Cardiovascular Drugs and Therapy最新文献

{"title":"Impact of Diabetes on Coronary Plaque Stabilization With Evolocumab: Insights From the YELLOW III Trial.","authors":"Keisuke Yasumura, Yuliya Vengrenyuk, Jiajia Liu, Pruthvi C Revaiah, Amit Hooda, Raman Sharma, Sahil Khera, Vishal Kapur, Joseph Sweeny, Prakash Krishnan, Pedro Moreno, Xiaobo Zhou, Jagat Narula, Roxana Mehran, Samin Sharma, Annapoorna S Kini","doi":"10.1007/s10557-026-07962-8","DOIUrl":"https://doi.org/10.1007/s10557-026-07962-8","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetes is associated with high-risk coronary plaque features and residual cardiovascular risk. Whether diabetes modifies plaque response to PCSK9 inhibition remains uncertain. We assessed the impact of diabetes on coronary plaque stabilization with evolocumab.</p><p><strong>Methods: </strong>This post hoc analysis of the YELLOW III trial included 110 patients with chronic coronary disease and lipid-rich, non-obstructive coronary lesions identified by optical coherence tomography (OCT). Patients were on maximally tolerated statin therapy and received evolocumab 140 mg every 2 weeks for 26 weeks. Serial OCT, near-infrared spectroscopy, and intravascular ultrasound were performed at baseline and follow-up. Peripheral blood mononuclear cell RNA sequencing compared transcriptomic profiles by diabetes status.</p><p><strong>Results: </strong>Among 110 patients, 56 had diabetes and 54 did not. At baseline, patients with diabetes had thinner minimum fibrous cap thickness (FCT), higher maximum lipid core burden index within 4 mm (maxLCBI4mm), and greater percent atheroma volume (PAV). LDL cholesterol reduction was similar between groups (-61.8 ± 26.8 vs -53.5 ± 30.9 mg/dL; p=0.137). Plaque response did not differ significantly by diabetes status for minimum FCT (29.3 ± 21.7 vs 24.3 ± 22.7 µm; p=0.231), maxLCBI4mm (-92.9 ± 142.3 vs -94.6 ± 139.9; p=0.948), and PAV (-1.4 ± 1.4 vs -1.3 ± 1.5%; p=0.698). Baseline diabetes-associated neutrophil- and platelet-related pathway enrichment was attenuated at follow-up.</p><p><strong>Conclusion: </strong>Despite maximally tolerated statin therapy, patients with diabetes exhibited more adverse plaque features. Evolocumab was associated with similar short-term plaque stabilization regardless of diabetes status, suggesting potential mechanistic insight into PCSK9 inhibition in diabetes.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036299","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":"Energetic Decoding of VSMC Plasticity: Metabolic Reprogramming and Phenotypic Switching.","authors":"Tingyu Yan, Qian Nie, Bo Xu, Xin Peng, Jiecan Zhou","doi":"10.1007/s10557-026-07959-3","DOIUrl":"https://doi.org/10.1007/s10557-026-07959-3","url":null,"abstract":"<p><p>Phenotypic switching of vascular smooth muscle cells (VSMCs) constitutes a pivotal event in the initiation and progression of various vascular diseases, including vascular calcification, atherosclerosis, aneurysm, and pulmonary arterial hypertension. The transition from a contractile to a synthetic phenotype is commonly characterized by increased proliferation, migration, and extracellular matrix synthesis, thus generating substantial bioenergetic demands. In recent years, accumulating evidence has indicated that metabolic reprogramming has emerged as a key regulatory dimension of VSMC plasticity. In this review, we systematically summarize the regulatory mechanisms by which metabolic reprogramming governs VSMC phenotypic switching, focusing mainly on glucose, lipid, and amino acid metabolism, while also discussing selected metabolite-derived signaling events and disease-context-specific metabolic patterns. We particularly emphasize how metabolic alterations collectively help shape VSMC fate through the integrated effects of energy supply, metabolic intermediates, and their associated signaling networks. Our aim is to establish a systematic theoretical framework linking metabolic reprogramming to VSMC phenotypic switching, thereby providing new insights into the mechanisms underlying vascular remodeling and laying a theoretical foundation for the development of metabolism-targeted therapeutic strategies.