{"title":"Supersaturated Oxygen Therapy in Acute Myocardial Infarction: Mechanisms, Efficacy, and Future Direction.","authors":"Uttam Kalluri, William Frishman","doi":"10.1097/CRD.0000000000000997","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000997","url":null,"abstract":"<p><p>Supersaturated oxygen (SSO2) therapy is a treatment modality that is gaining further attention and consideration for patients with coronary artery disease (CAD). SSO2 therapy is meant to be utilized as an adjuvant therapy with primary percutaneous coronary intervention to treat CAD. Animal models, particularly swine models, have been invaluable in demonstrating the potential benefits SSO2 therapy holds for treating CAD and myocardial infarction. Some trials have also demonstrated the benefit SSO2 therapy offers for patients with anterior ST-segment elevation myocardial infarction. One serious consideration while using SSO2 therapy is the potential for free radical production, which can further damage already compromised tissue. Although free radical production can stymie tissue healing, various pharmacological therapies can attenuate their effects, making SSO2 therapy with percutaneous coronary intervention a treatment modality that deserves serious consideration for further investigation and utility in clinical practice.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706420","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}
Syed Sarmad Javaid, Muhammad Adil Obaid, Tooba Noor, Musaddiq Kaleem, Areej Shakil, Shajee Ul Haque, Numra Abbasi, Emaan Saeed, Sadia Manan, Khadija Alam, Owais Gul, Fatima Anwer
{"title":"Impact of Continuous Positive Airway Pressure on Cardiovascular Health in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis.","authors":"Syed Sarmad Javaid, Muhammad Adil Obaid, Tooba Noor, Musaddiq Kaleem, Areej Shakil, Shajee Ul Haque, Numra Abbasi, Emaan Saeed, Sadia Manan, Khadija Alam, Owais Gul, Fatima Anwer","doi":"10.1097/CRD.0000000000001004","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001004","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is a growing health concern affecting nearly 1 billion people worldwide. Untreated OSA heightens the risk of cardiovascular (CV) complications. This meta-analysis aims to evaluate the effectiveness of continuous positive airway pressure (CPAP) in preventing adverse CV outcomes as compared with placebo or standard care in OSA patient Google Scholar, PubMed and Scopus databases were systematically searched from inception until March 2023. The outcomes of interest were major adverse CV events (MACE), all-cause mortality, CV mortality, stroke, unstable angina, new-onset atrial fibrillation (AF), myocardial infarction (MI), and hospitalization for heart failure (HF). A total of 9 361 participants from 9 randomized controlled trials and 6 observational studies were included in the analysis. Our meta-analysis reports that CPAP significantly reduces the risk of MACE [risk ratio (RR) = 0.69, 95% confidence interval (CI): 0.54-0.89] and CV mortality (RR = 0.53, 95% CI: 0.30-0.91) as compared with placebo or standard care in OSA patients. However, CPAP therapy did not show significant effects on specific CV conditions; unstable angina (RR = 1.20, 95% CI: 0.67-2.15), acute MI (RR = 0.95, 95% CI: 0.73-1.24), new-onset AF (RR = 0.89, 95% CI: 0.50-1.58), hospitalization for HF (RR = 0.83, 95% CI: 0.60-1.15), and stroke (RR = 0.89, 95% CI: 0.70-1.14). CPAP therapy significantly improves the MACE and CV mortality as compared with placebo or standard care in patients with OSA. However, no significant association was seen between CPAP and other CV outcomes, including unstable angina, MI, AF, HF hospitalization, and stroke.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688940","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}
Hadrian Hoang-Vu Tran, Audrey Thu, Anu Radha Twayana, Axel Fuertes, Marco Gonzalez, Maggie James, Krutagni Adwait Mehta, Marina Basta, William H Frishman, Wilbert S Aronow
