Progress in cardiovascular diseases最新文献

{"title":"The efficacy of revascularization in ischemic cardiomyopathy.","authors":"Kais Hyasat, Chieh-Shou Su, Ajay J Kirtane, Margaret McEntegart","doi":"10.1016/j.pcad.2024.12.007","DOIUrl":"10.1016/j.pcad.2024.12.007","url":null,"abstract":"<p><p>Ischemic cardiomyopathy (ICM) is characterized by myocardial dysfunction due to myocardial ischemia, associated with the presence of significant coronary artery disease (CAD). We provide a comprehensive review of the current evidence for coronary revascularization in ICM, including consideration of the different modalities of coronary artery bypass grafting and percutaneous coronary intervention. In addition to a contemporary assessment of the literature, we aim to provide real-world insights and perspectives to guide clinical decision-making in this heterogeneous and complex patient population.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916694","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":"Anti-consumption agents: Tirzepatide and semaglutide for treating obesity-related diseases and addictions, and improving life expectancy.","authors":"James H O'Keefe, W Grant Franco, Evan L O'Keefe","doi":"10.1016/j.pcad.2024.12.010","DOIUrl":"10.1016/j.pcad.2024.12.010","url":null,"abstract":"<p><p>American culture encourages overconsumption, fueled by ubiquitous availability and pervasive marketing of ultra-processed foods and other addictive substances. This chronic overindulgence has contributed to rising rates of obesity, type 2 diabetes (T2D), substance abuse, mental health disorders and premature mortality. Glucose-like peptide-1 agonists (GLP-1RAs) affect the brain's reward pathway that mediates addiction to foods and various other substances. Evolving data suggest that tirzepatide and semaglutide may be the first effective \"anti-consumption\" agents with potential applications in reducing food cravings, obesity, alcohol consumption, nicotine addiction, recreational drug use, and even uncontrollable shopping behaviors. Tirzepatide and semaglutide, unlike prior weight-loss drugs, are effective and relatively safe/well-tolerated medications that are associated with reduced risks for myocardial infarction, stroke, cardiovascular death, heart failure, progressive kidney and liver disease, obstructive sleep apnea, debilitating osteoarthritis, polycystic ovarian syndrome, neurodegenerative disease and premature mortality. Observational studies show that GLP-1RAs are associated with spontaneous nonvolitional reductions in use of alcohol, nicotine, and recreational drugs. Because obesity and substance abuse are so prevalent in the United States, GLP-1RA drugs may be uniquely helpful in addressing overconsumption and addiction issues thereby improving overall health and life expectancy.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916442","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":"Calcified plaque modification during percutaneous coronary revascularization.","authors":"Jarrod Frizzell, Dean J Kereiakes","doi":"10.1016/j.pcad.2024.12.001","DOIUrl":"10.1016/j.pcad.2024.12.001","url":null,"abstract":"<p><p>The presence and severity of calcified coronary plaque negatively impacts angiographic and clinical outcomes following percutaneous coronary intervention (PCI). Severe coronary calcification is associated with suboptimal stent delivery, deployment, apposition and expansion which can lead to in-stent restenosis and/or thrombosis. Severe coronary calcification is associated with incremental hazard for adverse clinical events, including death, during 5-10 years following PCI despite the use of new generation drug- eluting stents. Multiple technologies including high-pressure noncompliant and modified (cutting/scoring) balloons, atheroablative technologies (laser, rotational or orbital atherectomy), and more recently, intravascular lithotripsy have been used to modify calcified plaque and facilitate optimal coronary stent implantation. Intravascular imaging is critically important to determine the extent and distribution (superficial or deep) of coronary calcification and to aid selection and sequence for use of calcium modifying technologies. Unfortunately, large scale randomized comparative trials of calcium modifying technologies are limited and the relative safety and effectiveness of these modalities is poorly defined. Recent mechanistic and clinical data supporting the use of plaque modifying technologies are reviewed to provide insights into their optimal use.