Cardiology in Review最新文献

{"title":"A Thorough Literature Review of the Potential Benefits and Drawbacks of Long-Term Aspirin Use for the Primary Prevention of Cardiovascular Disease.","authors":"Abdalhakim R M Shubietah, Monica Pernia Marin, Islam M Rajab, Majd H Oweidat, Alaa Zayed, Alaa Hmeedan","doi":"10.1097/CRD.0000000000000722","DOIUrl":"10.1097/CRD.0000000000000722","url":null,"abstract":"<p><p>This article examines the role of aspirin in the primary prevention of cardiovascular disease. It highlights findings from major studies such as ASPREE (ASPirin in Reducing Events in the Elderly), ARRIVE (Aspirin to Reduce Risk of Initial Vascular Events), and ASPREE-XT (ASPirin in Reducing Events in the Elderly - eXTension), among others. The review focuses on aspirin's role in primary prevention for specific populations including older adults, diabetics, hypertension patients, rheumatoid arthritis patients, kidney transplant recipients, and those with specific lipoprotein(a) genotypes, among other groups. We review these studies, noting aspirin's role in reducing events such as myocardial infarctions and its potential for increasing bleeding risks. The review also considers the implications for patients with kidney disease, referencing the Chronic Renal Insufficiency Cohort (CRIC) study and the International Polycap Study-3 (TIPS-3) trial. Additionally, it addresses the shifting paradigms in guidelines from the US Preventive Services Task Force and other entities, underscoring the importance of individualized aspirin use by balancing benefits against bleeding risks. The article further explores the concept of platelet reactivity, discusses strategies for improving adherence to aspirin therapy, and identifies existing research gaps, such as the phenomenon of aspirin resistance. It concludes by suggesting potential areas for future investigation to enhance understanding and application of aspirin in cardiovascular disease prevention.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"541-554"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086892","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":"Staged Versus Concomitant TAVI and PCI for the Treatment of Coexisting Aortic Stenosis and Coronary Artery Disease.","authors":"Manasi Mahesh Shirke, William Wang, Joseph Welch, Farqhan Faisal, Dang Nguyen, Amer Harky","doi":"10.1097/CRD.0000000000000712","DOIUrl":"10.1097/CRD.0000000000000712","url":null,"abstract":"<p><p>Aortic stenosis (AS) is one of the most common valvular pathologies. Severe coronary artery disease (CAD) often coexists with AS. Transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) have been established as alternatives to open surgical interventions. The data on the timing for the treatment of the 2 conditions are scarce and depend on multiple factors. This review compares the clinical outcomes of the concomitant versus staged PCI and TAVI for the treatment of AS and CAD. A systematic, electronic search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to identify relevant articles that compared outcomes of the staged versus concomitant approaches for the TAVI and PCI. Seven studies were included involving 3745 patients. We found no statistically significant difference in primary outcomes such as 30-day mortality [odds ratio (OR) = 0.78; 95% confidence interval (CI): 0.39-1.57] and secondary outcomes including length of hospital stay (mean difference = -4.74, 95% CI: -10.96 to 1.48), new-onset renal failure (OR = 0.83, 95% CI: 0.22-3.13), cerebrovascular accidents (OR = 1.28, 95% CI: 0.64-2.57), and intraoperative blood loss (OR = 0.83, 95% CI: 0.32-2.12). New pacemaker insertion was statistically significant in favor of the concomitant approach (OR = 0.78, 95% CI: 0.63-0.96). This analysis suggests that while the 2 approaches are largely comparable in terms of most outcomes, patients at risk of requiring a pacemaker postprocedure may benefit from a concomitant approach. In conclusion, concomitant TAVI + PCI approach is nonsuperior to the staged approach for the treatment of CAD and AS. This review calls for robust trials in the field to further strengthen the evidence.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"476-482"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956585","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 Heart Failure With Preserved Ejection Fraction: Exploring Recent Evidence in Therapeutic Potential for the Obese Population.","authors":"Josef Kusayev, Yisrael Levy, David Weininger, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000000726","DOIUrl":"10.1097/CRD.0000000000000726","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) is an increasingly prevalent condition, particularly among the aging population in the United States, and is associated with significant challenges due to its complex pathophysiology and limited therapeutic options. Historically, few pharmacological therapies have successfully mitigated HFpEF, making the emergence of effective treatments particularly significant. This review evaluates recent evidence on the therapeutic potential of semaglutide for managing HFpEF, especially in the obese population. Results from the STEP-HFpEF and STEP-HFpEF DM trials demonstrate that semaglutide, a glucagon-like peptide-1 receptor agonist originally developed for type 2 diabetes but now also approved for obesity treatment, significantly improves clinical outcomes such as symptom scores, body weight, exercise capacity, and inflammation markers in the obese population suffering from HFpEF. These improvements are attributed to both the weight loss induced by semaglutide and its direct effects on the congestive pathophysiology of HFpEF. The efficacy of semaglutide offers new hope for addressing a condition that has long lacked effective pharmacological interventions.