Cardiology in Review最新文献

{"title":"Safety and Glycemic Efficacy of Perioperative Liraglutide in Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Ibrahim Gamal, Mohamed Hamouda Elkasaby, Osama Ewidat, Nuha Riyad, Zahra Sadin, Angad Singh Gill, Mahmoud Nassar, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001465","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001465","url":null,"abstract":"<p><p>Perioperative hyperglycemia in cardiac surgery is associated with wound infection, acute kidney injury, and death, yet the intravenous insulin used to treat it is itself coupled to hypoglycemia. Glucagon-like peptide-1 receptor agonists lower glucose only when glucose is elevated and might therefore separate glycemic control from hypoglycemic risk. We searched PubMed/MEDLINE, Scopus, Web of Science, and CENTRAL through September 2025 for randomized controlled trials of perioperative subcutaneous liraglutide versus placebo or insulin-based usual care in adults undergoing cardiac surgery. Two reviewers screened, extracted data, and applied the Cochrane Risk of Bias 2 tool independently; certainty was graded using GRADE. Effects were pooled by inverse variance, fixed-effect when I2 was below 50%. Seven reports of 4 trials, enrolling 446 randomized patients, were eligible. Liraglutide did not alter 30-day mortality (1/161 vs 3/160; risk ratio [RR] 0.42, 95% confidence interval [CI], 0.06-2.81), the composite of any postoperative complication (68/129 vs 76/132; RR 0.92; 95% CI, 0.74-1.14), cardiac adverse events (RR 1.08; 95% CI, 0.83-1.40), hypoglycemia (8/165 vs 9/166; RR 0.85; 95% CI, 0.34-2.13), or postoperative nausea and vomiting (RR 3.01; 95% CI, 0.26-35.27).</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Coronary Intervention in Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis With Reconstructed Individual Patient Data and GRADE Assessment.","authors":"Mazen Negmeldin Yassin, Karim Elfeqi, Ahmed Abdelmaksoud, Fouad Hanna, Abdelrahman El-Helbawy, Mohamed Hamouda Elkasaby, Amr Mohsen, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001467","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001467","url":null,"abstract":"<p><p>Coronary artery disease coexists in approximately 50% of transcatheter aortic valve implantation candidates, yet the role of percutaneous coronary intervention (PCI) remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials comparing PCI with conservative management or deferral in transcatheter aortic valve implantation candidates with coronary artery disease. We searched 4 databases from inception to June 19, 2026. Odds ratios (ORs) were pooled using random-effects models with restricted maximum likelihood estimation and Hartung-Knapp-Sidik-Jonkman adjustment. Individual patient data were reconstructed from published Kaplan-Meier curves. Risk of bias and certainty of evidence were assessed. Three randomized controlled trials (n = 1156 patients) were included. PCI showed no significant reductions in all-cause death (OR 0.88; 95% confidence interval [CI], 0.62-1.25; I2 = 0%), cardiovascular death (OR 0.72; 95% CI, 0.40-1.29; I2 = 0%), or myocardial infarction (OR 0.85; 95% CI, 0.17-4.18; I2 = 51.8%). Stroke was significantly reduced with PCI (OR 0.68; 95% CI, 0.48-0.95; I2 = 0%). PCI was associated with a trend toward increased any bleeding (OR 2.26; 95% CI, 0.81-6.29; I2 = 69.8%) and major bleeding (OR 1.70; 95% CI, 0.63-4.60; I2 = 35.9%).</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microvascular Diseases of the Eye: Retinal Vasculature as a Cardiometabolic Biomarker.","authors":"Brandon M Bessen, Matthew B Weiss, William H Frishman","doi":"10.1097/CRD.0000000000001446","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001446","url":null,"abstract":"<p><p>Microvascular disease of the eye encompasses both structural and functional changes to the retinal vessels. Cardiometabolic disorders, such as hypertension and diabetes, are associated with early, measurable abnormalities in the retinal microvascular network that often emerge before cardiovascular disease becomes detectable. These features can be directly, noninvasively assessed with a multitude of evolving imaging techniques. Furthermore, these vascular changes can be used to predict future cardiac events, making them promising biomarkers for systemic disease. Early detection is essential, as retinal microvascular pathology not only reflects systemic health but, in certain conditions, can be detrimental to vision. Therefore, clinical evaluation requires a combination of ocular-specific strategies and a focus on underlying metabolic risk factors. As screening techniques advance, integrating assessment of the ocular microcirculation into broader cardiovascular care may become increasingly valuable.