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814896","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":"Survival of the fittest? Peak oxygen uptake and all-cause mortality among older adults in Norway.","authors":"Atefe R Tari, Daniel E Brissach, Emma M L Ingeström, Javaid Nauman, Tristan Tyrell, Carl Foster, Kimberley Radtke, John P Porcari, Stian Lydersen, Leonard A Kaminsky, Jonathan Myers, Tara L Walker, Jeff S Coombes, Dorthe Stensvold, Ulrik Wisløff","doi":"10.1016/j.pcad.2024.11.004","DOIUrl":"10.1016/j.pcad.2024.11.004","url":null,"abstract":"<p><strong>Objective: </strong>To determine the cardiorespiratory fitness (CRF) levels needed to avoid the Grim Reaper (Death) among older adults. We hypothesized that an above average peak oxygen uptake (VO_2peak) is needed for 70-77-year-old men and women to delay the encounter with Death.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>General population of older adults in Norway.</p><p><strong>Participants: </strong>788 women and 777 men aged 70-77 years.</p><p><strong>Intervention: </strong>Clinical assessments, including a test of VO_2peak. Participants were categorised based on their baseline VO_2peak and changes after 1 year. This study explored associations between VO_2peak and 5-year all-cause mortality using Cox proportional hazard models.</p><p><strong>Main outcome measure: </strong>All-cause mortality.</p><p><strong>Results: </strong>Death caught up with 5.3 % of men and 3.7 % of women. Compared to unfit men and women, fewer men (Hazard Ratio [HR]: 0.34, 95 % Confidence Interval [CI] 0.15-0.78) and women (HR: 0.41, 95 % CI 0.17-0.98) classified as moderately fit encountered Death with no additional risk reduction among those classified as being more fit. It appears to be easier for the Grim Reaper to claim those in poorer physical condition, specifically VO_2peak levels <26.5 mL/kg/min for men and 22.2 mL/kg/min for women (corresponding to ≥85 % of the observed age- and sex-specific average).</p><p><strong>Conclusion: </strong>The Grim Reaper typically targets individuals with VO_2peak levels <26.5 mL/kg/min/ and <22.2 mL/kg/min when chasing male and female souls aged 70-77 years, respectively, reflecting his penchant for limited CRF. These data underscore the importance of maintaining or enhancing CRF throughout life, providing clear targets for clinicians in assessing patient CRF levels.</p><p><strong>Trial registration: </strong>ClinicalTrials.govNCT01666340.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788296","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":"Omega-3 and Risk of atrial fibrillation: Vagally-mediated double-edged sword.","authors":"Evan L O'Keefe, James H O'Keefe, Hussam Abuissa, Mark Metzinger, Ellen Murray, Grant Franco, Carl J Lavie, William S Harris","doi":"10.1016/j.pcad.2024.11.003","DOIUrl":"10.1016/j.pcad.2024.11.003","url":null,"abstract":"<p><strong>Objective: </strong>Studies regarding effects of omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on risk of atrial fibrillation (AF) have reported discordant results. The aim of this review is to clarify effects of marine omega-3 intake on risk of AF.</p><p><strong>Patients and methods: </strong>A PubMed search was performed using terms: atrial fibrillation, omega-3, EPA, DHA, vagal tone. We summarized findings from randomized clinical trials (RCTs), epidemiology studies, and meta-analyses evaluating effects/associations of DHA + EPA on risk of AF. Also, vagal tone was explored as a mediator between omega-3 and risk of AF.</p><p><strong>Results: </strong>Meta-analyses of 8 RCTs and 17 prospective cohort studies comprised of 83,112 and 54,799 individuals, respectively, investigated the link between omega-3 intake and incident AF. The RCTs reported that treatment with DHA and/or EPA was associated with a 24 % increased relative risk of AF (absolute risk 4.0 % vs 3.3 %; relative risk [RR] 1.24, 95 % confidence interval [CI] 1.11-1.38, p = 0.0002). This was dose-dependent; DHA + EPA doses of ∼1000 mg/d increased AF risk ∼12 %, whereas 1800 to 4000 mg/d increased AF risk by ∼50 %. In contrast, observational studies focused on DHA + EPA blood levels or dietary intake have generally reported that higher omega-3 levels/consumption are associated with lower AF risk. Maximal AF risk reduction. (12 %) occurred at ∼650 mg/d of dietary DHA + EPA. Other studies have indicated that omega-3 fatty acids can dose-dependently increase vagal tone, which could explain the biphasic relationship between DHA + EPA and AF risk. Experimental studies show that low-level vagal stimulation decreases risk of AF, whereas high-level vagal stimulation increases risk of AF.</p><p><strong>Conclusion: </strong>Higher consumption of dietary omega-3 is associated with decreased AF risk. In contrast, pharmaceutical dosing of omega-3 increases AF in a dose-dependent manner, which may be mediated by vagal tone.