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"465-469"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956583","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":"Role of Colchicine in Cardiovascular Disorders.","authors":"Errol Moras, Lakshmi Subramanian, Francisco Romeo, Kruti Gandhi, Sivaguha Yadunath Prabhakaran, Adlyn Moras, Chayakrit Krittanawong, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000000723","DOIUrl":"10.1097/CRD.0000000000000723","url":null,"abstract":"<p><p>Inflammation has played a pivotal role in atherosclerosis and other cardiovascular disorders, prompting the exploration of anti-inflammatory therapies to improve cardiovascular outcomes. Colchicine, a well-established agent in conditions such as gout and familial Mediterranean fever, has emerged as a promising novel anti-inflammatory agent in the realm of cardiovascular diseases. Its ability to target both traditional risk factors and residual inflammatory risk marks a significant advancement in cardiovascular prevention strategies, indicating a new era in cardiovascular care. Landmark trials have supported the efficacy and safety of low-dose colchicine in reducing major adverse cardiovascular events when combined with standard therapies. In addition, its endorsement by major cardiovascular societies underscores its significance as the first targeted anti-inflammatory therapy for cardiovascular disease. However, careful monitoring for drug interactions and adverse effects, particularly on kidney and liver function, is essential for safe use. In this review, we aim to comprehensively summarize the mechanisms of action of colchicine, its molecular and biochemical targets in various cardiovascular conditions, and its pharmacokinetics, and delve deeply into the existing evidence on its safety and efficacy in the treatment of cardiovascular disorders, including coronary artery disease, pericarditis, atrial fibrillation, and heart failure.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"555-565"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944103","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":"Comparison of Outcomes Between Right and Left Upper Extremity Access in Endovascular Aortic Repair for Patients with Thoracoabdominal and Abdominal Aortic Aneurysms: A Systematic Review and Meta-Analysis.","authors":"Aman Goyal, Laveeza Fatima, Hritvik Jain, Muhammad Daoud Tariq, Fiza Mushtaq, Mahammed Z Khan Suheb, Eileen Lu, Rozi Khan, Amir Humza Sohail","doi":"10.1097/CRD.0000000000000734","DOIUrl":"10.1097/CRD.0000000000000734","url":null,"abstract":"<p><p>Traditionally, left-sided upper extremity (LUE) access has been preferred in patients undergoing endovascular aortic repair (EVAR) to manage aortic aneurysms and decrease the risk of cerebrovascular adverse events. Recently, right-sided upper extremity access (RUE) has gained popularity owing to its greater maneuverability and ergonomics. However, synthesized data comparing the safety and efficacy of RUE and LUE accesses are limited. A comprehensive literature search was conducted on various databases from inception to September 2023 to retrieve all studies that compared RUE and LUE access in EVAR. Data on stroke, 30-day mortality, technical success, access-site complications, total time required for fluoroscopy, and contrast agent requirement were extracted, pooled, and analyzed. Forest plots were generated using a random-effects model on review manager by pooling the risk ratios (RRs) and standard mean differences (SMDs). Ten observational studies with a total of 3994 patients were included in our analysis with 1186 patients in the RUE and 2808 patients in the LUE access groups. EVAR using RUE access was associated with a significantly lower amount of contrast agent requirement than the LUE access group [SMD, -0.23; 95% confidence interval (CI), -0.45 to -0.02; P = 0.03]. There was no significant difference between the 2 groups in terms of the risk of stroke (RR, 1.62; 95% CI, 0.81-3.22; P = 0.17), 30-day mortality (RR, 1.42; 95% CI, 0.50-4.06; P = 0.51), rate of technical success (RR, 0.98; 95% CI, 0.95-1.01; P = 0.18), risk of access-site complications (RR, 1.00; 95% CI, 0.72-1.39; P = 0.99), and total time required for fluoroscopy (SMD, 0.07; 95% CI, -0.39 to 0.26; P = 0.69). The use of RUE access in EVAR appears to be comparable to LUE access in terms of the risk of stroke, access-related complications, all-cause mortality, technical success rate, and fluoroscopy duration. The RUE group required a lower volume of contrast agent.