Cardiology in Review最新文献

{"title":"Coronary Stent Infection: A Systematic Review of Literature.","authors":"Syed Ahmed Salahuddin Ayyubi, Ayesha Rehman, Laveeza Fatima, Muhammad Ahmed, Mahboob Ur Rehman, Rabia Zameer, Jahanzeb Malik","doi":"10.1097/CRD.0000000000000631","DOIUrl":"10.1097/CRD.0000000000000631","url":null,"abstract":"<p><p>Coronary stent infection is a rare yet serious complication of coronary artery stenting, with potentially significant morbidity and mortality. This systematic review aimed to comprehensively assess the available evidence on the diagnosis, management, and outcomes of coronary stent infection. A comprehensive search of electronic databases, including PubMed, Embase, Cochrane Library, and Scopus, was conducted from inception until March 2023, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 1 case series and 41 case reports, covering a cumulative sample size of 44 patients, were included in the analysis. The predominant stent types were drug-eluting stents in 22 studies, bare-metal stents in 3 studies, and a combination of drug-eluting stents and bare-metal stents in 4 studies. Staphylococcus aureus was the predominant identified organism in microbiological profiles. Primary outcomes, including mortality, morbidity, and recurrence rates, were evaluated. The aggregate mortality rate across studies was 18%, underscoring the severity of coronary stent infections. Morbidity ranged from 3% to 60%, with a spectrum of complications such as sepsis, heart failure, and embolic events. Recurrence rates varied from 3% to 33%, emphasizing the importance of effective management. Treatment strategies encompassed antibiotics alone, antibiotics with stent removal, and antibiotics with stent retention, with the duration of antibiotic therapy ranging from 2 weeks to 12 months. The optimal management strategy remains uncertain due to limited high-quality evidence. Early diagnosis and treatment were emphasized as critical factors in improving outcomes. Prophylactic antibiotics during stenting procedures and increased awareness among healthcare providers were suggested as preventive measures.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"272-278"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458082","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":"Transradial Access as an Innovative Approach for Endovascular Thrombectomy: A Living Systematic Review and Meta-Analysis.","authors":"Mohamed Elfil, Hazem S Ghaith, Ankita Jain, Eris Spirollari, Ariel Sacknovitz, Ahmed Elmashad, Mohammad Aladawi, Mohamed M Salem, Zaid Najdawi, Mohammad El-Ghanem, Priyank Khandelwal, Pascal Jabbour, Hosam Aljehani, Justin Santarelli, Chirag D Gandhi, Fawaz Al-Mufti","doi":"10.1097/CRD.0000000000000923","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000923","url":null,"abstract":"<p><p>Endovascular thrombectomy (EVT) is the standard treatment for acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). Transradial access (TRA) has emerged as an alternative to traditional transfemoral access (TFA), showing promise in reducing access-site complications. This systematic review and meta-analysis aim to comprehensively assess the procedural and clinical outcomes of TRA versus TFA for EVT in AIS-LVO patients. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we searched electronic databases for studies comparing TRA and TFA in EVT. Eligible studies, comprising 2138 patients, were analyzed for outcomes, including successful and complete recanalization, favorable functional outcomes [modified Rankin Scale (mRS) 0-2), access-to-perfusion time, first-pass reperfusion, mean number of passes, and complications. Risk of bias was assessed using the Newcastle-Ottawa Scale and Risk of Bias Assessment tool-2. Both TRA and TFA groups demonstrated comparable rates of successful recanalization, complete recanalization, and favorable functional outcomes at 90 days. Procedural metrics, including first-pass reperfusion, mean number of passes, and access-to-perfusion time, showed no statistically significant differences between the 2 approaches. TRA exhibited fewer access-site complications, but rates of symptomatic intracranial hemorrhage were similar. This meta-analysis suggests that TRA is a safe and non-inferior alternative to TFA for EVT in AIS-LVO patients, potentially reducing access-site complications. However, caution is needed due to the observational nature of most studies. Future randomized trials are essential to provide robust evidence for the comparative efficacy of TRA and TFA, addressing anatomical variations and procedural nuances.