{"title":"Targeting Corin and Furin in Hypertension and Heart Failure: A New Therapeutic Frontier in Cardiovascular Therapeutics.","authors":"Hadrian Hoang-Vu Tran, Audrey Thu, Anu Radha Twayana, Axel Fuertes, Marco Gonzalez, Maggie James, Krutagni Adwait Mehta, Marina Basta, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000000999","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000999","url":null,"abstract":"<p><p>Corin and furin are protetic enzymes central to the activation of natriuretic peptides (NPs), which regulate cardiovascular homeostasis. Recent insights suggest that disruptions in the Corin-Furin axis-via genetic polymorphisms, aberrant post-translational modifications, or disease-associated downregulation-contribute to the pathogenesis of hypertension, heart failure, and myocardial fibrosis. This study examines current challenges in enzymatic stability, pharmacodynamics, and delivery of corin- and furin-based therapies, emphasizing translational barriers and the need for precision medicine. We review preclinical models demonstrating the therapeutic promise of recombinant corin and furin inhibitors, as well as the limitations posed by species-specificity, short half-lives, and incomplete pharmacogenomic data. Multiomics platforms and systems biology approaches are highlighted as essential tools for identifying actionable targets, guiding patient stratification, and integrating corin genotyping into clinical care. Emerging strategies include engineered proteases, small-molecule modulators, and RNA-based interventions aimed at restoring proteolytic balance and enhancing NP signaling. While clinical application remains nascent, these findings underscore the therapeutic potential of targeting local NP-processing mechanisms. A comprehensive understanding of corin and furin function, regulation, and interactomes is critical for developing personalized interventions in cardiovascular disease.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658522","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}
Hall Zhang, Victoria Maksymiuk, William H Frishman, Wilbert S Aronow
{"title":"Potential Therapeutic Benefits of Glucagon-Like-Peptide-1 Agonists and Atrial Fibrillation.","authors":"Hall Zhang, Victoria Maksymiuk, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001003","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001003","url":null,"abstract":"<p><p>Glucagon-like peptide-1 (GLP-1) agonists, originally developed as a treatment for type 2 diabetes, have been increasingly shown to demonstrate benefits for patients within the realm of cardiovascular disease, such as patients with obesity and congestive heart failure. As rates of patients with these conditions climb, the prevalence of atrial fibrillation, one of the world's most common arrhythmias, has also increased. The goal of this literature review is to examine what, if any, links GLP-1 agonists may have in preventing or treating atrial fibrillation. To date, a number of meta-analyses have been conducted studying potential relationships between GLP-1 agonists and atrial fibrillation, but there has yet to be a randomized controlled trial fully exploring GLP-1's effects on atrial fibrillation.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658521","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}
Rimsha Ahmad, Syed Sadam Hussain, Saifullah Khan, Mahnoor Niaz, Mahesh Kumar, William Frishman, Wilbert S Aronow
{"title":"Apolipoprotein A-I Infusions in Coronary Artery Disease: A Systematic Review.","authors":"Rimsha Ahmad, Syed Sadam Hussain, Saifullah Khan, Mahnoor Niaz, Mahesh Kumar, William Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001002","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001002","url":null,"abstract":"<p><p>Coronary artery disease (CAD) is the leading cause of death globally. Apolipoprotein A-1 (apoA-1), the primary protein component of high-density lipoprotein (HDL), facilitates reverse cholesterol transport and has emerged as a potential therapeutic target. While pharmacologic efforts to raise HDL-C levels have failed to reduce cardiovascular events, focus has shifted to HDL functionality, particularly cholesterol efflux capacity (CEC). ApoA-1 infusions have demonstrated antiatherogenic effects in preclinical models and early human trials by enhancing CEC and promoting cholesterol clearance. This review summarizes the rationale and evolving clinical trial landscape investigating apoA-1 infusions as a novel therapy for CAD prevention and treatment.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648669","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}
Hadrian Hoang-Vu Tran, Audrey Thu, Anu Radha Twayana, Axel Fuertes, Marco Gonzalez, Marina Basta, Maggie James, Krutagni Adwait Mehta, William H Frishman, Wilbert S Aronow