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776025","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":"Cardiovascular outcomes among giant cell myocarditis compared with cardiac sarcoidosis: A propensity score-matched analysis.","authors":"Vikash Jaiswal, Muhammad Hanif, Yusra Mashkoor, Aanchal Sawhney, Tushar Kumar, Juveriya Yasmeen, F N U Sundas, Jishanth Mattumpuram, Adrija Hajra, Carl J Lavie, Dhrubajyoti Bandyopadhyay","doi":"10.1016/j.pcad.2024.11.002","DOIUrl":"10.1016/j.pcad.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>Giant cell myocarditis (GCM) and cardiac sarcoidosis (CS) are rare inflammatory diseases of the myocardium with poor prognosis. Cardiovascular disease outcomes among both diseases have not been well studied with limited literature.</p><p><strong>Objective: </strong>This study aims to investigate the cardiovascular outcomes among patients with GCM and CS.</p><p><strong>Method: </strong>We queried the TriNeTX Global Collaborative Network for adult patients with giant cell myocarditis and cardiac sarcoidosis between January 2000 to May 2023 and created two groups: one with giant cell myocarditis and second with cardiac sarcoidosis. Both the groups were followed for 6 months and 12 months.</p><p><strong>Result: </strong>After propensity score matched analysis (PSM), among the 4804 patients (2402 patients in each group), the mean age of patients was 57.1 and 57.6 years in GCM and CS groups, respectively. PSM analysis showed that primary outcome i.e., all-cause mortality was significantly higher in GCM group both after 6 months [relative risk (RR) 2.33, 95 % confidence interval (CI): 1.64-3.30, p < 0.01] and 1 year follow up [RR, 1.54 (95 % CI: 1.20-1.98), p < 0.01] as compared with CS group. However, secondary outcomes i.e., heart failure (HF) at 6 month (RR 0.66, 95 % CI: 0.52-0.85, p < 0.01), and at 1 year (RR 0.60, 95 % CI: 0.49-0.73, p < 0.01), ventricular tachycardia (VT) at 6 months (RR 0.34, 95 % CI: 0.25-0.46, p < 0.01), and at 1 year (RR 0.32, 95 % CI: 0.25-0.41, p < 0.01), atrioventricular (AV) node block at 6 month (RR 0.45, 95 % CI: 0.33-0.61, p < 0.01), and at 1 year (RR 0.43, 95 % CI: 0.34-0.55, p < 0.01), and atrial flutter and fibrillation (AF) at 6 months (RR 0.67, 95 % CI: 0.48-0.94, p = 0.02), and at 1 year (RR 0.59, 95 % CI: 0.45-0.76, p < 0.01) were found significantly lower in GCM group as compared to CS group. On the other hand, heart transplant incidence was comparable between both the groups.</p><p><strong>Conclusion: </strong>These findings suggest that GCM patients have high risk of mortality and lower risk of HF, VT, AV node block, and AF when compared with CS.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669616","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":"Use of mechanical circulatory support in high-risk percutaneous coronary interventions.","authors":"Zaid Al Jebaje, Ahmad Jabri, Tushar Mishra, Adnan Halboni, Asem Ayyad, Anas Alameh, Rama Ellauzi, Francisco B Alexandrino, Khaldoon Alaswad, Mir Babar Basir","doi":"10.1016/j.pcad.2024.10.007","DOIUrl":"10.1016/j.pcad.2024.10.007","url":null,"abstract":"<p><p>As the field of percutaneous coronary intervention grows in volume, expertise, and available tools, interventional cardiologists are increasingly performing more complex and higher-risk coronary artery procedures. Mechanical circulatory support devices, previously used only in urgent situations, are now being utilized as supplementary tools to enhance outcomes in elective complex cases. This shift has sparked significant discussions about patient and device selection, as well as the potential risks involved. In this article, we explore the various devices and their distinct features. Additionally, we also introduce algorithms for device selection, placement and weaning to help guide physicians during their care for their high-risk PCI patients.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515604","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":"Advancements and future perspectives in coronary angiography-derived fractional flow reserve.","authors":"Carlos Collet, Daniel K Amponsah, Thabo Mahendiran, Takuya Mizukami, Adriaan Wilgenhof, William F Fearon","doi":"10.1016/j.pcad.2024.08.002","DOIUrl":"10.1016/j.pcad.2024.08.002","url":null,"abstract":"<p><p>Angiography-derived fractional flow reserve (FFR) has emerged as a non-invasive technique to assess the functional significance of coronary artery stenoses. The clinical applications of angiography-derived FFR span a wide range of scenarios, including assessing intermediate coronary lesions and guiding revascularization decisions. This review paper aims to provide an overview of angiography-derived FFR, including its principles, clinical applications, and evidence supporting its accuracy and utility. Lastly, the review discusses future directions and ongoing research in the field, including the integration of angiography-derived FFR into routine clinical practice.