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959616","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":"FlowTriever System for Pulmonary Embolism: A Review of Clinical Evidence.","authors":"David Haner Wasserstein, William H Frishman","doi":"10.1097/CRD.0000000000000605","DOIUrl":"10.1097/CRD.0000000000000605","url":null,"abstract":"<p><p>Pulmonary embolism (PE) is a significant cause of cardiovascular mortality, and its incidence has been increasing due to the growing aging population. Systemic or catheter-directed thrombolytic treatment for PE has an increased risk of bleeding that may offset the benefit in some patients. Mechanical thrombectomy devices such as the FlowTriever System are designed to resolve vascular occlusion and correct ventilation-perfusion mismatch without the need for thrombolytic drugs. This review covers the FlowTriever system, clinical data from the FlowTriever Pulmonary Embolectomy Clinical Study, FlowTriever for Acute Massive Pulmonary Embolism, and FlowTriever All-comer Registry for Patient Safety and Hemodynamics trials, and real-world experiences, demonstrating its safety and effectiveness in treating intermediate-risk and high-risk PE. Additionally, we explore off-label uses of the FlowTriever System for various large vessel thromboses.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"199-201"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71420974","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":"Mental Health Sequelae of Cardiac Events: A Comprehensive Review of Biological Mechanisms, Prevalence, and Interdisciplinary Care Approaches.","authors":"Oisharja Fardeen Oishe, Sadia Islam, Parisa Pakrad, Rahul Chikatimalla, Rohit Jain","doi":"10.1097/CRD.0000000000000924","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000924","url":null,"abstract":"<p><p>Cardiovascular diseases are the leading cause of mortality worldwide, with postcardiac events such as myocardial infarction, acute coronary syndrome, and sudden cardiac arrest causing significant physiological trauma and psychological effects. This study explores the complex interplay between cardiac events and mental health disorders, focusing on the biological and psychological pathways that connect these conditions in at-risk populations. The acute stress response following a cardiac event involves the activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, leading to the release of stress hormones and inflammatory cytokines. Prolonged activation of these systems can result in neurotransmitter imbalances, neuroinflammation, and epigenetic modifications, increasing the susceptibility to mental health disorders such as depression, anxiety, and posttraumatic stress disorder (PTSD). Women exhibit a higher vulnerability to these conditions due to hormonal fluctuations and a more pronounced stress response. The prevalence of mental health disorders following cardiac events is substantial, with PTSD rates being particularly high among survivors of myocardial infarction and out-of-hospital cardiac arrest. These psychological conditions are associated with poor physical recovery, reduced quality of life, and an increased risk of recurrent cardiac events and mortality. Resilience and adaptive coping mechanisms serve as protective factors, highlighting the importance of integrating mental health care within cardiac rehabilitation programs. This study emphasizes the need for early detection, targeted interventions, and an interdisciplinary approach to improve mental health outcomes in patients recovering from cardiac incidents. Understanding the psychiatric sequelae of cardiac events is crucial for cardiologists, particularly in the management of postmyocardial infarction patients, ischemic attack survivors, and individuals undergoing open-heart surgery. Early detection and interdisciplinary interventions can improve long-term outcomes.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062424","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":"Semaglutide in Patients with Obesity and Heart Failure Irrespective of Their Baseline Ejection Fraction: An Efficacy and Safety Meta-analysis of Randomized Controlled Trials.","authors":"Zina Otmani, Hazem Ayman Elsayed, Mazen Negmeldin Aly Yassin, Mohamed Jalil Saihi, Mohamed A Aldemerdash, Ahmad Alzawahreh, Amr Hassan, Farouq Bahaa Alahmed, Ahmed R Gonnah, Ahmed Abdelaziz","doi":"10.1097/CRD.0000000000000925","DOIUrl":"https://doi.org/10.1097/CRD.0000000000000925","url":null,"abstract":"<p><p>Obesity in heart failure (HF) patients often experience a significant burden of symptoms and physical limitations. Semaglutide, a glucagon-like peptide 1 receptor agonist, has a beneficial impact on cardiovascular outcomes in obese patients, but its role in patients with HF remains unclear. In our meta-analysis, we aimed to evaluate the safety and efficacy of semaglutide in obese HF patients. Five databases were searched from inception to August 2024 to identify randomized controlled trials (RCTs) that compared semaglutide to placebo in obese patients with HF regardless of the baseline ejection fraction (EF). Our primary outcome was the incidence of cardiovascular (CV) mortality. We performed a main subgroup analysis based on the ejection fraction [heart failure with