Cardiovascular Drugs and Therapy最新文献

{"title":"Effect of Low-Dose Dexmedetomidine as an Anesthetic Adjuvant on Intraoperative Hemodynamics and Prognosis in Patients Undergoing Cardiac Surgery.","authors":"Zhi-Wei Fan, Shi-Liang Li, Yu-Xian Tang, Wei-Min Qiang, Yu-Ting Wu, Jun-Yuan Ge, Lin-Wei Chen, Kun-Sheng Li","doi":"10.1007/s10557-025-07713-1","DOIUrl":"10.1007/s10557-025-07713-1","url":null,"abstract":"<p><strong>Purpose: </strong>Dexmedetomidine, as an anesthetic adjuvant, has a guideline-recommended dose of 0.2-0.7 µg/kg/h. We sought to compare the intraoperative hemodynamic and prognostic performance of cardiac surgical patients receiving the guideline-recommended dose of dexmedetomidine to those receiving a dose lower than the guideline.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 871 patients who were maintained under anesthesia with dexmedetomidine during cardiac surgery, of whom 414 patients received the guideline-recommended dose as a control group and 457 below the guideline-recommended dose as a low-dose group. A cohort of patients in the low-dose and control group (155 vs 155) was created by propensity score matching. The primary outcome was a composite of adverse outcomes, including bradycardia, atrial fibrillation, and hypotension. Secondary outcomes assessed included delirium, analgesic medication use, cardiac intensive care unit (CICU) length of stay, and duration of mechanical ventilation.</p><p><strong>Results: </strong>After propensity matching, the maximum heart rate difference, maximum systolic blood pressure difference, maximum diastolic blood pressure value, and maximum mean arterial pressure difference before and after cardiopulmonary bypass and after cessation of pumping were significantly different in the low-dose group compared with the control group (P < 0.01). Compared with the control group, the low-dose group had a higher incidence of postoperative atrial fibrillation (34.8% vs. 23.9%, P = 0.034), and the length of stay in the cardiac intensive care unit (median 4 days, quartiles 3-5 days vs. median 3 days, quartiles 3-4 days, P < 0.001) was significantly longer.</p><p><strong>Conclusion: </strong>Compared with lower dose, receiving dexmedetomidine pumped at the guideline-recommended dose in anesthetic assistance for cardiac surgery resulted in smoother intraoperative hemodynamic performance and an improvement in the incidence of postoperative atrial fibrillation, shorter stay in the cardiac intensive care unit, and better prognostic performance.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"621-630"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Course Potent P2Y₁₂ Inhibitor-Based DAPT Versus Clopidogrel-Based DAPT After PCI: A Propensity-Matched Real-World Study.","authors":"Natchanon Kulsumritpon","doi":"10.1007/s10557-025-07750-w","DOIUrl":"10.1007/s10557-025-07750-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate whether a 1-month course of ticagrelor or prasugrel followed by clopidogrel offers any clinical advantage over clopidogrel-based dual antiplatelet therapy (DAPT) in routine practice.</p><p><strong>Methods: </strong>We conducted a retrospective, propensity-matched cohort study of ACS patients who underwent PCI between 2015 and 2021 at Chiang Rai Prachanukroh Hospital. Patients were grouped by their P2Y₁₂ regimen: 1-month potent P2Y₁₂ inhibitor (ticagrelor or prasugrel) followed by clopidogrel, or continuous clopidogrel-based DAPT. All patients received aspirin. Propensity score matching and Cox regression were used to adjust for confounders. The primary outcome was a composite of thrombotic readmission or all-cause mortality at 1 year. Bleeding-related readmissions were assessed as the safety endpoint.</p><p><strong>Results: </strong>A total of 1,117 patients were included. After matching, no significant differences were observed in the primary composite outcome across comparisons. In the clopidogrel vs. ticagrelor cohort (n = 161 per group), adjusted hazard ratio (HR) was 1.09 (95% CI: 0.56-2.11; P = 0.808). For clopidogrel vs. prasugrel (n = 139 per group), HR was 0.97 (95% CI: 0.43-2.22; P = 0.945). In the ticagrelor vs. prasugrel cohort (n = 275 per group), HR was 0.62 (95% CI: 0.33-1.17; P = 0.143). LVEF < 40% and residual coronary disease were independently associated with adverse outcomes (HR 4.44 and 8.39, respectively).