Cardiovascular Drugs and Therapy最新文献

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Low Thyroid Hormones Level Attenuates Mitochondrial Dysfunction and Right Ventricular Failure in Pulmonary Hypertensive Rats. 低甲状腺激素水平可减轻肺动脉高压大鼠的线粒体功能障碍和右心室衰竭
IF 3.1 3区 医学
Cardiovascular Drugs and Therapy Pub Date : 2024-08-31 DOI: 10.1007/s10557-024-07618-5
Natalia Soares Carvalho Souza, Thais Barenco-Marins, Ana Paula Ferraz, Raiana Andrade Quintanilha Barbosa, Leonardo Maciel, Cristiano Gonçalves Ponte, Fernando Azevedo Cruz Seara, Emerson Lopes Olivares, Jose Hamilton Matheus Nascimento
{"title":"Low Thyroid Hormones Level Attenuates Mitochondrial Dysfunction and Right Ventricular Failure in Pulmonary Hypertensive Rats.","authors":"Natalia Soares Carvalho Souza, Thais Barenco-Marins, Ana Paula Ferraz, Raiana Andrade Quintanilha Barbosa, Leonardo Maciel, Cristiano Gonçalves Ponte, Fernando Azevedo Cruz Seara, Emerson Lopes Olivares, Jose Hamilton Matheus Nascimento","doi":"10.1007/s10557-024-07618-5","DOIUrl":"https://doi.org/10.1007/s10557-024-07618-5","url":null,"abstract":"<p><strong>Purpose: </strong>This study is to investigate the repercussions of hypothyroidism in the pathophysiological progression of pulmonary arterial hypertension (PAH).</p><p><strong>Methods: </strong>While the control (CTL, n = 5) male Wistar rats received vehicle, PAH was induced with monocrotaline (MCT group, n = 15). Hypothyroidism was induced in a subset of rats by methimazole 3 weeks prior to the MCT injection (MMZ + MCT group, n = 15). Plasma thyroid hormones were measured by radioimmunoassay. Electrocardiographic, echocardiographic, and hemodynamic analyses were performed to evaluate the progression of PAH. Gene expression of antioxidant enzymes and cardiac hypertrophy markers were assessed by qPCR. Mitochondrial respiration, ATP levels, and ROS production were measured in right ventricular (RV) samples.</p><p><strong>Results: </strong>Plasma T3 and T4 decreased in both MCT and MMZ + MCT groups (p < 0.05). Right ventricular systolic pressure (RVSP) increased, and RV - dP/dt, + dP/dt, and contractility index decreased in the MCT versus the CTL group and remained within control levels in the MMZ + MCT group (p < 0.05). Relative RV weight, RV wall thickness, RV diastolic area, and relative lung weight were augmented in the MCT versus the CTL group, whereas all parameters were improved to the CTL levels in the MMZ + MCT group (p < 0.05). Only the MCT group exhibited an increased duration of QTc interval compared to the baseline period (p < 0.05). ADP-induced mitochondrial respiration and ATP levels were decreased, and ROS production was increased in MCT versus the CTL group (p < 0.05), while the MMZ + MCT group exhibited increased mitochondrial respiration versus the MCT group (p < 0.05).</p><p><strong>Conclusion: </strong>Hypothyroidism attenuated the RV mitochondrial dysfunction and the pathophysiological progression of MCT-induced PAH.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104708","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}
引用次数: 0
Comparative Efficacy of Colchicine and Intensive Low-density Lipoprotein Cholesterol Lowering in Patients with Atherosclerotic Diseases receiving Statins: A Network Meta-analysis of Randomized Controlled Trials. 服用他汀类药物的动脉粥样硬化症患者服用秋水仙碱和强化降低低密度脂蛋白胆固醇的疗效比较:随机对照试验网络 Meta 分析》。
IF 3.1 3区 医学
Cardiovascular Drugs and Therapy Pub Date : 2024-08-29 DOI: 10.1007/s10557-024-07622-9
Zhenhong Ou, Fangchao Wang, Yunlin Chen, Xueyuan Liu, Boli Ran, Yuehui Yin, Kun Cui
