Cardiovascular Drugs and Therapy最新文献

{"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":"https://doi.org/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":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-26","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":"ALKBH5 Regulates Inflammation and Pyroptosis of Coronary Heart Disease by Targeting SPEN in a YTHDF1-Mediated Manner.","authors":"Shan Huang, Jizhang Huang, Yongguang Lu, Zewen Hong, Guoyong Lai, Yunyu Chen","doi":"10.1007/s10557-025-07746-6","DOIUrl":"https://doi.org/10.1007/s10557-025-07746-6","url":null,"abstract":"<p><strong>Purpose: </strong>Coronary heart disease (CHD) occurs when the arteries supplying blood to the heart become narrowed or blocked owing to plaque buildup, leading to reduced blood flow and potential heart attacks. N6-methyladenosine (m⁶A) modification is a common form of post-transcriptional RNA modification. ALKB homolog 5 (ALKBH5) is an RNA demethylase that specifically removes the m⁶A modification from RNA. This study aimed to investigate the role of ALKBH5 in CHD and the underlying mechanism.</p><p><strong>Methods: </strong>Both cellular and animal CHD models were established. The expression levels of Alkbh5 and fibrosis-related markers were analyzed by qRT-PCR. Cell viability and cytotoxicity were assessed via cell counting kit-8. Inflammatory cytokines levels were detected by ELISA. Flow cytometry was used to detect pyroptosis. The interaction between ALKBH5/YTH N6-methyladenosine RNA binding protein (YTHDF)1 and SPEN transcriptional repressor (SPEN) was examined through RNA immunoprecipitation and dual-luciferase reporter assays.</p><p><strong>Results: </strong>ALKBH5-mediated demethylation of m⁶A was decreased in CHD rat heart tissues and oxidized low-density lipoprotein (ox-LDL)-treated H9c2 cells. In addition, Alkbh5 overexpression increased the cell viability and suppressed the inflammation, pyroptosis, and fibrosis in ox-LDL-treated H9c2 cells. In in vivo studies, Alkbh5 overexpression reduced myocardial injury and fibrosis in CHD rats by suppressing inflammation and pyroptosis. Mechanically, Alkbh5 overexpression decreased the stability of Spen mRNA. Additionally, ALKBH5/YTHDF1 m⁶A axis regulated the expression of Spen. Moreover, Ythdf1 overexpression counteracted ALKBH5-mediated inhibition of inflammation, pyroptosis, and fibrosis in ox-LDL-treated H9c2 cells.</p><p><strong>Conclusion: </strong>ALKBH5 regulated inflammation and pyroptosis of CHD by targeting SPEN in a YTHDF1-mediated manner, which could provide a reference for CHD treatment.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717618","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":"Pericardial Delivery of BMSC-Derived Extracellular Vesicles: A Paradigm Shift in Heart Failure Therapy.","authors":"Brijesh Sathian, Javed Iqbal, Syed Muhammad Ali","doi":"10.1007/s10557-025-07754-6","DOIUrl":"https://doi.org/10.1007/s10557-025-07754-6","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682093","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":"Further Considerations on Cardioprotective Effect of Aloperine Against Myocardial Ischemia/Reperfusion Injury.","authors":"Yu Hu, Tai Li, Chao Wu","doi":"10.1007/s10557-025-07752-8","DOIUrl":"https://doi.org/10.1007/s10557-025-07752-8","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667258","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":"Concerns Regarding Midodrine Utilization in Cancer Patients with Heart Failure.","authors":"Çağrı Zorlu","doi":"10.1007/s10557-025-07751-9","DOIUrl":"https://doi.org/10.1007/s10557-025-07751-9","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658526","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":"https://doi.org/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":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tenecteplase Before Endovascular Thrombectomy (EVT): A Step Forward in Acute Stroke Management.","authors":"Muhammad Zubair","doi":"10.1007/s10557-025-07748-4","DOIUrl":"https://doi.org/10.1007/s10557-025-07748-4","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607449","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":"GLP1-RA and SGLT2-i: Implementation and Insulin Deescalation Strategies.","authors":"Arthi Palani, Sagar Patel, Shriya Patel, Shivani Srivastava, Jay Patel, Salman Salehin, Yochai Birnbaum, Joseph Allencherril","doi":"10.1007/s10557-025-07744-8","DOIUrl":"https://doi.org/10.1007/s10557-025-07744-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review will summarize the most contemporary trials for glucagon-like peptide 1 receptor agonists (GLP1-RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2-i) and present guidance on management and recommendations on adjunctive tapering of insulin in patients with insulin-dependent diabetes mellitus, which we term \"de-insulinization.