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"496-502"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174824","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":"High-Sensitivity Cardiac Troponin Assays in Acute Heart Failure, Moving Beyond Myocardial Infarction.","authors":"Abhishek Kumar, Manisha Gupta, Muneshwar Kumar, Amratansh Varshney","doi":"10.1097/CRD.0000000000000732","DOIUrl":"10.1097/CRD.0000000000000732","url":null,"abstract":"<p><p>Cardiac troponins are essential structural proteins found in the contractile apparatus of cardiac myocytes. During myocardial damage, such as in myocardial infarction (MI), these troponins are released into the bloodstream. As a result, they play a central role in the diagnosis of MI, serving as sensitive and specific markers for cardiac injury. Earlier assays that were used for measuring troponin levels were considered as a dichotomous test, categorizing patients as being positive or negative for MI. The recent introduction of high-sensitivity cardiac troponin assays has revolutionized cardiac troponin detection. These assays can detect troponin levels that are 100 times lower than what traditional methods can detect. Hence it is now considered a quantitative measure of cardiac myocyte injury not only in the setting of MI but also in subjects without MI such as heart failure, in whom it can be regarded as a marker for myocardial stress. This review aims to establish the relationship between high-sensitivity cardiac troponin levels and the prognosis of patients suffering from acute heart failure. Additionally, this seeks to identify other applications where the release of troponin from the cardiomyocyte can provide prognostic information. This information can be vital in determining the appropriate treatment options for patients, ultimately improving their quality of life and positively impacting health economics.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"488-495"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726193","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":"The First Triple Agonist for Antiobesity: Retatrutide.","authors":"Lauren Tetelbaun, Jamie A Mullally, William H Frishman","doi":"10.1097/CRD.0000000000000793","DOIUrl":"10.1097/CRD.0000000000000793","url":null,"abstract":"<p><p>The prevalence of individuals with overweight and obesity has increased by 18% since 1990 and it is projected that by 2030, nearly 50% of US adults will have obesity. Lifestyle modifications, such as diet and exercise, typically lead to approximately 3-5% weight loss, whereas 5-15% weight loss is necessary to significantly impact obesity-associated comorbidities and improve overall health outcomes. In addition to lifestyle modifications, pharmacotherapy has been utilized as an adjunctive treatment to increase weight loss and improve health outcomes. The Food and Drug Administration has currently approved 6 drugs to treat overweight and obesity, with the recently approved drugs surging in popularity after demonstrating superior weight loss outcomes. Additionally, a number of agents are in the pipeline, offering promise of unprecedented degrees of weight loss. One such drug is retatrutide, which is a triple agonist targeting the glucagon-like peptide-1 receptor (GLP-1R), glucose-dependent insulinotropic polypeptide receptor, and glucagon receptor. Phase 1 and 2 clinical trials have demonstrated the safety, tolerability, and pharmacokinetics of retatrutide in patients with obesity and/or type 2 diabetes. The pharmacokinetics of retatrutide were dose proportional and its mean half-life of approximately 6 days supported a once-weekly dosing. The safety profile was similar to GLP-1R agonists and glucose-dependent insulinotropic polypeptide receptor/GLP-1R co-agonists, with gastrointestinal disorders being the most common adverse effects reported. Each trial demonstrated greater weight loss with retatrutide treatment in comparison to placebo, with greatest efficacy at higher doses. Overall, these clinical trials have demonstrated the superior efficacy of retatrutide as a weight loss medication in patients with overweight and obesity.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":"575-579"},"PeriodicalIF":3.