{"title":"Orally Inhaled Flecainide for Paroxysmal Atrial Fibrillation: Emerging Evidence and Therapeutic Potential in Cardioversion to Sinus Rhythm.","authors":"Hadrian Hoang-Vu Tran, Audrey Thu, Anu Radha Twayana, Axel Fuertes, Marco Gonzalez, Marina Basta, Maggie James, Krutagni Adwait Mehta, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001000","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001000","url":null,"abstract":"<p><p>Atrial fibrillation (AF) remains the most common sustained arrhythmia, with a growing need for rapid, effective, and patient-centered rhythm control strategies. Inhaled flecainide, a novel formulation of a well-established class individual consideration antiarrhythmic, offers an innovative approach by utilizing the pulmonary route to achieve rapid systemic absorption and therapeutic onset. This review examines the clinical efficacy, safety, and practical implications of inhaled flecainide for the treatment of recent-onset paroxysmal AF. Data from the RESTORE-1 trial and related studies suggest that inhaled flecainide enables conversion to sinus rhythm within 30 minutes at reduced dosages, with fewer systemic side effects compared to intravenous therapies. The most commonly reported adverse events-cough and oropharyngeal discomfort-were transient and nonserious. Despite promising early results, challenges such as delivery device variability, long-term pulmonary safety, and regulatory hurdles remain. Advances in nebulizer technology and drug formulation, including 2-hydroxypropyl-beta-cyclodextrin complexes, aim to improve dosing consistency and therapeutic outcomes. Larger, controlled trials are needed to confirm efficacy, define optimal dosing, and support broader clinical adoption. Inhaled flecainide holds strong potential for use in both clinical and outpatient settings, offering a faster, safer, and more accessible alternative for rhythm control in AF.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648671","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}
Hadrian Hoang-Vu Tran, Audrey Thu, Anu Radha Twayana, Axel Fuertes, Marco Gonzalez, Marina Basta, Maggie James, Krutagni Adwait Mehta, William H Frishman, Wilbert S Aronow
{"title":"Coronary Sinus Reducer in Refractory Angina: A Targeted Approach to Microvascular Ischemia and Symptom Relief.","authors":"Hadrian Hoang-Vu Tran, Audrey Thu, Anu Radha Twayana, Axel Fuertes, Marco Gonzalez, Marina Basta, Maggie James, Krutagni Adwait Mehta, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001001","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001001","url":null,"abstract":"<p><p>Refractory angina remains a therapeutic challenge in patients with advanced coronary artery disease who are not amenable to further revascularization and remain symptomatic despite optimal medical therapy. The coronary sinus reducer (CSR) is a novel, device-based therapy that aims to alleviate angina by increasing coronary sinus pressure and redistributing blood flow toward ischemic myocardial territories, particularly in the subendocardial region. This article reviews current evidence on the comparative effectiveness of CSR relative to established pharmacologic and interventional therapies, with a focus on its potential role in patients with microvascular versus macrovascular ischemia. Data from randomized trials and real-world registries demonstrate significant symptomatic improvement and favorable safety outcomes in the majority of CSR-treated patients, though nonresponder rates remain between 15% and 30%. Emerging evidence suggests CSR may be particularly effective in patients with microvascular dysfunction, such as those with angina and no obstructive coronary artery disease. However, long-term efficacy, ideal patient selection criteria, and mechanistic underpinnings remain areas of ongoing investigation. Current and upcoming trials such as COSIRA-II (CSR for Treatment of RA) and REMEDY-PILOT (Reducing microvascular dysfunction in patients with angina, ischaemia, and unobstructed coronary arteries- a pilot study) aim to address these uncertainties. CSR represents a promising addition to the therapeutic landscape for refractory angina, particularly in complex or no-option cases, pending further clinical validation.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648670","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}
Amit Raizada, Manish A Parikh, William H Frishman, Stephen J Peterson
{"title":"The Significance of Premature Atrial Contractions in the Normal Heart.","authors":"Amit Raizada, Manish A Parikh, William H Frishman, Stephen J Peterson","doi":"10.1097/CRD.0000000000000986","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000986","url":null,"abstract":"<p><p>The incidence of premature atrial contractions (PAC) in a structurally normal heart can result in clinically significant consequences, including arrhythmias, increased risk of all-cause mortality, and the development of PAC-induced cardiomyopathy. In a patient with an otherwise normal heart, it is essential to consider the patient's age, the presence of symptoms, and the PAC frequency when deciding whether treatment is warranted and when to initiate it. This review aims to assess the clinical significance of PACs in a normal heart and discuss the optimal timing and strategy for treatment.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607446","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}