\"</p><p><strong>Recent findings: </strong>GLP1-RA and SGLT2-i are the principal classes of diabetes medications evidencing cardiovascular benefit. However, there is limited consensus on how to effectively prescribe and maintain these medications for patients on other glucose-lowering therapy, especially insulin. Patients with type 2 diabetes and cardiovascular disease should be started on either a GLP-1RA, SGLT-i, or both in high-risk cases, while simultaneously tapering any prescribed insulin regimen. Initial selection and transition of therapy should be approached individually and systematically, with prioritization of patients with other comorbidities such as coronary artery disease, chronic kidney disease, and other diabetes complications.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599530","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":"Resuscitative Mean Arterial Pressure Targets in Cardiovascular Disease: A Narrative Review of Clinical Outcomes.","authors":"Prasanti A Kotta, Lakshmi Uppalapati, Madhivanan Elango, Jeffrey Triska, Mourad H Senussi","doi":"10.1007/s10557-025-07738-6","DOIUrl":"https://doi.org/10.1007/s10557-025-07738-6","url":null,"abstract":"<p><p>Mean arterial pressure (MAP) is a commonly used hemodynamic proxy for tissue perfusion. Continuous MAP monitoring and maintenance of MAP targets remains a cornerstone for managing shock states. However, co-morbidities and individual variations can complicate the relationship between MAP and organ perfusion. Factors such as fluid balance, microvascular circulation, and endothelial function all influence tissue perfusion. This review examines the nuances of MAP management across various patient populations with cardiovascular disease, including acute myocardial infarction cardiogenic shock, non-acute myocardial infarction cardiogenic shock, cardiac arrest, and cardiac surgery. We discuss the importance of individualized MAP targets, considering underlying health conditions, clinical scenarios, and individual shock physiology. Additionally, the importance of monitoring end-organ autoregulation and perfusion is emphasized to optimize shock management. We discuss a limited body of literature which indicates that higher MAPs are associated with improved outcomes in patients with cardiogenic shock, post-cardiac arrest, and after cardiac surgery. However, owing to the post-hoc and retrospective nature of most of these studies, whether higher MAPs truly lead to improved clinical outcomes or whether patients with higher MAPs are inherently less sick and therefore more likely to have better outcomes cannot be discerned from the available data. Further research, particularly prospective RCTs, is essential to define MAP targets that may improve outcomes across different patient populations and clinical settings.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574891","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":"The Emerging Role of Lactate and Lactylation Modifications in the Pathophysiology of Atherosclerotic Cardiovascular Diseases.","authors":"Xianqiong Lu, Qiyuan Luo, Danfeng Yu, Yan He, Jiyu Chen","doi":"10.1007/s10557-025-07732-y","DOIUrl":"https://doi.org/10.1007/s10557-025-07732-y","url":null,"abstract":"<p><p>Atherosclerosis is a chronic disease that is characterized by lipid accumulation and inflammation in the arterial wall. Atherosclerotic plaques form beneath the intima of large and medium-sized arteries and this is a leading cause of ischemic heart disease and stroke. Recently, with the intensification of global aging trends, the prevalence of atherosclerosis has increased significantly. Lactate, which is a byproduct of glycolysis, plays crucial roles in cell signaling, inflammatory responses, and metabolic regulation. Research on lactate and lactylation modifications in atherosclerotic cardiovascular diseases has gradually gained attention. This article reviews the latest research progress on lactate and its modifications in atherosclerotic cardiovascular diseases; explores mechanisms in pathological processes such as inflammation, oxidative stress, and apoptosis; and analyzes the potential as biomarkers and therapeutic targets. This review provides a reference for further studies on the role of lactate and lactylation in atherosclerotic cardiovascular diseases.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574892","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}