis of different combinations of DAPT across various clinical conditions of cardiovascular disease and are not restricted to CABG post-ACS. This SRMA aimed to evaluate the safety and efficacy of Ticagrelor with Aspirin (TA) versus aspirin alone in patients who underwent CABG following ACS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Electronic databases were searched for studies involving patients who underwent CABG after ACS and received TA in the intervention arm versus aspirin in the control arm. The primary outcomes were death and major bleeding. The secondary outcomes were Composite Cardiovascular Outcomes (CCO), Myocardial Infarction (MI), stroke, saphenous vein graft patency, revascularization, and side effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Data from five studies (4 RCTs and one cohort study; 9,659 patients) were analysed. The risk of death [OR 1.18 (95% CI 0.60-2.28); P =0.63; I²=46%] and major bleeding [OR 1.65 (95% CI 0.95-2.86); P =0.07; I²=44%] was numerically higher with TA than with aspirin alone, although these differences were not statistically significant. Composite cardiovascular outcomes [OR 0.96 (95% CI 0.74-1.24); P=0.74; I²=0%], myocardial infarction [OR 0.99 (95% CI 0.67- 1.46); P =0.94; I²=0%], stroke [OR 0.60 (95% CI 0.33-1.08); P =0.09; I²=0%], saphenous vein graft patency [OR 1.75 (95% CI 0.93-3.27); P =0.08; I²=75%], and revascularisation [OR 1.21 (95% CI 0.46-3.15); P =0.70; I²=49%] were similar between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;These findings suggest that the theoretical advantage of intensified platelet inhibition with ticagrelor-based DAPT does not translate into improved clinical outcomes in patients undergoing CABG after ACS. The pathophysiology of graft failure, which is often driven by technical factors and progressive atherosclerosis rather than platelet-mediated thrombosis alone, may partly explain the absence of additional benefit from potent dual antiplatelet therapy. At the same time, the observed numerical increase in bleeding events highlights the potential trade-off associated with more aggressive platelet inhibition in the postoperative setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In patients undergoing CABG following ACS, ticagrelor-aspirin DAPT does not confer significant improvement in ischemic outcomes compared with aspirin monotherapy and may increase bleeding risk. Aspirin alone appears to provide comparable protection, supporting its continued role as the cornerstone of antiplatelet therapy after surgical revascularization. Nevertheless, antiplatelet therapy after CABG should be individualised according to each patient's ischaemic/thrombotic and bleeding risk rather than applied ","PeriodicalId":93925,"journal":{"name":"Cardiovascular & hematological disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explainable Hybrid Deep Learning Framework for Cardiovascular Disease Prediction and Clinical Decision Support.","authors":"Bhaskar Adepu, T Archana","doi":"10.2174/011871529X487473260629112351","DOIUrl":"https://doi.org/10.2174/011871529X487473260629112351","url":null,"abstract":"<p><strong>Introduction: </strong>The main concern of the world's public health is cardiovascular disease. There are many different types of machine learning models available to help clinicians identify cardiovascular disease at an early stage and predict future risk. In this study, we propose HCVDNet, a hybrid machine learning-deep learning model that can be used to improve the predictive accuracy of models as well as provide clinicians with clear explanations of the results of their predictions.</p><p><strong>Methods: </strong>The proposed architecture is a combination of three ensemble learning algorithms (XGBoost, CatBoost, and Random Forest) to learn features from data in the first step; then, the second step uses Convolutional Neural Networks (CNNs) and Long Short-Term Memory (LSTM) networks to create a deep context model of the data. We have integrated two post-hoc explainable artificial intelligence techniques (SHAP and LIME) into our architecture to produce explanations at both the global and instance levels of data. Our experiments will use cardiovascular- related datasets found in the UCI and Kaggle databases.</p><p><strong>Results: </strong>The performance of the proposed framework was significantly superior to that of other baseline machine learning and deep learning-based architectures in terms of accuracy, as it reached 96.94%, AUC reached 98.72%, and ECE was 0.021. As such, SHAP and LIME were used to evaluate the model's output to determine whether there were any clinically relevant and, therefore, reliable feature patterns within its outputs.