{"title":"Comparative Efficacy of Colchicine and Intensive Low-density Lipoprotein Cholesterol Lowering in Patients with Atherosclerotic Diseases receiving Statins: A Network Meta-analysis of Randomized Controlled Trials.","authors":"Zhenhong Ou, Fangchao Wang, Yunlin Chen, Xueyuan Liu, Boli Ran, Yuehui Yin, Kun Cui","doi":"10.1007/s10557-024-07622-9","DOIUrl":"https://doi.org/10.1007/s10557-024-07622-9","url":null,"abstract":"<p><strong>Aims: </strong>Adding intensive low-density lipoprotein cholesterol (LDL-C)-lowering agents or colchicine to statin has been shown to result in additional cardiovascular benefits for patients with atherosclerotic cardiovascular diseases (ASCVD). We aimed to compare the efficacy and safety of these supplementary agents in patients with ASCVD receiving statin.</p><p><strong>Methods: </strong>We performed a systematic review and frequentist network meta-analysis of randomized controlled trials. The primary efficacy endpoint was the main adverse cardiovascular event (MACE), and the secondary efficacy endpoints were myocardial infarct, stroke, coronary revascularization, cardiovascular death, and all-cause mortality, respectively. The safety endpoints were treatment discontinuation and non-cardiovascular death. We obtained estimates for efficacy outcomes and safety endpoints and presented these estimates as risk ratio (RR) with 95% confidence intervals. We ranked the comparative efficacy and safety of all drugs with P-scores.</p><p><strong>Results: </strong>Seventeen trials totaling 85,823 participants treated with colchicine (5926 participants), intensive LDL-C lowering (37,854 participants) via proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, Niemann-Pick C1-like 1 protein (NPC1L1) inhibitor or ATP citrate lyase (ACL) inhibitor, or statin alone (42,043 participants) were included. Colchicine was associated with a greater reduction in the risk of MACE (RR 0.72, 0.69-0.91), stroke (RR 0.55, 0.33-0.92), and coronary revascularization (RR 0.73, 0.60-0.90) compared with NPC1L1 inhibitor, and it provided a larger reduction in the risk of MACE (RR 0.79, 0.69-0.91) compared to PCSK9 inhibitor. However, colchicine was associated with increased risk of non-cardiovascular death compared with NPC1L1 inhibitor (RR 1.48, 1.04-2.10) and PCSK9 inhibitor (RR 1.57, 1.08-2.27). Although no regimen prolonged survival, colchicine had worse performance on non-cardiovascular death and all-cause mortality.</p><p><strong>Conclusions: </strong>In patients with ASCVD receiving statin, colchicine seems to be more effective than intensive LDL-C-lowering therapy with PCSK9 inhibitor or NPC1L1 inhibitor for cardiovascular prevention. However, using colchicine as an alternative to intensive LDL-C-lowering therapy may need to be weighed against the cardiovascular benefits and the potential harms of higher non-cardiovascular death.</p><p><strong>Trial registration: </strong>PROSPERO Identifier: CRD42023441385.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104706","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}
引用次数: 0
Can We Leave No Metal Behind? DCB vs. DES in Large Coronary Arteries. 我们能不留下任何金属吗?大冠状动脉中的 DCB 与 DES。
IF 3.1 3区 医学
Cardiovascular Drugs and Therapy Pub Date : 2024-08-23 DOI: 10.1007/s10557-024-07623-8
Grace Lian, Spencer Ng, George A Stouffer
{"title":"Can We Leave No Metal Behind? DCB vs. DES in Large Coronary Arteries.","authors":"Grace Lian, Spencer Ng, George A Stouffer","doi":"10.1007/s10557-024-07623-8","DOIUrl":"https://doi.org/10.1007/s10557-024-07623-8","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035277","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}