preserved ejection fraction (HFpEF) and HF with reduced EF (HFrEF)]. Five RCTs with a total of 6898 patients were included in our meta-analysis. Semaglutide significantly reduced the overall incidence of CV mortality compared with placebo [risk ratio (RR), 0.74; 95% confidence interval (CI), 0.58-0.94; P = 0.02]. Similar rates were observed in HFrEF patients (RR, 0.66; 95% CI, 0.47-0.92; P = 0.01), without difference in HFpEF patients (RR, 0.84; 95% CI, 0.59-1.22; P = 0.37). Moreover, semaglutide demonstrated a positive impact on KCCQ-CSS [mean difference (MD), 7.72; 95% CI, 5.28-10.17; P < 0.001] and 6-minute walk test (MD, 14.83; 95% CI, 4.23-25.43; P = 0.006) compared with placebo. Semaglutide exhibited a significant reduction in CV mortality and improvement in the Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score and 6-minute walk distance. Long-term RCTs are warranted to validate the current findings in obese HF patients.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967036","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":"Influence of Plant-Based Diet on the Cardiovascular System: A Narrative Review.","authors":"Gurusha Jangid, Helen A O Popoola-Samuel, Kausalya Goda, F N U Anamika, Vasu Gupta, Sai Gautham Kanagala, Ripudaman Singh Munjal","doi":"10.1097/CRD.0000000000000613","DOIUrl":"10.1097/CRD.0000000000000613","url":null,"abstract":"<p><p>A plant-based diet (PBD) includes multiple dietary patterns such as vegetarianism, veganism, lacto-ovo-vegetarianism, etc. A well-balanced PBD has positive effects on body mass index, hyperlipidemia, and type 2 diabetes, and it is associated with decreased risk of cardiovascular diseases. Due to its high fiber content, which lowers levels of low-density lipoprotein cholesterol, high antioxidant content, which prevents capillary wall damage; the presence of polyunsaturated fatty acids, which have an anti-inflammatory effect, improvement in glucose homeostasis through improved insulin sensitivity, and impact on the gut microbiota, it has been proven to be beneficial for the heart. Despite their possible benefits, PBDs can be low in essential nutrients such as vitamin B12, zinc, vitamin D, iodine, and amino acids. This review aims to analyze the influence of PBDs on the cardiovascular system and associated disease progression.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"265-268"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41101468","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":"Methylxanthine Derivatives in the Treatment of Sinus Node Dysfunction: A Systematic Review.","authors":"Hunter R Roth, Justin P Reinert","doi":"10.1097/CRD.0000000000000609","DOIUrl":"10.1097/CRD.0000000000000609","url":null,"abstract":"<p><p>While the chronotropic effects of theophylline and aminophylline are well-known, their clinical application in the treatment of sinus node dysfunction has not been established in a review. The purpose of this systematic review is to evaluate the efficacy and safety of methylxanthines in the treatment of bradyarrhythmias associated with sinus node dysfunction. A systematic review was conducted in accordance with PRISMA guidelines on Embase, PubMed, MEDLINE, Cochrane Central, Web of Science, SciELO, Korean Citation Index, Global Index Medicus, and CINAHL through June 2023. A total of 607 studies were identified through the literature search. After applying the inclusion and exclusion criteria, 14 studies were included in this review. The causes of bradyarrhythmias involving the sinoatrial node included acute cervical spinal cord injury, coronavirus disease of 2019, carotid sinus syncope, chronotropic incompetence, heart transplant, and chronic sinus node dysfunction. Theophylline and aminophylline were shown to be effective for increasing heart rate and reducing the reoccurrence of bradyarrhythmias. The data on symptom resolution was conflicting. While many case studies reported a resolution of symptoms, a randomized controlled trial reported no significant difference in symptom scores between the control, theophylline, and pacemaker groups in the treatment of sick sinus syndrome. The incidence of adverse effects was low across all study designs. The data suggests methylxanthines may be useful as an alternative or bridge to nonpharmacologic pacing; however, dosing has yet to be established for various indications. Overall, methylxanthines proved safe and effective as a pharmacologic therapy for bradyarrhythmic manifestations of sinus node dysfunction.