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987955","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":"Introducing Allopurinol to the Medical Treatment of Marfan Syndrome: Advantages, Limitations, and Potential Extension to other Aortopathies.","authors":"Gustavo Egea, Rodrigo Barbosa de Souza, Gisela Teixidó-Turà, Aleksandra Mas-Stachurska, Arturo Evangelista, Bart Loeys","doi":"10.1007/s10557-026-07954-8","DOIUrl":"https://doi.org/10.1007/s10557-026-07954-8","url":null,"abstract":"<p><p>Marfan syndrome (MFS), a multisystemic connective tissue disorder, shows intra- and interfamilial aortopathy variability. More than 3,000 mutations have been reported in the FBN1 gene, which encodes fibrillin-1, a component of microfibrils and elastic fibres. Aortic dilatation mainly affects the aortic root and the ascending aorta. However, dissection of the aortic wall can occur either before or after the aortic arch (type A and type B dissections, respectively). There is no doubt that progress in aortic surgery has significantly improved patients' life expectancy, but conversely, current medical treatment based on beta-blockers (BBs) and angiotensin receptor blockers (ARBs) only slightly slows aortic growth. Aortopathy is the result of multiple defects in cellular and subcellular processes that affect aortic wall cells and extracellular matrix homeostasis and organisation. Pathomechanisms include dysregulated cell signalling, altered mechanotransduction, and oxidative stress. Therefore, it is reasonable to consider a multi-target strategy for medical treatment. Here, we suggest the concurrent administration of allopurinol with current medical treatment. Allopurinol's mode of action is based on its strong antioxidant effects, demonstrated in preclinical assays in different MFS mouse models. Allopurinol is a widely used compound in medical practice for gout, and has been proven safe, economical and effective in other cardiovascular diseases. The recent approval of allopurinol as an orphan drug for the treatment of MFS by the European Medicines Agency (EMA) adds further value to its potential inclusion in standard medical therapy in the near future.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987928","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":"Apixaban Versus LMWH in CAT/VTE: A Comment on Clinical and Methodological Heterogeneity.","authors":"Chenchen Wu","doi":"10.1007/s10557-026-07960-w","DOIUrl":"https://doi.org/10.1007/s10557-026-07960-w","url":null,"abstract":"<p><p>We commend Huang et al. for separating treatment from postoperative prophylaxis in CAT/VTE. However, the pooled analysis still combines clinically distinct exposure patterns, heterogeneous LMWH comparators, and studies with different follow-up windows, which limits interpretability of the reported risk ratios. Observational before-after and quality-improvement studies are also vulnerable to secular trend bias, and acute treatment should not be merged with extended therapy. Future meta-analyses should use drug-specific stratification, time-standardized or hazard-based methods, concurrent controls, and phase-specific analyses to better estimate apixaban's effect while preserving clinically meaningful differences between indications and treatment phases in cancer-associated thrombosis across settings and improving decision-making in practice.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966231","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":"Incomplete Ascertainment of the Composite MACCE Outcome in the ACOR ViV-TAVI Antithrombotic Registry Analysis.","authors":"Muhammad Shaheer Ahmad Baloch, Qazi Sherjeel Ur Rehman, Muhammad Zohaib Saleem","doi":"10.1007/s10557-026-07946-8","DOIUrl":"https://doi.org/10.1007/s10557-026-07946-8","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943784","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":"Dendritic Cells in the Immunoregulation of Myocardial Infarction: Mechanisms and Therapeutic Strategies.","authors":"Chenyang Jiang, Yuan Ma, Shuang Deng, Dongfeng Wan, Pingping Zhou","doi":"10.1007/s10557-026-07955-7","DOIUrl":"https://doi.org/10.1007/s10557-026-07955-7","url":null,"abstract":"<p><p>Myocardial infarction (MI) remains a leading cause of mortality and long-term disability worldwide. Its pathological process involves multiple interconnected