引用次数: 0
Effect of Preoperative Mitral Regurgitation on LVAD Outcomes in Patients with Elevated Pulmonary Vascular Resistance. 肺血管阻力升高患者术前二尖瓣反流对 LVAD 效果的影响
IF 3.1 3区 医学
Cardiovascular Drugs and Therapy Pub Date : 2024-08-20 DOI: 10.1007/s10557-024-07581-1
Riyad Yazan Kherallah, Harveen K Lamba, Andrew B Civitello, Ajith P Nair, Leo Simpson, Alexis E Shafii, Gabriel Loor, Joggy K George, Reynolds M Delgado, Kenneth K Liao, Raymond F Stainback, O H Frazier, Srikanth Koneru
{"title":"Effect of Preoperative Mitral Regurgitation on LVAD Outcomes in Patients with Elevated Pulmonary Vascular Resistance.","authors":"Riyad Yazan Kherallah, Harveen K Lamba, Andrew B Civitello, Ajith P Nair, Leo Simpson, Alexis E Shafii, Gabriel Loor, Joggy K George, Reynolds M Delgado, Kenneth K Liao, Raymond F Stainback, O H Frazier, Srikanth Koneru","doi":"10.1007/s10557-024-07581-1","DOIUrl":"https://doi.org/10.1007/s10557-024-07581-1","url":null,"abstract":"<p><strong>Purpose: </strong>In patients with end-stage heart failure who undergo left ventricular assist device (LVAD) implantation, higher pulmonary vascular resistance (PVR) is associated with higher right heart failure rates and ineligibility for heart transplant. Concomitant mitral regurgitation (MR) could potentially worsen pulmonary hemodynamics and lead to worse outcomes; however, its effects in this patient population have not been specifically examined.</p><p><strong>Methods: </strong>Using an institutional database spanning November 2003 to August 2017, we retrospectively identified patients with elevated PVR who underwent LVAD implantation. Patients were stratified by concurrent MR: moderate/severe (PVR + MR) vs. mild/none (PVR - MR). Cumulative incidence functions and Fine-Gray competing risk regression were performed to assess the effect of MR on heart transplant rates and overall survival during index LVAD support.</p><p><strong>Results: </strong>Of 644 LVAD recipients, 232 (171 HeartMate II, 59 HeartWare, 2 HeartMate III) had baseline PVR > 3 Woods units; of these, 124 (53%) were INTERMACS 1-2, and 133 (57%) had moderate/severe MR (≥ 3 +). Patients with PVR + MR had larger a baseline left ventricular end-diastolic diameter than patients with PVR - MR (87.9 ± 38.2 mm vs. 75.9 ± 38.0 mm; P = 0.02). Median clinical follow-up was 18.8 months (interquartile range: 4.7-36.4 months). Moderate/severe MR was associated with lower mortality rates during index LVAD support (adjusted hazard ratio 0.64, 95% CI 0.41-0.98; P = 0.045) and higher heart transplant rates (adjusted odds ratio 2.86, 95% CI 1.31-6.25; P = 0.009). No differences in stroke, gastrointestinal bleeding, or right heart failure rates were observed.</p><p><strong>Conclusions: </strong>Among LVAD recipients with elevated preoperative PVR, those with moderate/severe MR had better overall survival and higher transplant rates than those with mild/no MR. These hypothesis-generating findings could be explained by incremental LVAD benefits resulting from reduction of MR and better LV unloading in a subset of patients with larger ventricles at baseline. In patients with preoperative elevated PVR, MR severity may be a prognostic sign that can inform patient selection for end-stage heart failure therapy.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003695","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}
引用次数: 0
Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants Compared with Vitamin K Antagonists in Patients with Atrial Fibrillation and Type 2 Valvular Heart Disease: A Systematic Review and Meta-Analysis. 心房颤动和 2 型瓣膜性心脏病患者口服非维生素 K 拮抗剂与维生素 K 拮抗剂的疗效和安全性比较:系统回顾与元分析》。
IF 3.1 3区 医学
Cardiovascular Drugs and Therapy Pub Date : 2024-08-17 DOI: 10.1007/s10557-024-07616-7
Xiaoyun Liang, Shangyu Liu, Lishuang Ji, Fangfang Ma, Guoyuan Song, Fang Li, Gang Liu
{"title":"Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants Compared with Vitamin K Antagonists in Patients with Atrial Fibrillation and Type 2 Valvular Heart Disease: A Systematic Review and Meta-Analysis.","authors":"Xiaoyun Liang, Shangyu Liu, Lishuang Ji, Fangfang Ma, Guoyuan Song, Fang Li, Gang Liu","doi":"10.1007/s10557-024-07616-7","DOIUrl":"https://doi.org/10.1007/s10557-024-07616-7","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aimed to evaluate the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) compared with vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF) and type 2 valvular heart disease (VHD).</p><p><strong>Methods: </strong>We searched the PubMed, LILACS, and MEDLINE databases to retrieve, randomized controlled trials (RCTs) comparing NOACs and VKAs in patients with AF and type 2 VHD, excluding mitral stenosis (moderate to severe, of rheumatic origin) or mechanical heart valves. The efficacy outcomes assessed were stroke and systemic embolism (SE), while safety outcomes included major bleeding and intracranial hemorrhage (ICH).</p><p><strong>Results: </strong>Seven RCTs, including 16,070 patients with AF and type 2 VHD, were included. NOACs reduced the risk of stroke/SE (relative risk [RR], 0.75; 95% confidence interval [CI], 0.64-0.89; P = 0.0005), with no significant difference in major bleeding (RR, 0.88; 95% CI, 0.64-1.21; P = 0.43). The risk of ICH was reduced with NOACs (RR, 0.46; 95% CI, 0.27-0.77; P = 0.003). For patients with AF and bioprosthetic heart valve (five trials, 2805 patients), stroke/SE risks (RR, 0.65, 95% CI, 0.44-0.96) with NOACs were superior to VKAs. Major bleeding risks without ENVISAGE TAVI AF trial (RR, 0.53; 95% CI, 0.30-0.94; P = 0.03) with NOACs were superior to VKAs. The risks of ICH (RR, 0.61; 95% CI 0.34-1.09; P = 0.09) with NOACs were comparable to VKAs.</p><p><strong>Conclusions: </strong>NOACs demonstrate efficacy and safety in patients with AF and type 2 VHD and reduce the risk of stroke/SE and ICH when compared with those with VKAs.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995367","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}
引用次数: 0
Exercise Enhances Anti-contractile Effects of PVAT Through Endogenous H2S in High-Fat Diet-Induced Obesity Hypertension. 在高脂饮食诱发的肥胖性高血压中,运动通过内源性 H2S 增强 PVAT 的抗收缩效应
IF 3.1 3区 医学
Cardiovascular Drugs and Therapy Pub Date : 2024-08-12 DOI: 10.1007/s10557-024-07612-x
Chaoge Wang, Linjie Shu, Ran Cheng, Mengsi Yan, Wenhao Liang, Jie Zhou, Niujin Shi, Lidan Chen, Linyu Peng, Junhao Huang, Min Hu, Jingwen Liao
{"title":"Exercise Enhances Anti-contractile Effects of PVAT Through Endogenous H<sub>2</sub>S in High-Fat Diet-Induced Obesity Hypertension.","authors":"Chaoge Wang, Linjie Shu, Ran Cheng, Mengsi Yan, Wenhao Liang, Jie Zhou, Niujin Shi, Lidan Chen, Linyu Peng, Junhao Huang, Min Hu, Jingwen Liao","doi":"10.1007/s10557-024-07612-x","DOIUrl":"https://doi.org/10.1007/s10557-024-07612-x","url":null,"abstract":"<p><strong>Purpose: </strong>Hydrogen sulfide (H<sub>2</sub>S) secreted by perivascular adipose tissue (PVAT) is a critical vasodilator, which might be involved during the pathogenesis of hypertension. The present study aimed to investigate the exact role of H<sub>2</sub>S on the regulation of PVAT anti-contraction by long-term exercise in obesity hypertension.