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914890","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":"Antegrade techniques for chronic total occlusion percutaneous coronary intervention.","authors":"Reza Masoomi, Silvia Moscardelli, Taishi Hirai, Lorenzo Azzalini","doi":"10.1016/j.pcad.2024.07.001","DOIUrl":"10.1016/j.pcad.2024.07.001","url":null,"abstract":"<p><p>Antegrade techniques are the foundation of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Antegrade wiring with the intent to achieve an intraplaque guidewire tracking is not always feasible, and crossing into the extraplaque space with subsequent reentry (antegrade dissection and reentry), might be needed, particularly in more complex occlusions. The present article reviews in detail the antegrade approaches to CTO PCI, focusing on equipment, techniques, and overcoming challenges.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736224","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":"Comparing the efficacy and safety of endovascular therapy versus surgical revascularization for critical limb-threatening ischemia: A systematic review and Meta-analysis.","authors":"Mohamad Riad Abouzid, Ankit Vyas, Ibrahim Kamel, Junaid Anwar, Shorouk Elshafei, Venkat Subramaniam, William Bennett, Carl J Lavie, Chima Nwaukwa, Christopher J White, Rajan A G Patel","doi":"10.1016/j.pcad.2024.06.008","DOIUrl":"10.1016/j.pcad.2024.06.008","url":null,"abstract":"<p><strong>Introduction: </strong>Critical limb-threatening ischemia (CLTI) is a severe manifestation of peripheral artery disease (PAD) that can lead to limb amputation and significantly reduce quality of life. In addition to guideline-directed medical therapy (GDMT), endovascular therapy and surgical revascularization are the two revascularization options for CLTI. In recent years, there has been an ongoing debate about the best approach for CLTI patients. The purpose of this meta-analysis is to examine the current evidence and compare the clinical outcomes of endovascular therapy and surgical revascularization for CLTI.</p><p><strong>Methods: </strong>We conducted a systematic search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) for studies comparing the outcomes of endovascular therapy versus surgery in patients with CLTI. The primary outcomes were major adverse limb events (MALE) and major adverse cardiovascular events (MACE), while secondary outcomes included risk of bleeding, wound complications, readmission, unplanned reoperation, acute renal failure, and length of hospital stay. Pooled data was analyzed using the fixed-effect model or the random-effect model in Review Manager 5.3. The Newcastle-Ottawa Scale and Cochrane risk of bias assessment tool were used to assess the bias of included studies.</p><p><strong>Results: </strong>A total of 16 studies (47,609 patients) were included in this meta-analysis. The overall effect favors surgery over endovascular intervention in terms of MALE [odds ratio (OR) 1.13, 95% CI (1.01-1.28), P = 0.04]. Endovascular therapy is associated with lower MACE rates compared to surgery [OR 0.62, 95% CI (0.51-0.76), P < 0.00001]. Furthermore, the risk of bleeding, wound complications, readmission, unplanned reoperation, acute renal failure as well as the length of hospital stay was lower for endovascular intervention. Finally, there was no statistically significant difference in 30-day mortality between the two groups [OR 0.94, 95% CI 0.79-1.12, P = 0.52; Fig. 3i], and the pooled studies were homogeneous [P = 0.39; I2 = 5%].</p><p><strong>Conclusion: </strong>Surgery may be the preferred treatment option for CLTI patients, as it is associated with a lower risk of MALE than endovascular therapy. However, endovascular therapy may be associated with a lower risk of MACE and lower rates of bleeding, wound complications, readmission, unplanned reoperation, acute renal failure, and shorter hospital stays. There was no statistically significant difference in 30-day mortality between the two groups. Ultimately, the decision to use endovascular therapy or surgery as the primary treatment strategy should be based on a multi-disciplinary team approach with careful consideration of patient characteristics and anatomy.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565465","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}