</p><p><strong>Conclusion: </strong>A 1-month course of potent P2Y₁₂ inhibitor followed by clopidogrel was not superior to clopidogrel-based DAPT in reducing thrombotic readmission or mortality. Optimizing revascularization and heart failure therapy remains essential in high-risk patients.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"631-643"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Pericardial Delivery of Bone Marrow-Derived Extracellular Vesicles: A Novel Therapeutic Approach for HfmrEF.","authors":"Xingyue Feng, Xinyu Nie, Can Xu","doi":"10.1007/s10557-025-07776-0","DOIUrl":"10.1007/s10557-025-07776-0","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"433-434"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revealing the Process of Vein Graft Failure: A Panoramic Review from Etiology Analysis to Mechanism Explanation and Treatment Strategy.","authors":"Haidong Yan, Cheng Cheng, Yang Song, Liangliang Luo, Daxing Liu, Dengshen Zhang","doi":"10.1007/s10557-025-07711-3","DOIUrl":"10.1007/s10557-025-07711-3","url":null,"abstract":"<p><p>Although coronary artery bypass grafting remains the primary surgical intervention for coronary heart disease, the occurrence of postoperative vascular stenosis is a limiting factor that negatively impacts the long-term efficacy of the procedure and increases the risk of associated postoperative and cardiovascular complications. Therefore, it is imperative to establish a more complete understanding of the physiological and pathological changes and risk factors related to vein graft stenosis, including the underlying mechanisms, to improve preventive measures and treatment strategies for the management of saphenous vein graft failure. The aim of this comprehensive review was to summarize the known etiological mechanisms that drive vein graft failure development and progression and to explore strategies for its prevention and management, including surgical techniques, pharmacological interventions, gene therapy, and other treatment modalities that may improve clinical outcomes, such as those that target specific signaling pathways. Table 1 lists the abbreviations used in this article.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"645-670"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sotagliflozin: Two Birds with One Stone?","authors":"Juan Antonio Requena-Ibáñez, Kristine Mørk Kindberg, Carlos G Santos-Gallego, M Urooj Zafar, Juan J Badimon","doi":"10.1007/s10557-025-07723-z","DOIUrl":"10.1007/s10557-025-07723-z","url":null,"abstract":"<p><strong>Purpose: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i), initially developed as antidiabetic agents, have become a cornerstone in the treatment of heart failure (HF) due to their well-established cardio-renal benefits. Clinical trials with SGLT2i have shown a reduction in major adverse cardiovascular events (MACE) across a broad range of patients with no effect on atherothrombotic cardiovascular events such as myocardial infarction (MI) or stroke. On the other hand, sotagliflozin, the first of a new class of dual SLGT1-2 inhibitor (SGLT1-2i), reduces MACE, with independent reductions in MI and stroke, an effect not seen with SGLT2 inhibition alone.</p><p><strong>Method: </strong>A comprehensive literature review was conducted using PubMed and Scopus, focusing on publications from the last 5 years. Articles were selected based on relevance, methodological rigor, and citation impact.</p><p><strong>Results: </strong>SGLT1 and SGLT2 work complimentarily in urinary glucose reabsorption, while SGlT1 also regulates dietary glucose in the intestine. However, its function in other organs remains undefined. SGLT1 is overexpressed in the failing heart and has been associated with increased oxidative stress, cardiomyocyte hypertrophy, and fibrosis. Additionally, SGLT1 also plays an important role in platelet activation and thrombus formation. Experimental studies suggest that sotagliflozin, by inhibiting SGLT1, reverses the metabolic derangements associated with SGLT1 overexpression.</p><p><strong>Conclusion: </strong>These observations suggest that dual SGLT1-2 inhibition may offer additional benefits over single SGLT2-i. Further comparative and mechanistic studies are required to understand and differentiate the clinical impact of SGLT2i vs. SGLT1-2i, particularly in non-diabetic HF patients.