European cardiology最新文献

{"title":"The Use of Apabetalone in Reducing Cardiovascular Outcomes, Based on the Current Evidence and Trials.","authors":"Yimeng Zhang, Nimai Desai, Derek Connolly","doi":"10.15420/ecr.2023.38","DOIUrl":"10.15420/ecr.2023.38","url":null,"abstract":"<p><p>The use of apabetalone, a novel therapeutic agent targeting epigenetic regulation, has been the source of much interest in its ability to subvert major adverse cardiovascular events. Derived from BETonMACE, clinical trials have explored its potential benefits in improving cardiovascular health. Apabetalone operates through selective inhibition of bromodomain and extra-terminal domain proteins, influencing gene expression and cellular pathways implicated in cardiovascular disease progression to influence lipid metabolism, downplay oxidative burden and reduce inflammation. The BETonMACE trial recruited patients with type 2 diabetes and recent acute coronary syndrome events. The primary endpoint was the composite of cardiovascular death, MI and stroke. This article explores the various clinical research and outcomes related to apabetalone and its use in the context of its proposed mechanism.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":"20 ","pages":"e04"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Oral Anticoagulant Use in Older Adults with Atrial Fibrillation: Challenges and Solutions.","authors":"Monika Bhandari, Akshyaya Pradhan, Pravesh Vishwakarma, Laura Di Renzo, Ferdinando Iellamo, Wahid Ali, Marco Alfonso Perrone","doi":"10.15420/ecr.2024.17","DOIUrl":"10.15420/ecr.2024.17","url":null,"abstract":"<p><p>AF is the most common arrhythmia in clinical practice, with a large preponderance in the older (>75 years) adult population. Stroke is the most feared complication of AF, with huge corresponding morbidity and mortality. Anticoagulation is the mainstay for stroke prevention in AF, but is commonly underutilised in clinical practice due to the fear of intracerebral bleeding. Bleeding is the primary concern in older patients with conventional vitamin K antagonist use. Direct oral anticoagulants (DOACs) have been used for a decade in clinical practice and have been found to reduce major bleeds. The advantages of DOAC use in older patients include obviating the need for intermittent international normalised ratio monitoring, fewer drug interactions and reduction in intracerebral haemorrhage. The disadvantages of DOAC use include older patients having to take multiple doses per day and a lack of a universal antidote, as opposed to vitamin K antagonists. However, a lack of head-to-head trials among DOACs and specific randomised controlled trials in older patients preclude a definite conclusion regarding the ideal DOAC that should be used in the older population. Factor XI inhibition is an emerging approach for oral anticoagulation that holds promise for dissociating thrombosis from haemostasis. This provides an additional avenue for reducing bleeding in the older adult population.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":"20 ","pages":"e03"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interdisciplinary Management of Cardiotoxicity in Outpatient Settings: A Survey on Practices, Perceptions and Potential for Improvement.","authors":"Silvio Quick, Lorena Payo-Anez, Clara Marx Casimiro de Almeida, Jochen Schmitt, Karim Ibrahim, Markus Kösters, Marian Christoph, Tina Haase, Lorenz Harst","doi":"10.15420/ecr.2023.49","DOIUrl":"https://doi.org/10.15420/ecr.2023.49","url":null,"abstract":"<p><strong>Background: </strong>Cardiotoxicity is a major concern in patients undergoing chemotherapy, requiring interdisciplinary management. However, the extent to which cardiotoxicity is managed in the outpatient setting among these specialists may vary, potentially leading to gaps in patient care.</p><p><strong>Methods: </strong>This questionnaire study assessed the current practices and perceptions of cardiologists, oncologists and gynaecologists regarding the management of cardiotoxicity in patients undergoing outpatient chemotherapy in Germany.