Cardiovascular Drugs and Therapy最新文献

{"title":"Optimal P2Y₁₂ Inhibitor After Myocardial Infarction: Can Angio-IMR Guide Treatment Selection?","authors":"Shubh Desai, Leslie A Ynalvez, Xander H T Wehrens","doi":"10.1007/s10557-025-07745-7","DOIUrl":"https://doi.org/10.1007/s10557-025-07745-7","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539090","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 in Heart Failure with Preserved or Mildly Reduced Ejection Fraction: A Promising Therapeutic Advancement.","authors":"Muhammad Zubair, Sohrab Khan","doi":"10.1007/s10557-025-07743-9","DOIUrl":"https://doi.org/10.1007/s10557-025-07743-9","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539089","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":"https://doi.org/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":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-25","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":"Key Insights for DOAC Management in Complex Patients.","authors":"Muhammad Zubair","doi":"10.1007/s10557-025-07742-w","DOIUrl":"10.1007/s10557-025-07742-w","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339919","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":"Impact of Percutaneous Coronary Interventions on Coronary Microvascular System: Coronary Stenting Versus Drug-Coated Balloon Angioplasty.","authors":"Uğur Özkan, Fatih Kardaş, Çağlar Kaya, Kenan Yalta","doi":"10.1007/s10557-025-07737-7","DOIUrl":"10.1007/s10557-025-07737-7","url":null,"abstract":"","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332516","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":"Clinical Implication of Quantitative Flow Ratio to Predict Clinical Outcomes in De Novo Coronary Lesions After Drug-Coated Balloon Angioplasty.","authors":"Feng Liu, Haipeng Cai","doi":"10.1007/s10557-025-07735-9","DOIUrl":"10.1007/s10557-025-07735-9","url":null,"abstract":"<p><strong>Purpose: </strong>The association between the intra-procedure quantitative flow ratio (QFR) and clinical outcomes after drug-coated balloon (DCB) angioplasty has not been investigated. This study aimed to investigate the clinical predictive value of pre-DCB QFR, a functional assessment of lesion preparation, for clinical outcomes in de novo coronary lesions after DCB angioplasty.</p><p><strong>Methods: </strong>This retrospective study included 170 consecutive patients undergoing DCB angioplasty for 177 de novo coronary lesions between January 2021 and December 2022. The QFR was computed at baseline, pre-DCB, and post-DCB. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause death, cardiac death, target vessel myocardial infarction, and target lesion revascularization.</p><p><strong>Results: </strong>During 2-year follow-up, 37 patients with 38 lesions have experienced MACE. The pre-DCB QFR, measured after pre-dilation, was significantly lower in the MACE group. Receiver operator characteristic curve analysis showed the optimal pre-DCB QFR cut-off value for predicting MACE was 0.925 (area under curve = 0.782, 95% confidence interval [CI] 0.702-0.861, sensitivity = 78.9%, specificity = 74.8%, p < 0.001). A pre-DCB QFR < 0.925 was associated with a significantly higher risk of MACE compared with a value > 0.925 (46.1% vs. 7.1%, p < 0.001). In multivariable Cox regression analyses, pre-DCB QFR < 0.925 was associated with an over sixfold increased risk of MACE (hazard ratio = 7.483, 95% CI 3.363-16.653, p < 0.001).</p><p><strong>Conclusion: </strong>The pre-DCB QFR was a promising predictor of unfavorable clinical outcomes in de novo coronary lesions after DCB angioplasty.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332514","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":"Direct Oral Anticoagulants in Valvular Diseases and Prosthetic Valves: Why Not?","authors":"Konstantinos Lampropoulos, Michail Penteris, Grigorios Gerotziafas","doi":"10.1007/s10557-025-07736-8","DOIUrl":"10.1007/s10557-025-07736-8","url":null,"abstract":"<p><p>Valvular heart disease (VHD) and atrial fibrillation (AF) often coexist and lead to a prothrombotic state that necessitates the use of anticoagulants for the prevention of thromboembolic events. Direct oral anticoagulants (DOACs) are a significant advancement in anticoagulation therapy for patients with AF and VHD, leading to comparable efficacy and improved safety outcomes compared to vitamin K antagonists (VKAs). However, their role in patients with severe mitral stenosis, mechanical heart valves, and rheumatic heart disease remains limited due to the lack of robust data from clinical trials. As such warfarin continues to be the anticoagulant of choice for these populations. For patients with bioprosthetic valves or following transcatheter aortic valve implantation (TAVI), DOACs may be a viable alternative, but individualized risk assessment is crucial. The EHRA classification provides a practical framework for the management of patients with AF, but there are still challenges in its clinical application due to mixed valvular pathologies and patient-specific factors. Clinicians must carefully weigh the risk of thromboembolic and bleeding events, consider the patients' preferences, and advise regular follow-up to optimize the treatment outcomes. Overall, while DOACs offer convenience and similar efficacy and safety compared to VKAs, VKAs remain the anticoagulant of choice for specific subgroups, underscoring the need for personalized approaches regarding anticoagulation therapy.