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"671-679"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Angiotensin-Converting Enzyme Inhibitors/Angiotensin II Receptor Blockers on Prognosis in Acute Coronary Syndrome Patients with Preserved Ejection Fraction Undergoing Regular Dialysis.","authors":"Yike Li, Enmin Xie, Qiang Chen, Yanxiang Gao, Zhen Meng, Changan Yu, Yaliu Yang, Zhaoxue Sheng, Conghan Fu, Limei Du, Wenyue Pang, Mulei Chen, Jingang Zheng","doi":"10.1007/s10557-025-07720-2","DOIUrl":"10.1007/s10557-025-07720-2","url":null,"abstract":"<p><strong>Purpose: </strong>The utilization of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) following myocardial infarction (MI) is substantiated by evidence derived from trials conducted during the thrombolysis era. However, limited evidence suggests that ACEI/ARB confer benefits to patients with preserved left ventricular ejection fraction (LVEF). Notably, these studies typically exclude patients undergoing regular dialysis. In this study, we examined the association between the use of ACEI/ARB and the 5-year outcomes in patients with acute coronary syndrome (ACS) who are on regular dialysis and possess preserved left ventricular function.</p><p><strong>Methods: </strong>This multicenter retrospective study enrolled a total of 1249 dialysis patients diagnosed with coronary heart disease (CAD). A total of 603 patients meeting the inclusion and exclusion criteria were analyzed.</p><p><strong>Results: </strong>The mean age of the cohort was 61.7 years, with 70.6% being male; 313 (51.9%) patients were treated with ACEI/ARB. Over a 5-year follow-up period, the use of ACEI/ARB had no benefit on the composite outcome of major adverse cardiovascular events (MACE) (31.3% vs. 29.0%, p = 0.988). However, ACEI/ARBs reduced mortality across all causes (24.9% vs. 33.1%, p = 0.012) and cardiovascular deaths (14.7% vs. 21.4%, p = 0.015). Furthermore, ACEI/ARB demonstrated a more pronounced cardiovascular mortality benefit in patients with poorer left ventricular function (LVEF 50-60%).</p><p><strong>Conclusion: </strong>In dialysis patients with ACS and preserved left ventricular function, ACEI/ARB reduces all-cause and cardiovascular mortality. Additionally, a more pronounced survival benefit is observed in patients with impaired LVEF (50-60%). However, no benefit was found regarding MACE.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"589-598"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midkine Promote Atherosclerosis by Regulating the Expression of ATP-Binding Cassette Transporter A1 via Activator Protein-1.","authors":"Yixin Tang, Yaqin Cai, Fengling Peng, Ming Li, Zhongcheng Mo","doi":"10.1007/s10557-025-07717-x","DOIUrl":"10.1007/s10557-025-07717-x","url":null,"abstract":"<p><strong>Purpose: </strong>Midkine (MK) has been shown to facilitate atherosclerotic plaque formation by downregulating the expression of ATP-binding cassette transporter A1 (ABCA1). However, the mechanism by which MK regulates ABCA1 to promote atherosclerosis remains incompletely understood. In this study, we sought to investigate the molecular mechanism by which MK's regulation of ABCA1 influences the pathogenesis of atherosclerosis.</p><p><strong>Methods: </strong>Male apoE^-/- mice were subjected to a high-fat diet to establish an atherosclerosis model. The model mice received intraperitoneal injections of MK and activator protein-1 (AP-l) inhibitor SR11302. The ATP-binding cassette transporter A1 (ABCA1) and AP1 expression were detected using immunohistochemistry (IHC), quantitative polymerase chain reaction (qPCR), and western blotting (WB). RAW264.7 macrophages were incubated with oxidized low-density lipoprotein (ox-LDL) to generate foam cells. These foam cells were treated with MK, SR11302, JNK inhibitor SP600125, and PI3K inhibitor wortmannin. The expression of ABCA1, AP-1, JNK, and PI3K were detected using qPCR and WB. The cholesterol efflux and lipid accumulation of cells were analyzed using scintillation counting and oil red O staining, respectively.