</p><p><strong>Discussion: </strong>The findings indicate that incorporating ensemble learning with deep temporal modeling enhances both the accuracy of predictive capabilities and the interpretability of these predictions. The interpretability modules further support physician confidence in the AI-assisted decision-making process by providing a clear explanation of how each feature contributes to the medically meaningful outputs generated from the model.</p><p><strong>Conclusion: </strong>As a result, H-CVDNet is capable of developing a high-performance, highly interpretable diagnostic framework for predicting cardiovascular risk. In addition, because it is designed to be FHIR compliant, it can seamlessly integrate into existing electronic health record systems. Thus, there appears to be considerable opportunity to deploy this type of AI-based framework in real-time clinical settings and provide additional, dependable AI-based healthcare analytics.</p>","PeriodicalId":93925,"journal":{"name":"Cardiovascular & hematological disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiorenal Hemodynamic Effects of SGLT2 Inhibitors Across Heart Failure Phenotypes: A Structured Narrative Review.","authors":"Sidharth Gautam Senapati","doi":"10.2174/011871529X499537260703103129","DOIUrl":"https://doi.org/10.2174/011871529X499537260703103129","url":null,"abstract":"<p><strong>Introduction: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have become the mainstay treatment for heart failure with reduced ejection fraction (HFrEF) and have found wider applications in other forms of heart failure as well. Despite their known beneficial impact, how much of this benefit is attributed to the actual cardiorenal hemodynamic effect versus association with surrogate parameters or clinical endpoints remains unknown.</p><p><strong>Methods: </strong>This narrative review evaluates available evidence from 2012-2026, collected from PubMed, Scopus, and Web of Science databases. Eligible literature includes randomized controlled trials, prospective studies, mechanistic studies of kidney physiology, biomarker studies, and relevant meta-analyses on the use of SGLT2i in heart failure and cardiorenal diseases. Available evidence is classified by study type into hemodynamic studies, renal physiology studies, studies on surrogate markers, and clinical studies.</p><p><strong>Results: </strong>The strongest evidence concerning the role of SGLT2i in heart failure comes from their use in patients with HFrEF. Specifically, SGLT2 inhibitors dapagliflozin and empagliflozin have been shown to reduce heart failure exacerbation and cardiovascular deaths. In cases of HFmrEF and HFpEF, the beneficial effects of SGLT2 inhibitors can be attributed to a reduced risk of heart failure-related complications such as hospitalization. From the standpoint of the underlying mechanism of action, SGLT2i are associated with osmotic diuresis and natriuresis, restored tubuloglomerular feedback, reduced blood pressure, and maintenance of renal function. However, their impact on myocardial bioenergetics, inflammatory state, endothelial health, and myocardial remodeling is supported mainly by mechanistic, translational, and indirect clinical evidence rather than direct hemodynamic trials.</p><p><strong>Discussion: </strong>Based on current literature, it can be argued that the SGLT2 inhibitors have been consistently providing clinical and renal benefits for HF phenotypes; however, the observed effects cannot be used to claim a single mechanism based on the hemodynamic pathway. Improvement of biomarkers and benefits on clinical outcomes confirm the biological plausibility; however, data from direct invasively assessed hemodynamics are lacking.</p><p><strong>Conclusion: </strong>Sodium-glucose cotransporter 2 inhibitors have shown clear evidence-based cardiorenal benefits in HFrEF and reduction of HF hospitalizations in HFmrEF and HFpEF.</p>","PeriodicalId":93925,"journal":{"name":"Cardiovascular & hematological disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catestatin as a Marker of Cardiovascular Diseases.","authors":"Irina V Gubareva, Ekaterina Yu Gubareva, Sergey A Tokarev, Lina Yu Shvan","doi":"10.2174/011871529X447719260514063200","DOIUrl":"https://doi.org/10.2174/011871529X447719260514063200","url":null,"abstract":"<p><strong>Background: </strong>Catestatin (CST), a 21-amino acid peptide derived from Chromogranin A, is a potent endogenous inhibitor of catecholamine release and a key regulator of sympathovagal balance essential for cardiovascular homeostasis. Given its multifaceted physiological role, CST has emerged as a promising biomarker for hypertensive and ischemic disorders. This review synthesizes current evidence on CST dynamics and its mechanistic involvement in disease progression.