stages, including atherosclerosis, ischemia-reperfusion injury, ventricular remodeling, and fibrosis. Dendritic cells (DCs), as key antigen-presenting cells bridging innate and adaptive immunity, exert bidirectional immunoregulatory functions in the pathogenesis of MI. During atherogenesis, DCs actively participate in lipid deposition, foam cell formation, and inflammatory regulation. Following MI, DCs influence myocardial injury and repair through diverse mechanisms, including cytokine secretion, T cell differentiation modulation, and exosome-mediated intercellular communication. Clinical studies have revealed a marked reduction in circulating DCs in MI patients, accompanied by functional hyperactivation of the residual DC population, which correlates closely with adverse clinical outcomes. On the therapeutic front, several DC-targeted strategies have demonstrated efficacy in preclinical models, including the C-X-C motif chemokine receptor 4 antagonists POL5551 and POL6326, mannosylated cytotoxic T-lymphocyte-associated protein 4-presenting small extracellular vesicles (CM@sEVs), tolerogenic dendritic cells (tDCs), and DC-derived exosomes (Dex), all of which have shown potential to improve cardiac function, attenuate fibrosis, and promote angiogenesis. Additionally, conventional medications such as statins and angiotensin-converting enzyme inhibitors can also modulate DC functions to confer cardioprotection. This review provides a comprehensive overview of the immunoregulatory mechanisms of DCs across the pathological spectrum of MI and highlights recent progress in DC-based therapeutic strategies, aiming to provide a theoretical foundation for the immunotargeted treatment of MI.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917881","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":"Vascular Immunometabolism in Atherosclerosis: Emerging Roles of Glycometabolic Reprogramming in Immune and Vascular Cells.","authors":"Haoshuang Li, Anni Song, Jiachen Zhang, Hongwei Dong, Xiaoci Li, Ying Zhao","doi":"10.1007/s10557-026-07956-6","DOIUrl":"https://doi.org/10.1007/s10557-026-07956-6","url":null,"abstract":"<p><p>The progression of atherosclerosis is closely associated with alterations in cellular glucose metabolism and vascular immunometabolic regulation. Increasing evidence indicates that glycometabolic reprogramming in macrophages, ECs, and vascular smooth muscle cells contributes to plaque development by modulating inflammatory activation, oxidative stress, lipid metabolism, and cellular phenotypic changes. In this review, we summarize recent advances in glycometabolic reprogramming during atherosclerosis, focusing on glycolysis, the pentose phosphate pathway, and lactate-mediated epigenetic regulation. We further discuss how metabolic alterations interact with immune responses, trained immunity, epigenetic remodeling, and cellular senescence to regulate the atherosclerotic microenvironment. In addition, we highlight potential therapeutic targets involved in metabolic regulation, including key glycolytic enzymes such as 6-phosphofructo-2-kinase and lactate dehydrogenase A, as well as metabolic-epigenetic pathways such as the TRAP1/HDAC3/H4K12la axis. However, significant challenges remain regarding cell-type specificity, therapeutic selectivity, and clinical translation of metabolic interventions. Understanding the complex relationship between glycometabolic reprogramming and vascular immunometabolism can provide mechanistic insights and guide future investigations of metabolic interventions for atherosclerosis.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918241","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":"Endophenotyping Without Anchors: Operational and Evidentiary Gaps in the Stroke-Heart Syndrome Framework.","authors":"Samia Nawaz, ShahMeer Nawaz, Manal Nawaz","doi":"10.1007/s10557-026-07957-5","DOIUrl":"https://doi.org/10.1007/s10557-026-07957-5","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917897","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":"Finerenone Use in Heart Failure Patients with Type 2 Diabetes and Kidney Disease: An Analysis of the FINE-TURK Registry.","authors":"Serap Yadigar, Suat Akgür, Tolga Sinan Güvenç, Mehmet Sezen, Büşra Özcan, Elif Yıldırım Ayaz, Betül