</p><p><strong>Methods: </strong>After the establishment of obesity hypertension (24 weeks) through a high-fat diet, male Sprague-Dawley rats were randomly assigned to control group (HC), exercise group (HE), cystathionine γ-lyase (CSE) blocking group (HCB), and exercise combined with CSE blocking group (HEB). Exercise and CSE inhibitor regimens were performed throughout 13 weeks.</p><p><strong>Results: </strong>After 13 weeks of intervention, blood pressure was significantly decreased by long-term exercise (HC vs. HE, P < 0.05) but not by exercise combined with the CSE inhibitor regimen. Meanwhile, the CSE inhibitor significantly blocked the production of H<sub>2</sub>S in PVAT even after exercise (HE vs. HEB, P < 0.05). Furthermore, long-term exercise altered the expressions of voltage-dependent K<sup>+</sup> (K<sub>v</sub>) channel subunits 7 (KCNQs), which were diminished by CSE inhibition in mesenteric arteries. As for vascular tension assessment, after incubation with or without KCNQ opener (retigabine), the anti-contractile effect of PVAT (with or without transferred bath solution of PVAT) was significantly enhanced by long-term exercise and eliminated by the CSE inhibitor regimen (P < 0.05); KCNQ inhibitor (XE991) blunted this effect except for HE.</p><p><strong>Conclusions: </strong>These results collectively suggest that endogenous H<sub>2</sub>S is a strong regulator of the anti-contractile effect of PVAT in obesity hypertension by long-term exercise, and KCNQ in the resistance artery might be involved during this process but not the only target channel mediated by H<sub>2</sub>S.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916181","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}
引用次数: 0
How Much Is Enough? 多少才够?
IF 3.1 3区 医学
Cardiovascular Drugs and Therapy Pub Date : 2024-08-08 DOI: 10.1007/s10557-024-07615-8
Yochai Birnbaum, Lisa Kay McClendon, Masafumi Kitakaze
{"title":"How Much Is Enough?","authors":"Yochai Birnbaum, Lisa Kay McClendon, Masafumi Kitakaze","doi":"10.1007/s10557-024-07615-8","DOIUrl":"https://doi.org/10.1007/s10557-024-07615-8","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901078","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}
引用次数: 0
Levosimendan: A New Therapeutical Strategy in Patients with Renal Insufficiency. 左西孟旦:肾功能不全患者的新治疗策略
IF 3.1 3区 医学
Cardiovascular Drugs and Therapy Pub Date : 2024-08-07 DOI: 10.1007/s10557-024-07614-9
Xinwen Liu, Mengkai Lu, Yanna Yu, Nannan Shen, Haijiang Xia, Jiana Shi, Yongping Fu, Ying Hu
{"title":"Levosimendan: A New Therapeutical Strategy in Patients with Renal Insufficiency.","authors":"Xinwen Liu, Mengkai Lu, Yanna Yu, Nannan Shen, Haijiang Xia, Jiana Shi, Yongping Fu, Ying Hu","doi":"10.1007/s10557-024-07614-9","DOIUrl":"https://doi.org/10.1007/s10557-024-07614-9","url":null,"abstract":"<p><p>Levosimendan, a Ca2 + sensitizer with positive inotropic effects, is primarily employed for the short-term treatment of acute decompensated heart failure (ADHF). Levosimendan exerts renal function protection through various mechanisms, including anti-apoptosis, anti-inflammatory, and antioxidant effects in vivo. Additionally, levosimendan may have a protective effect on individuals with heart failure and renal insufficiency, as well as on renal function impairment after cardiac surgery. However, the application of levosimendan in patients with severe renal dysfunction remains controversial. This article delves into the use of levosimendan in severe renal insufficiency, explores its impact on renal function, and provides a comprehensive overview of its impact on renal function after cardiac surgery.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896857","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}