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopausal Hormone Therapy and Cardiovascular Risk: Current Evidence and Treatment Recommendations.","authors":"Ashwin A Pillai, Aryan Mehta, Shea-Lee Godin, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001464","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001464","url":null,"abstract":"<p><p>In 2025, the US Food and Drug Administration (FDA) removed its prior class-wide boxed warnings for menopausal hormone therapy (MHT), paving the way for increased clinical use. Menopause accelerates cardiovascular risk independently of chronological aging, manifesting as a 7.5% increase in carotid-femoral pulse wave velocity within 1 year and a hypertension prevalence of 66.6% in women aged 55-64 years. Risk stratification for MHT hinges on the timing of initiation and the administered formulation. The 2025 Women's Health Initiative secondary analysis suggests that in symptomatic women aged 50-59 years, combination (estrogen-progestogen) MHT maintains atherosclerotic neutrality while reducing vasomotor symptoms by 59%. Conversely, atherosclerotic risk increases in women aged 70-79 years (hazard ratio 3.22 for combined therapy). Route of administration dictates the metabolic effect: oral estrogens undergo hepatic first-pass metabolism, elevating venous thromboembolism risk and increasing triglycerides by 5-15%, whereas transdermal formulations bypass hepatic first-pass metabolism, decrease triglycerides by 5-30%, and carry a neutral thromboembolic risk profile. When concurrent progestogen therapy is required, natural micronized progesterone is favored over synthetic medroxyprogesterone acetate to preserve estrogen-mediated vascular benefits. Oral or transdermal systemic MHT can be considered for vasomotor symptom management in women <60 years or within 10 years of menopause with a 10-year atherosclerotic cardiovascular disease risk of <5% and a coronary artery calcium score of zero.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"StrokeNet Thrombectomy Endovascular Platform (STEP): A Catalyst for Stroke Research: Retraction.","authors":"Chaitanya B Medicherla, Amr Salem, Vikalpa Dammavalam, Eris Spirollari, Ankita Jain, Ariel Sacknovitz, Stephan A Mayer, Chirag D Gandhi, Fawaz Al-Mufti","doi":"10.1097/CRD.0000000000001371","DOIUrl":"10.1097/CRD.0000000000001371","url":null,"abstract":"","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"462"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Therapy as a Treatment for Valvular Aortic Stenosis: A Review.","authors":"Nermeen Kidwai, William H Frishman","doi":"10.1097/CRD.0000000000000810","DOIUrl":"10.1097/CRD.0000000000000810","url":null,"abstract":"<p><p>Calcific aortic stenosis is the most common form of aortic stenosis, and offers a poor prognosis in affected patients. Current treatment methods for aortic stenosis, including open surgical aortic valve repair and transcatheter aortic valve replacement, are invasive, and require the patient to undergo open-heart surgery with cardiopulmonary bypass. Ultrasound therapy offers a potential solution for patients ineligible for traditional surgical treatment. Noninvasive ultrasound therapy allows for decalcification of aortic valves without open sternotomy or cardiopulmonary bypass. This article reviews the use of ultrasound therapy for aortic stenosis, including this newer method of noninvasive ultrasound therapy.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"445-450"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Oral Anticoagulants Exhibit Lower Risks of Mortality and Bleeding Compared to Vitamin K Antagonists in Atrial Fibrillation Patients on Chronic Hemodialysis: A Systematic Review and Meta-Analysis.","authors":"Aman Goyal, Surabhi Maheshwari, Laveeza Fatima, Binish Javed, Sawai Singh Rathore, Gauranga Mahalwar","doi":"10.1097/CRD.0000000000000713","DOIUrl":"10.1097/CRD.0000000000000713","url":null,"abstract":"<p><p>This meta-analysis aimed to assess the outcomes of patients with atrial fibrillation undergoing chronic hemodialysis, comparing the effectiveness of direct oral anticoagulants (DOACs) and vitamin K antagonists. A systematic search was conducted across various databases including PubMed, Embase, and Google Scholar. Efficacy outcomes focused on the risk of stroke and mortality, whereas safety outcomes assessed the risk of bleeding. Review Manager generated forest plots for data synthesis. Statistical significance was set at P < 0.05, and random-effects models were used. Subgroup analysis identified the sources of heterogeneity. Nine studies met the inclusion criteria for the final analysis. The risk of all-cause stroke [risk ratio (RR): 0.64; 95% confidence interval (CI): 0.51-0.81; P = 0.0001; I2 = 0%], ischemic stroke (RR: 0.53; 95% CI: 0.29-0.96; P = 0.04; I2 = 0%), all-cause mortality (RR: 0.73; 95% CI: 0.60-0.88; P = 0.001; I2 = 71%), major bleeding (RR: 0.63; 95% CI: 0.52-0.76; P < 0.00001; I2 = 44%), gastrointestinal bleeding (RR: 0.67; 95% CI: 0.53-0.85; P = 0.0009; I2 = 36%), intracranial hemorrhage (RR: 0.57; 95% CI: 0.38-0.84; P = 0.004; I2 = 0%) were lower in the DOAC group compared with the vitamin K antagonist group. The risk of cardiovascular-related death (RR: 1.34; 95% CI: 0.69-2.60; P = 0.39; I2 = 0%), clinically relevant nonmajor bleeding (RR: 0.90; 95% CI: 0.75-1.08; P = 0.26; I2 = 28%), and hemorrhagic stroke (RR: 0.36; 95% CI: 0.06-2.24; P = 0.28; I2 = 10%) showed no significant differences. In conclusion, the risks of all-cause stroke, ischemic stroke, all-cause mortality, major bleeding, gastrointestinal bleeding, and intracranial hemorrhage in patients with atrial fibrillation undergoing chronic hemodialysis were lower in the DOAC group.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"426-434"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Perioperative Acute Myocardial Ischemia Following Coronary Artery Bypass Grafting.","authors":"Ritika Kompella, Haris Patail, Tanya Sharma, Syed Abbas Haidry, William Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000000716","DOIUrl":"10.1097/CRD.0000000000000716","url":null,"abstract":"<p><p>Surgical revascularization and coronary artery bypass grafting are often pursued as treatment for obstructive coronary artery disease. Despite trends of increased referrals for complex percutaneous coronary intervention, surgical revascularization often remains the standard of care for patients with multivessel or complex coronary artery disease. Myocardial ischemia during the perioperative and postoperative periods during coronary artery bypass grafting remains a challenge. Nuanced consideration is necessary to decide on interventions that include conservative management and percutaneous or repeat surgical revascularization.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"435-444"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Perspectives in The Management of Paroxysmal Atrial Fibrillation: Dual AntiArrhythmic Medications.","authors":"Safa Al-Jammali, Rana Al-Zakhari, Arun Umesh Mahtani, Nidal Isber","doi":"10.1097/CRD.0000000000000738","DOIUrl":"10.1097/CRD.0000000000000738","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice projected to affect 12.1 million individuals by the year 2030. Patients who are diagnosed with AF have an increased risk of morbidity and mortality. Although catheter ablation is a class I treatment recommendation in patients with symptomatic paroxysmal AF, antiarrhythmic medications (AAM) continue to be the mainstay of treatment in limited resource settings not offering ablation procedures. Currently, the most used AAMs are those which block either the sodium or potassium channels. We hypothesized that the use of selective dual AAM (sodium and potassium channel blockers) (DAAM) improves the chance of maintaining sinus rhythm and decreases the need for catheter ablation when compared with single AAM (SAAM). This retrospective observational study was conducted in 150 patients with paroxysmal AF over 5 years at Richmond University Medical Center in Staten Island, New York. The following data were collected: age, sex, comorbidities, electrocardiogram findings, ejection fraction by echocardiography, classes of AAM, duration, and response to treatments. The primary endpoint included the absence of symptoms and maintenance of sinus rhythm. The secondary endpoint included the requirement of electrical cardioversion or catheter ablation. A total of 86 patients met the inclusion criteria in our analysis. The average age of the patients was 71.06 years (SD = 7.66). About 45 patients were given DAAM of either amiodarone + flecainide or dronedarone + flecainide and were treated for an average of 15.4 months, followed by catheter ablation, if needed. Also, 41 patients received a SAAM followed by catheter ablation, if needed. A Mann-Whitney test indicated that electrical cardioversion and catheter ablation were greater for the SAAM group (Md = 1) than for the DAAM group (Md = 0) (U = 294.00, P value <0.001; U = 507.00, P value <0.001, respectively). No pro-arrhythmic side effects or death were encountered in either group. Treatment of paroxysmal AF with DAAM is effective compared with SAAM and is less likely to need catheter ablation or electrical cardioversion. Well-designed prospective studies are needed to further explore the use of DAAM in the management of paroxysmal AF and its clinical impact in limited resource settings.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"457-461"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' Statement of Retraction.","authors":"","doi":"10.1097/CRD.0000000000001374","DOIUrl":"10.1097/CRD.0000000000001374","url":null,"abstract":"","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"463"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435113","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}