Maxwell Charlat, Elona Poltiyelova, Jesse Silverman, Aaron Lit, William H Frishman, Edward Lebovics
{"title":"Hypercholesterolemia of Cholestasis.","authors":"Maxwell Charlat, Elona Poltiyelova, Jesse Silverman, Aaron Lit, William H Frishman, Edward Lebovics","doi":"10.1097/CRD.0000000000000994","DOIUrl":"10.1097/CRD.0000000000000994","url":null,"abstract":"<p><p>Cholesterol is a lipid of widespread physiologic and pathologic importance, whose homeostasis is tightly regulated through multiple mechanisms, including transport via low-density lipoprotein. Elevated serum low-density lipoprotein strongly correlates with the development of atherosclerotic cardiovascular disease. Cholestatic liver diseases, such as primary biliary cholangitis (PBC), are associated with impaired cholesterol homeostasis. The pathophysiology of hypercholesterolemia of PBC involves defective hepatocyte cholesterol clearance, downregulation of bile synthesis, and increased cholesterogenesis. Lipoprotein X is a highly specific biomarker for cholestasis and, in rare cases, contributes to serum total cholesterol levels >1000 mg/dL. The extent of hypercholesterolemia in PBC is associated with worse liver-related outcomes; nevertheless, patients with PBC do not have increased risk for atherosclerotic cardiovascular disease. Cardiovascular risk stratification of patients with PBC is most accurately achieved by direct measurement of apolipoprotein B, the protein component of pro-atherosclerotic lipoproteins involved in cholesterol transport. First and second line therapies for the treatment of hypercholesterolemia in cholestatic liver disease are statins and proprotein convertase subtilisin/kexin type 9 inhibitors, respectively. Apolipoprotein B level should be rechecked periodically to measure therapeutic response.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607445","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}
Sangharsha Thapa, Sangam Shah, Madhur Bhattarai, Sajjad Ahmed Khan, Rachana Mehta, Sanjit Sah, Laxman Wagle, Swati Chand, Fawaz-Al Mufti, William H Frishman, Wilbert S Aronow
{"title":"Efficacy and Safety of Mechanical Thrombectomy in Acute Ischemic Stroke Secondary to Infective Endocarditis: A Systematic Review and Meta-Analysis.","authors":"Sangharsha Thapa, Sangam Shah, Madhur Bhattarai, Sajjad Ahmed Khan, Rachana Mehta, Sanjit Sah, Laxman Wagle, Swati Chand, Fawaz-Al Mufti, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000000996","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000996","url":null,"abstract":"<p><p>Acute ischemic stroke caused by infective endocarditis (IE) represents a critical and complex clinical scenario, often resulting from septic emboli leading to large vessel occlusion. While mechanical thrombectomy (MT) has become standard therapy for acute ischemic stroke in the general population, its role in the context of IE remains controversial due to heightened concerns regarding hemorrhagic transformation and procedural safety. To better understand the outcomes of MT in this high-risk population, we conducted a systematic review and meta-analysis comparing MT in patients with IE-related stroke to those with non-IE stroke etiologies. Three studies comprising a total of 132 patients with IE-related stroke and 381 patients with non-IE stroke were analyzed. Our results demonstrate that patients with IE-related stroke undergoing MT had significantly lower odds of successful recanalization and favorable functional outcomes, and a markedly higher risk of all-cause mortality. Specifically, successful recanalization was achieved less frequently [odds ratio (OR), 0.50; 95% confidence interval (CI), 0.29-0.84], and the rate of favorable outcomes (modified Rankin Scale 0-2) was lower (risk ratio, 0.63; 95% CI, 0.40-0.99). Mortality was significantly increased in the IE group (OR, 2.09; 95% CI, 1.11-3.92). These findings suggest that while MT may still offer a potential benefit in select cases, its overall outcomes in IE-related stroke are less favorable compared with other stroke etiologies. Caution is warranted when considering MT in this setting, and further prospective studies are needed to guide clinical decision-making.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599529","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}