Doğantekin, İlker Atay, Serpil Müge Değer, Mustafa Demir, Sümeyra Koyuncu, Üstün Yılmaz, Ayça İnci, Hülya Çolak, Bülent Demirelli, Serhan Tuğlular, Ebru Gök Oğuz, Mehmet Deniz Aylı, Ezgi Avanaz, Fatih Yılmaz, Beyza Doğan, Süleyman Karaköse, Mine Şebnem Karakan, Bahar Gürlek Demirci, Kültigin Türkmen, İsmail Baloğlu, Mehmet Batmazoğlu, Mehmet Mert, Emre Aydın, Fatma Yılmaz Aydın, Ergün Parmaksız, Pınar Özdemir, Bartu Ediz, Zeki Aydın, Mehmet Emin Demir, Siren Sezer, Suat Ünver, Öznur Baykal, Beril Akman Çakmak, Atila Altuntaş, Mahmud İslam, Fatma Sibel Koçak Yücel, Meral Mert, Belda Dursun, Necmi Eren, Simge Bardak Demir, Alper Tuna Güven, Mukadder Ayşe Bilgiç, Arda Erdut, Gülşah Keskin, Ahmet Ziya Şahin, Mehmet Horoz, Merve Tekinyıldız, Murat Duranay, Serkan Feyyaz Yalın, Murat Altunok, Funda Sarı, Ramazan Sarı, Dilek Torun, Serdar Kahvecioğlu, A Serap Yalçınkaya, Tülin Akagün, Hüseyin Çelik, Sinan Kazan, İlyas Öztürk, Mehmet Polat, Mehmet Fethullah Aydın, Meral Meşe, Melike Hazal Yavuz Umut, Asil Demirezen, Ülver Derici, Eda Altun, Erkan Şengül, Serkan Bakırdöğen, Ekrem Kara, Cüneyt Akgöl, Mahmut Başar Aykent, Ali İlter, Ahmet Ekmekçi, Sena Ulu, Mustafa Arıcı, Elif Arı Bakır","doi":"10.1007/s10557-026-07944-w","DOIUrl":"https://doi.org/10.1007/s10557-026-07944-w","url":null,"abstract":"<p><strong>Background: </strong>Finerenone, a non-steroidal mineralocorticoid receptor antagonist, improves cardiorenal outcomes in patients with type 2 diabetes mellitus and chronic kidney disease. However, real-world data on its use in patients with concomitant heart failure remain limited. This study aimed to evaluate the baseline characteristics and short-term renal safety and efficacy of finerenone in patients with type 2 diabetes, kidney disease, and heart failure from the FINE-TURK Registry.</p><p><strong>Methods: </strong>This was a retrospective, multicenter, observational registry analysis conducted across 56 centers in Türkiye. Among 1,168 patients initially enrolled, 918 patients with available heart failure status and ejection fraction data were included. Patients were categorized according to the presence of heart failure, and heart failure patients were further classified as HFrEF or HFmrEF/HFpEF. Three-month changes in serum potassium, estimated glomerular filtration rate, and albuminuria were assessed. Safety endpoints included serum potassium ≥ 5.5 mEq/L and eGFR ≤ 25 mL/min/1.73 m² at three months. The primary renal efficacy endpoint was a > 30% reduction in albuminuria from baseline.</p><p><strong>Results: </strong>Of 918 patients, 133 had heart failure. Patients with heart failure were older and had lower baseline eGFR compared with those without heart failure. They were also more likely to receive a lower starting dose of finerenone. At three months, changes in serum potassium, eGFR, and albuminuria were not significantly different between patients with and without heart failure. No excess risk of hyperkalemia or worsening renal function was observed in the heart failure group. In adjusted analyses, heart failure was associated with a greater likelihood of achieving a > 30% reduction in albuminuria. No significant differences in short-term renal safety or efficacy outcomes were observed between HFrEF and HFmrEF/HFpEF subgroups.</p><p><strong>Conclusions: </strong>In this nationwide real-world registry, patients with heart failure who were treated with finerenone had a higher-risk baseline profile, including older age and lower eGFR. Despite this, finerenone was not associated with increased short-term renal safety concerns and was linked to a clinically meaningful reduction in albuminuria. These findings support the short-term renal safety and potential efficacy of finerenone in patients with type 2 diabetes, kidney disease, and heart failure.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918043","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":"In-Hospital SGLT-2 Inhibitor Initiation in Acute Heart Failure: Clarifying Event Timing, Mechanisms, and Safety Boundaries.","authors":"Xiaoxue You","doi":"10.1007/s10557-026-07953-9","DOIUrl":"https://doi.org/10.1007/s10557-026-07953-9","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918140","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}