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892376","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":"From Physiological to Potential Cardiovascular Maladaptation in Endurance Exercise: Current Evidence, Pathophysiology, and Clinical Implications.","authors":"Juven Luvianto, Luh Oliva Saraswati Suastika","doi":"10.1097/CRD.0000000000001503","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001503","url":null,"abstract":"<p><p>Emerging evidence suggests that the cardiovascular benefits of exercise may not increase indefinitely with training volume and intensity. As participation in ultraendurance sports continues to rise, concerns have been raised regarding the potential adverse cardiovascular effects of exposure to extreme or ultraendurance exercise. In this Review, we synthesize the current evidence and the pathophysiology regarding the structural, functional, and electrical cardiovascular maladaptations to endurance exercise and highlight the clinical implications of these changes. Several evidences demonstrate that extreme exertion can induce transient cardiac dysfunction; when sustained over years, it may contribute to myocardial fibrosis and associated arrhythmic events. Endurance athletes frequently exhibit a higher prevalence of coronary artery calcification, atherosclerotic plaque burden, and increased arterial stiffness. The alteration driven by long-term endurance training is also strongly implicated in the higher incidence of atrial fibrillation. Although definitive long-term outcomes remain debated, the assumption that limitless exercise yields exclusively protective cardiovascular effects might no longer seem prudent. While regular exercise is unequivocally cardioprotective, extreme endurance training may cross a threshold from physiological adaptation to potential maladaptation. Understanding the pathophysiological mechanisms of exercise-induced cardiac remodeling is critical to optimize the benefit of exercise and the potential risk associated with exercise.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223155","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":"Cell-Based Inflammatory Indices for Risk Stratification in Acute Myocardial Infarction: Current Evidence and Future Perspectives.","authors":"Babak Payami, Negin Mousaeinejad, Amirhossein Borghei, Fatemeh Baharvand, Yasaman Borghei","doi":"10.1097/CRD.0000000000001491","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001491","url":null,"abstract":"<p><p>Acute myocardial infarction (AMI) remains a leading cause of cardiovascular morbidity and mortality worldwide, despite substantial advances in reperfusion strategies and guideline-directed therapies. Increasing evidence highlights the pivotal role of inflammation. Therefore, identifying reliable and accessible inflammatory biomarkers may provide valuable prognostic information for patients with AMI. Cell-based inflammatory indices derived from routine complete blood count parameters have emerged as promising biomarkers due to their simplicity, low cost, and widespread availability. Unlike single inflammatory markers, these indices reflect the complex interactions among different immune cell populations involved in cardiovascular inflammation. Recent studies have demonstrated associations between elevated cell-based inflammatory indices and adverse outcomes following AMI. Inflammation represents a central mechanism linking coronary plaque instability, myocardial injury, and adverse outcomes after AMI. Cell-based inflammatory indices provide a practical and cost-effective approach for evaluating systemic inflammatory activity and may improve prognostic assessment in patients with AMI. Further prospective studies are required to determine their optimal clinical application, standardized cutoff values, and integration into routine cardiovascular risk models.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223173","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":"Tirzepatide for Obstructive Sleep Apnea: Trial Evidence, Cardiometabolic Effects, and Implications for Cardiovascular Practice.","authors":"Fatima Safi Arslan, Rimsha Ahmad, William H Frishman, Wilbert S Aronow","doi":"10.1097/CRD.0000000000001504","DOIUrl":"https://doi.org/10.1097/CRD.0000000000001504","url":null,"abstract":"<p><p>Obstructive sleep apnea affects approximately one billion adults worldwide and is associated with hypertension, atrial fibrillation, heart failure, and stroke. Obesity is its dominant reversible cause, yet positive airway pressure therapy splints the pharyngeal airway without addressing the adiposity that narrows it, and randomized trials have not shown that it reduces cardiovascular events. In December 2024, the United States Food and Drug Administration approved tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, as the first drug for moderate-to-severe obstructive sleep apnea in adults with obesity. We summarize the pharmacology of tirzepatide and the anatomic basis by which weight reduction improves upper airway patency, notably reduction of tongue and parapharyngeal fat. We then review the SURMOUNT-OSA program: two parallel 52-week, double-blind, placebo-controlled phase 3 trials enrolling 469 adults with obesity and an apnea-hypopnea index of at least 15 events per hour, one conducted without positive airway pressure and one during established positive airway pressure use. Tirzepatide reduced the apnea-hypopnea index by an estimated 20.0 and 23.8 events per hour relative to placebo, with concurrent reductions in sleep apnea-specific hypoxic burden, body weight, systolic blood pressure, and high-sensitivity C-reactive protein.</p>","PeriodicalId":9549,"journal":{"name":"Cardiology in Review","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223243","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}