</p><p><strong>Results: </strong>A total of 1,329 medical professionals were contacted via an online questionnaire; 132 (9.9%) were included in the survey. The participants in our survey reported treating a total of 1,905 chemotherapy patients per month (range 1-200). Of these patients, only 37% of those treated by oncologists (n=13) and 48% of those treated by gynaecologists (n=53) received cardiological care. The results showed that 37% (49/132) of the healthcare professionals surveyed said they performed cardiovascular toxicity risk assessment of chemotherapy in their clinical practice. More than half of the participants (56%, 39/70) expressed a need for simplified cardio-oncology guidelines. The majority of participants (84% [59/70] and 83% [58/70], respectively) requested tools to assist in cardiovascular toxicity risk assessment and the implementation of appropriate therapeutic measures for patients undergoing chemotherapy.</p><p><strong>Conclusion: </strong>Our study underscores potential interdisciplinary care gaps, possibly increasing the risk of undetected cardiotoxicity. Variations in cardiotoxicity management among specialities highlight the need for increased awareness and improved collaboration. Interdisciplinary clinical pathways could address these issues, as could a dedicated cardio-oncology network for primary care physicians' support.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":"20 ","pages":"e02"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2024 European Society of Cardiology Atrial Fibrillation Guidelines: A Moving Goalpost.","authors":"Gheorghe-Andrei Dan, Antoni Martinez-Rubio","doi":"10.15420/ecr.2024.55","DOIUrl":"https://doi.org/10.15420/ecr.2024.55","url":null,"abstract":"","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":"20 ","pages":"e01"},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Atrial Small-conductance Calcium-activated Potassium Channels to New Antiarrhythmics.","authors":"Arnela Saljic, Jordi Heijman, Dobromir Dobrev","doi":"10.15420/ecr.2024.41","DOIUrl":"10.15420/ecr.2024.41","url":null,"abstract":"<p><p>Despite significant advances in its management, AF remains a major healthcare burden affecting millions of individuals. Rhythm control with antiarrhythmic drugs or catheter ablation has been shown to improve symptoms and outcomes in AF patients, but current treatment options have limited efficacy and/or significant side-effects. Novel mechanism-based approaches could potentially be more effective, enabling improved therapeutic strategies for managing AF. Small-conductance calcium-activated potassium (SK or KCa2.x) channels encoded by <i>KCNN1-3</i> have recently gathered interest as novel antiarrhythmic targets with potential atrial-predominant effects. Here, the molecular composition of smallconductance calcium-activated potassium channels and their complex regulation in AF as the basis for understanding the distinct mechanism of action of pore-blockers (apamin, UCL1684, ICAGEN) and modulators of calcium-dependent activation (NS8593, AP14145, AP30663) are summarised. Furthermore, the preclinical and early clinical evidence for the role of small-conductance calcium-activated potassium channel inhibitors in the treatment of AF are reviewed.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":"19 ","pages":"e26"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shifting Paradigms in the Management of Pulmonary Hypertension.","authors":"Akshyaya Pradhan, Richa Tyagi, Prachi Sharma, Jyoti Bajpai, Surya Kant","doi":"10.15420/ecr.2024.11","DOIUrl":"10.15420/ecr.2024.11","url":null,"abstract":"<p><p>Pulmonary arterial hypertension (PAH) is a long-term condition characterised by increased resistance to blood flow in the pulmonary circulation. The disease has a progressive course and is associated with a poor prognosis. Without treatment, PAH is associated with mortality in <3 years. Over the past decade, many advances have been made in revising the haemodynamic definition, clinical classification, risk calculation score, treatment options etc. Suggestions from the Sixth World Symposium on Pulmonary Hypertension were incorporated into a literature review that was included in the European Society of Cardiology/European Respiratory Society (ESC/ERS)'s most recent iteration of their guidelines in 2022. The traditional cut-off for pulmonary hypertension (PH), i.e., mean pulmonary artery pressure (mPAP) >25 mm Hg, has been challenged by observational cohort studies, which have shown poor outcomes for values of 21-24 mmHg; the new consensus is that PH is defined at mPAP >20 mm Hg. Although the gold standard for diagnosis and the major source of therapy guidance continues to be right cardiac catheterisation, echocardiography remains the initial test of choice. A multidisciplinary approach is highly recommended when treating PH patients and careful evaluation of patients will aid in proper diagnosis and prognosis. Pharmacotherapy for PAH has seen a paradigm