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332515","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":"Molecular Interplay of Gene Network Dynamics, Epigenetic Regulation, and Therapeutic Mapping in Cardiovascular Disease.","authors":"Md Rashedunnabi Akanda, Md Shiblee Sadik Sabuj, S M Abdus Salam, Eshrat Jahan","doi":"10.1007/s10557-025-07739-5","DOIUrl":"10.1007/s10557-025-07739-5","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiovascular diseases (CVDs) continue to be the leading cause of death globally, driven by a complex interplay of genetic, epigenetic, and environmental factors. Traditional risk factors alone fail to explain the individual variability in disease susceptibility and progression. Recent advances in genomics and epigenomics have revealed key molecular mechanisms that regulate cardiovascular function, highlighting the importance of gene network dynamics and epigenetic regulation.</p><p><strong>Methods: </strong>This review systematically analyzes peer-reviewed literature from the past decade sourced from electronic databases including PubMed and Google Scholar. It compiles the multifaceted roles of DNA methylation, histone modifications, chromatin remodeling, and noncoding RNAs in regulating cardiovascular gene expression, cellular phenotypes, and disease pathogenesis.</p><p><strong>Results: </strong>DNA methylation influences the transcriptional activity of gene expression associated with atherosclerosis, myocardial infarction, and hypertension, while histone modifications and ATP-dependent chromatin remodeling regulate cardiac hypertrophy, fibrosis, and regeneration. Noncoding RNAs further act as critical regulators of angiogenesis, inflammation, and myocardial remodeling. Therapeutically, these findings have facilitated the development of epigenetic drugs and gene-editing technologies targeting specific molecular pathways involved in CVD progression. Emerging technologies such as CRISPR/Cas9, RNA-based therapies, and small-molecule inhibitors of epigenetic enzymes hold potential for correct abnormal gene expression patterns. Moreover, integrative multi-omics and systems biology approaches are advancing personalized treatment strategies, improving the accuracy and effectiveness of cardiovascular interventions.</p><p><strong>Conclusion: </strong>Collectively, unraveling the complex molecular interactions among gene networks, epigenetic alterations, and targeted therapeutic mapping aims to combat CVD with better precision and efficacy.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332517","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 Administration of Extracellular Vesicles Derived from Bone Marrow Stem Cells Improved Doxorubicin-induced Heart Failure with Mid Range Ejection Fraction (HFmrEF) in Rats.","authors":"Jintao Dou, Yaping Xu, Yiqi Wang, Jinfu Chen, Zhikun Guo","doi":"10.1007/s10557-025-07721-1","DOIUrl":"https://doi.org/10.1007/s10557-025-07721-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the therapeutic effects of extracellular vesicles (EVs) derived from bone marrow mesenchymal stem cells (BMSCs) on heart failure in rats through intrapericardial injection.</p><p><strong>Methods: </strong>Initially, doxorubicin was used to induce apoptosis in H9C2 cells, and the protective effects of EVs on these cells were evaluated. EVs were injected into the pericardial cavity of rats with heart failure, followed by real-time in vivo imaging and immunofluorescence detection to confirm the implantation of EVs in the myocardium. Cardiac function was assessed via echocardiography after the pericardial injection. Immunohistochemical techniques were employed to measure the expression of BNP, IL-6, CD31, and VEGFA in rat heart tissue. Additionally, the collagen fiber content in the heart tissue was detected using Masson staining.</p><p><strong>Results: </strong>The results showed that EVs derived from BMSCs at a concentration of 100 μg/ml most effectively promoted the proliferation of H9C2 cells and protected them from doxorubicin-induced damage. Compared to the heart failure group, EV treatment significantly increased LVEF, LVFS, and CO. Following intrapericardial injection of BMSCs, in vivo imaging revealed high-intensity fluorescence signals in the cardiac region, and immunofluorescence confirmed the implantation of EVs in the myocardium. Post-EV treatment, the expression levels of BNP and IL-6 and collagen content in myocardial tissue were significantly reduced, whereas the levels of CD31 and VEGFA were significantly increased.</p><p><strong>Conclusion: </strong>EVs derived from BMSCs, when injected into the pericardial cavity, significantly improved cardiac function in heart failure rats through anti-inflammatory and pro-angiogenic mechanisms.</p>","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265309","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":"https://doi.org/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":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-10","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}