</p><p><strong>Results: </strong>MK-treated mice exhibited an accelerated development of atherosclerotic lesion (30% in the MK group vs. 20% in the control group), along with hepatic steatosis and lipid disorder. The expression of c-fos and AP-1 were up-regulated by MK in macrophages. Compared with the MK-treated group, inhibition of AP-1 using SR11302 or transfection with c-fos siRNA markedly enhanced the cholesterol efflux (12.73% in the MK + SR11302 group vs. 9.98% in the MK group, 12.73% in the MK + si-c-fos group vs. 10.02 % in the MK group), reduced lipid accumulation, and increased the protein levels of ABCA1 in macrophages. Compared to the MK-treated group, mice treated with both MK and SR11302 showed downregulated ABCA1 expression in aortic sinus lesions, a larger lesion area (22.59% vs. 18.54%), and significantly elevated levels of plasma total cholesterol (TC), low-density lipoprotein (LDL), and triglycerides (TG). These results suggest that MK-induced pharmacological inhibition of AP-1 augmented ABCA1 expression in plaques, ameliorated lipid disorders, and abrogated atherosclerosis progression in apoE^-/- mice. In addition, in vitro experiments revealed that the MK-induced up-regulation of c-fos expression was effectively suppressed by inhibitors of JNK and PI3K.</p><p><strong>Conclusions: </strong>Our findings unveil a novel mechanistic pathway in atherosclerosis, whereby MK promotes the development of atherosclerosis by up-regulating AP-1 in macrophages via the PI3K/AKT/JNK signaling cascade.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"435-446"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factor XIa Inhibitors Versus Direct Oral Anticoagulants for Atrial Fibrillation: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Sufyan Shahid, Minahil Iqbal, Mariam Shahabi, Muhammad Abdullah Ali, Allahdad Khan, Muhammad Ali Shahid, Hamyial Iqbal, Khadija Shahid, Salman Khalid","doi":"10.1007/s10557-025-07741-x","DOIUrl":"10.1007/s10557-025-07741-x","url":null,"abstract":"<p><strong>Introduction: </strong>Direct oral anticoagulants (DOACs) are the standard treatment for reducing thromboembolic risk in patients with atrial fibrillation (AF); however, bleeding remains a major concern. Factor XIa inhibitors have emerged as a potential alternative, but evidence about their therapeutic potential remains unclear. We performed a systematic review and meta-analysis to evaluate the comparative efficacy and safety of Factor XIa inhibitors versus DOACs for AF.</p><p><strong>Methods: </strong>PubMed, Embase, and Cochrane Library were systematically searched until February 15, 2025, to identify RCTs comparing Factor XIa inhibitors with DOACs in AF patients. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using a random-effects model. Statistical analysis was performed in RevMan 5.4 with p-value < 0.05 considered significant, and meta-analyses were conducted using a bivariate random-effects model. Study heterogeneity was measured using I² statistics, and study quality was assessed using the revised Cochrane risk-of-bias (RoB 2) tool.</p><p><strong>Results: </strong>Three RCTs comprising 16,845 patients (41% females) were included. The mean age of the participants was 74 years. Factor XIa inhibitors were associated with a significantly higher risk of ischemic stroke (RR: 3.32; 95% CI: 2.24-4.90, I²: 0%, p < 0.00001) but a lower risk of major or clinically relevant non-major (CRNM) bleeding (RR: 0.41; 95% CI: 0.33-0.49, I²: 0%, p < 0.00001) and minor bleeding (RR: 0.68; 95% CI: 0.49-0.93, I²: 64%, p = 0.02) compared to DOACs. However, there was no significant difference in the risk of all-cause mortality, cardiovascular mortality, or hemorrhagic stroke between the two groups.</p><p><strong>Conclusion: </strong>Factor XIa inhibitors are associated with a reduced risk of major, minor, and clinically relevant non-major bleeding than DOACs but simultaneously increase the risk of ischemic stroke. No significant differences were found in the risk of hemorrhagic stroke or overall mortality rates compared to DOACs.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"725-734"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Efficacy of Inclisiran in Veneto Region (Italy): The INCLIVEN Multicenter Registry.","authors":"Francesco Briani, Elena Sani, Gabriele Venturi, Francesco Bacchion, Sara Balzano, Marialberta Battocchio, Katia D'Elia, Giulia Maria Frigo, Luca Licchelli, Antonio Lupo, Alberto Marangoni, Luigi Rivetti, Mauro Scanferlato, Sabina Zambon, Maria Grazia Zenti, Elisabetta Rinaldi, Antonio Mugnolo","doi":"10.1007/s10557-025-07749-3","DOIUrl":"10.1007/s10557-025-07749-3","url":null,"abstract":"<p><strong>Purpose: </strong>Inclisiran is a long-acting small interfering RNA (siRNA) which prevents the synthesis of PCSK9 in hepatocytes, reducing LDL-C concentration. Only limited data are available in the literature regarding its use in real-world settings.