</p><p><strong>Methods: </strong>Following PRISMA 2020 guidelines, a systematic search of PubMed/MEDLINE and eLibrary.ru was conducted through October 2025. From 339 identified records, original clinical and experimental studies on CST biology, cardiovascular physiology, and its role in hypertension and coronary artery disease were selected.</p><p><strong>Results: </strong>CST is a stage-specific marker; its elevation reflects adaptive responses in early-stage disease, while systemic depletion predicts advanced target organ damage and adverse clinical outcomes. This dynamic profile, influenced by genetic and metabolic variability, establishes CST as a possible tool for risk stratification and monitoring progression in hypertensive and ischemic populations.</p><p><strong>Discussion: </strong>Current evidence for the mechanistic role of CST in cardiovascular diseases remains predominantly preclinical, with clinical studies often limited by small cohorts and heterogeneous methodologies. Despite these constraints, emerging data position CST as an indicator of autonomic and structural deterioration. Addressing existing inconsistencies in clinical findings is essential for validating CST as a standardized tool for cardiovascular risk assessment.</p><p><strong>Conclusion: </strong>Further large-scale longitudinal studies are warranted to standardize CST measurement protocols and validate its clinical utility as a prognostic biomarker in cardiovascular medicine.</p>","PeriodicalId":93925,"journal":{"name":"Cardiovascular & hematological disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IgG Kappa Multiple Myeloma with Cutaneous Plasmacytoma and Hypereosinophilic Leukocytosis in a Young Patient: A Rare Case Report.","authors":"Bibhant Shah, Arjun Kachhwaha, Gayathri K S, Nilotpal Chowdhury, Uttam Kumar Nath","doi":"10.2174/011871529X417454260101035551","DOIUrl":"https://doi.org/10.2174/011871529X417454260101035551","url":null,"abstract":"<p><strong>Background: </strong>Multiple myeloma (MM) is a malignant plasma cell disorder with a median age at diagnosis of 69 years. Its occurrence in individuals younger than 30 years is exceptionally uncommon, accounting for approximately 0.3% of all cases. Classic manifestations include bone pain, anemia, renal dysfunction, and hypercalcemia. Extramedullary disease (EMD), such as plasmacytomas, represents a more aggressive phenotype. Among these, cutaneous plasmacytomas-monoclonal plasma cell infiltrates in the skin-are exceedingly rare.</p><p><strong>Case presentation: </strong>A 27-year-old man presented with fatigue, dysphagia, and widespread violaceous papulonodular skin lesions. Examination revealed pallor, oral ulcers, splenomegaly, and blistering nodules over the trunk and extremities. Laboratory evaluation showed bicytopenia, leukocytosis, hyperproteinemia with a reversed albumin-globulin ratio, and renal dysfunction. Serum protein electrophoresis demonstrated an M-spike, and bone marrow aspiration revealed 32% plasma cells, confirming multiple myeloma. Whole-body PET-CT identified generalized osteolytic lesions involving the calvarium, ribs, vertebrae, and appendicular skeleton. Skin biopsy confirmed cutaneous plasmacytoma. Baseline echocardiography showed mild pericardial effusion with preserved left ventricular function; NT-proBNP was elevated. Renal impairment due to light chain cast nephropathy improved after plasmapheresis and initiation of the VRd regimen [bortezomib, lenalidomide, dexamethasone]. After eight cycles, disease relapse occurred with new subcutaneous nodules. Therapy was escalated to Dara-KCd [daratumumab, carfilzomib, cyclophosphamide, dexamethasone], followed by daratumumab, pomalidomide, and dexamethasone, leading to regression of lesions. The patient continues second-line therapy with reassessment planned after four cycles and consideration for early autologous stem cell transplantation.</p><p><strong>Conclusion: </strong>Cutaneous plasmacytoma with hypereosinophilic leukocytosis in young patients with IgG kappa MM is exceedingly rare. Recognition of such atypical presentations is crucial for early detection of extramedullary disease and timely institution of intensive therapy.</p>","PeriodicalId":93925,"journal":{"name":"Cardiovascular & hematological disorders drug targets","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}