引用次数: 0
Antiplatelet Agents and Oral Anticoagulant Use in Patients with Atrial Fibrillation and Carotid Artery Disease After First-Time Ischaemic Stroke. 首次缺血性脑卒中后心房颤动和颈动脉疾病患者使用抗血小板药物和口服抗凝剂的情况。
IF 3.1 3区 医学
Cardiovascular Drugs and Therapy Pub Date : 2024-08-01 Epub Date: 2023-01-24 DOI: 10.1007/s10557-023-07433-4
Stephanie L Harrison, Benjamin J R Buckley, Deirdre A Lane, Elnara Fazio-Eynullayeva, Paula Underhill, Andrew Hill, David J Werring, Gregory Y H Lip
{"title":"Antiplatelet Agents and Oral Anticoagulant Use in Patients with Atrial Fibrillation and Carotid Artery Disease After First-Time Ischaemic Stroke.","authors":"Stephanie L Harrison, Benjamin J R Buckley, Deirdre A Lane, Elnara Fazio-Eynullayeva, Paula Underhill, Andrew Hill, David J Werring, Gregory Y H Lip","doi":"10.1007/s10557-023-07433-4","DOIUrl":"10.1007/s10557-023-07433-4","url":null,"abstract":"<p><strong>Introduction: </strong>People with atrial fibrillation (AF) frequently have competing mechanisms for ischaemic stroke, including extracranial carotid atherosclerosis. The objective of this study was to determine associations between use of oral anticoagulants (OACs) plus antiplatelet agents (APA) after ischaemic stroke and outcomes for patients with AF and carotid artery disease.</p><p><strong>Patients and methods: </strong>A retrospective cohort study was conducted. Participants receiving OACs with or without APA were propensity score-matched for age, sex, ethnicity, co-morbidities and presence of cardiac and vascular implants and grafts. Outcomes were 1-year mortality, recurrent stroke and major bleeding.</p><p><strong>Results: </strong>Of 5708 patients, 24.1% (n=1628) received non-vitamin K antagonist OACs (NOACs) with no APA, 26.0% (n=1401) received NOACs plus APA, 20.7% (n=1243) received warfarin without APA and 29.2% (n=1436) received warfarin plus APA. There was no significant difference in risk of recurrent stroke between the groups. Compared to receiving NOACs without APA, receiving warfarin plus APA was associated with a higher risk of mortality (hazard ratio (HR) 1.51 (95% confidence interval (CI) 1.20, 1.89)) and major bleeding (HR 1.66 (95% CI 1.40, 1.96)). Receiving NOACs plus APA was also associated with a higher risk of major bleeding compared to NOACs without APA (HR 1.27 (95% CI 1.07, 1.51), respectively).</p><p><strong>Conclusions: </strong>The results suggest for patients with AF and carotid artery disease after ischaemic stroke, receiving NOACs without APA is associated with a lower risk of major bleeding with no negative impact on recurrent stroke or mortality. Evidence from randomised trials is needed to confirm this finding.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11266273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10605007","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}
引用次数: 0
Dexamethasone-Induced Arterial Stiffening Is Attenuated by Training due to a Better Balance Between Aortic Collagen and Elastin Levels. 由于主动脉胶原蛋白和弹性蛋白水平之间的平衡得到改善,地塞米松诱发的动脉僵化会因训练而减弱。
IF 3.1 3区 医学
Cardiovascular Drugs and Therapy Pub Date : 2024-08-01 Epub Date: 2023-02-16 DOI: 10.1007/s10557-023-07438-z
Vinicius F de Paula, Lidieli P Tardelli, Sandra L Amaral
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