shift with the successful use of newer agents in more extensive, longer and more inclusive trials driven by hard endpoints. Macitentan, selexipag and riociguat are three oral agents that have shown astounding success in PAH randomised studies in the past decade. Upfront combination therapy with two agents is now becoming the norm (following the AMBITION, OPTIMA and ITALY trials) and the momentum is shifting towards triple therapy as for essential hypertension. More recently, inhaled treprostinil was shown to improve exercise capacity in PH associated with interstitial lung disease in the phase III INCREASE study and has been granted regulatory approval for World Health Organization group 3 PH. A new class of drug, sotatercept (a tumour growth factor-β signalling inhibitor), has also been recently approved by the Food and Drug Administration for management of PAH based on positive results from the phase III STELLAR study. Pulmonary artery denervation and balloon pulmonary angioplasty have emerged as viable alternatives in PH that are resistant to drug therapy. This article aims to summarise the key changes and recent advances in diagnosis and managing PH in general, with an emphasis on certain subgroups.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":"19 ","pages":"e25"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Implications of Non-steroidal Anti-inflammatory Drugs: A Comprehensive Review, with Emphasis on Patients with Rheumatoid Arthritis.","authors":"Eirik Ikdahl, Anne Kerola, Eli Sollerud, Anne Grete Semb","doi":"10.15420/ecr.2024.24","DOIUrl":"10.15420/ecr.2024.24","url":null,"abstract":"<p><p>This review examines the cardiovascular risks associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs), both traditional NSAIDs and cyclooxygenase-2 selective inhibitors (COXIBs). It describes the history of traditional NSAIDs and the development of COXIBs to explain why their cardiovascular side effects were unnoticed for many decades. Further, the review presents the mechanism of action of NSAIDs, to elucidate the possible underlying basis for why they are associated with an increased risk of cardiovascular disease. Finally, data on the cardiovascular risk with NSAID use in patients with rheumatoid arthritis are presented, and we propose possible explanations for why the risk of cardiovascular side effects in these patients seems to be less pronounced than in the general population.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":"19 ","pages":"e27"},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2024 European Society of Cardiology Guidelines on Peripheral Arterial and Aortic Diseases.","authors":"Giuseppe Ferrante, Brittany A Bacallao, Francesco Gioia, Guido Del Monaco, Francesco Amata","doi":"10.15420/ecr.2024.45","DOIUrl":"https://doi.org/10.15420/ecr.2024.45","url":null,"abstract":"","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":"19 ","pages":"e24"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is New from the 2024 European Society of Cardiology Congress on the Management of Chronic Coronary Syndromes? Updated Guidelines and Trials.","authors":"Filippo Luca Gurgoglione, Giampaolo Niccoli","doi":"10.15420/ecr.2024.43","DOIUrl":"10.15420/ecr.2024.43","url":null,"abstract":"","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":"19 ","pages":"e23"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commencement of Atorvastatin and Ezetimibe Immediately in Patients Presenting with Acute Coronary Syndrome.","authors":"Mohammed Sallam, Hossameldin Hassan, Derek Connolly, Mohammed Shamim Rahman","doi":"10.15420/ecr.2024.06","DOIUrl":"10.15420/ecr.2024.06","url":null,"abstract":"<p><p>Lipids are implicated in the development of coronary atherosclerosis. Achieving a significant reduction in lipid levels remains a crucial aspect of secondary prevention following an acute coronary syndrome event. Novel lipid-lowering therapies now provide clinicians with a variety of therapeutic strategies to choose from and tailor to individual patient needs. This review focuses on evidence supporting the importance of early and intensive lipid-lowering therapy use in patients presenting with acute coronary syndrome, specifically addressing data relating to atorvastatin and ezetimibe use in this high-risk cohort of patients.</p>","PeriodicalId":93994,"journal":{"name":"European cardiology","volume":"19 ","pages":"e22"},"PeriodicalIF":0.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142718046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}