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"246-255"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71420987","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":"Mechanism of Ion Channel Impairment in the Occurrence of Arrhythmia in Patients with Hypertrophic Cardiomyopathy.","authors":"Ke Zhang, Shengwei Wang, Xiaoyan Li, Hao Cui, Yongqiang Lai","doi":"10.1097/CRD.0000000000000612","DOIUrl":"10.1097/CRD.0000000000000612","url":null,"abstract":"<p><p>Sudden cardiac death is the most unpredictable and devastating consequence of hypertrophic cardiomyopathy, most often caused by persistent ventricular tachycardia or ventricular fibrillation. Although myocardial hypertrophy, fibrosis, and microvascular disorders are the main mechanisms of persistent reentrant ventricular arrhythmias in patients with advanced hypertrophic cardiomyopathy, the cardiomyocyte mechanism based on ion channel abnormalities may play an important role in the early stages of the disease.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"260-264"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41109139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline High-Sensitivity C-Reactive Protein as a Predictor of Adverse Clinical Events in Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Meta-Analysis.","authors":"Shanshan Yang, Yuxiang Pan, Wan Zheng","doi":"10.1097/CRD.0000000000000604","DOIUrl":"10.1097/CRD.0000000000000604","url":null,"abstract":"<p><p>Inflammation in patients with coronary artery disease (CAD) has been linked to adverse clinical outcomes. A useful biomarker for measuring inflammation levels, high-sensitivity C-reactive protein (hs-CRP) in the blood can be used to detect the presence of low-grade inflammation. This study sought to assess the predictive value of baseline hs-CRP levels for adverse clinical events in CAD patients undergoing percutaneous coronary intervention (PCI). To investigate this topic, a meta-analysis was performed. We conducted a systematic search of PubMed, Embase, and the Cochrane Library for original articles reporting the correlation between hs-CRP levels and adverse clinical events in CAD patients undergoing PCI. We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and conducted a meta-analysis by extracting relevant data. Our pooled calculations yielded hazard ratios or odds ratios with 95% confidence intervals. A total of 28 studies comprising 60544 patients were included in this analysis. High baseline hs-CRP levels predicted increased risk for major adverse cardiac events ( P = 0.037), major adverse cardiac and cerebrovascular events ( P = 0.020), all-cause mortality ( P = 0.001), cardiovascular mortality ( P < 0.001), death and/or myocardial infarction ( P = 0.017) in patients, as well as restenosis ( P < 0.001). However, there was no association between elevated baseline hs-CRP levels and thrombosis. In conclusion, in CAD patients undergoing PCI, baseline hs-CRP levels are reliable predictors of major adverse cardiac events, major adverse cardiac and cerebrovascular events, all-cause mortality, cardiovascular mortality, death and/or myocardial infarction, and restenosis. Therefore, hs-CRP can effectively assist in prognosis determination for CAD patients undergoing PCI.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"227-238"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41092744","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":"Artificial Intelligence in the Prevention and Detection of Cardiovascular Disease.","authors":"Harris Z Whiteson, William H Frishman","doi":"10.1097/CRD.0000000000000606","DOIUrl":"10.1097/CRD.0000000000000606","url":null,"abstract":"<p><p>For more than 60 years, artificial intelligence (AI) has served as a mainstay in augmenting and assisting the lives of individuals across a wide array of interests and professional fields. Functioning to create deep computer simulations, analyze data, solve problems, and synthesize human behavior/emotion, AI has recently become a topic of popular interest in many fields of medicine. Despite decades of usage, modern AI-and its newer branch of machine learning (ML)-have yet to find a fully established and regulated niche in medicine. Understanding the clinical implications that AI and ML might be able to play in cardiovascular medicine, studies have sought to understand and compare how this technology compares with human rationality and diagnostics. Utilizing AI and ML in an array of cardiovascular medical techniques, analyses, and predictive measurements seems to have produced accurate results while also saving healthcare providers time and enabling them to expand their reach to further populations. Although current research and literature might hypothesize AI's potential clinical applications, it is nearly impossible to fully understand the breadth and scope that this new technology can play in the future. In this article, we attempt to analyze a few of the potential applications of AI and ML for the detection, prevention, and treatment of cardiovascular disease. Additionally, we discuss how AI might make cardiovascular care more equitable and highlight a few precautions for utilizing this technology.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"239-242"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41232568","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}