</p><p><strong>Methods: </strong>In this observational multicenter registry, we included high cardiovascular risk patients from 12 lipid clinics in the Veneto region of Italy who started inclisiran therapy between October 2022 and February 2024. Primary endpoint was changes in LDL-C concentrations at 3 months of follow-up after inclisiran administration. Secondary endpoints were changes in LDL-C concentrations at 9 months of follow-up, safety, percentage of patients reaching LDL-C targets and efficacy of inclisiran according to background therapy and clinical characteristics of the population.</p><p><strong>Results: </strong>Mean LDL-C levels at baseline (n = 240) were 118.7 ± 48.7 mg/dl, then they significantly fell to 56.7 ± 40.4 mg/dl (-52.3 ± 24.3%; p < 0.001) at 3 months (n = 238) and to 60.5 ± 40.1 mg/dl (-50.0 ± 22.7%; p < 0.001) at 9 months (n = 138). Three (1.3%) patients reported mild injection-site side effects. LDL-C target achievement according to ESC/EAS 2019 guidelines was 64.7% at 3 months and 62.3% at 9 months. Patients on statin therapy had a greater LDL-C reduction compared to patients with statin intolerance. At 3 months across we observed greater LDL-C reduction in patients with diabetes (59.9 ± 23.2% vs 49.7 ± 24.1%; p = 0.004). In the multivariable analysis diabetes mellitus (p = 0.006) and background statin therapy (p = 0.034) were independent predictors for greater LDL-C reduction.</p><p><strong>Conclusion: </strong>This real-world multicenter registry supports inclisiran as an effective, well-tolerated option for managing hypercholesterolemia in high cardiovascular risk patients.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"611-619"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Artery Bypass Grafting With or Without Concomitant Surgical Ventricular Reconstruction in Ischemic Cardiomyopathy Patients.","authors":"Jianbo Liao, Zhuoming Zhou, Yi Zhang, Zhilin Miao, Gang Li, Hanri Xiao, Qiushi Ren, Bohao Jian, Zhongkai Wu, Mengya Liang","doi":"10.1007/s10557-025-07728-8","DOIUrl":"10.1007/s10557-025-07728-8","url":null,"abstract":"<p><strong>Purpose: </strong>The present study aims to compare the long-term outcomes of surgical ventricular reconstruction (SVR) combined with coronary artery bypass grafting (CABG) versus CABG alone in patients with ischemic cardiomyopathy (ICM).</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, Embase, Scopus, Cochrane Library, and Web of Science until November 2024. Studies comparing SVR + CABG and CABG in patients with ischemic cardiomyopathy (left ventricular ejection fraction less than 40%) were included. The primary outcome included long-term mortality, and the secondary outcomes included hospital mortality, rehospitalization for cardiac causes, and other cardiac function indicators.</p><p><strong>Results: </strong>Twelve studies with a total of 3188 patients were included, with 1629 undergoing SVR + CABG and 1559 undergoing CABG. Patients who underwent SVR + CABG had a higher survival rate (HR 0.82; 95% CI, 0.69-0.96; I² = 4%; P = 0.01) and a more significant postoperative left ventricular end-systolic volume index (ESVI) reduction (MD 15.53; 95% CI, 6.41-24.65; I² = 93%; P = 0.01). In the subgroup analysis, the Dor (endoventricular circular patch plasty) surgery provided additional survival benefits compared with CABG (HR 0.83; 95% CI, 0.70-0.97; I² = 9%; P = 0.02). The reconstructed Kaplan-Meier curves show that the survival rates in the SVR + CABG, Dor, Non-Dor, Mannequin-free, Mannequin, and CABG groups were 81.13%, 82.02%, 76.38%, 83.23%, 69.40%, and 71.42% at 60 months, respectively.</p><p><strong>Conclusions: </strong>Compared with CABG, SVR + CABG is associated with higher survival, a more significant reduction in ESVI, fewer rehospitalizations for cardiac causes, and more patients gaining postoperative New York Heart Association class improvement.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":"681-695"},"PeriodicalIF":3.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}