Cardiology and Therapy最新文献

{"title":"Current and Future Treatment Landscape of Transthyretin Amyloid Cardiomyopathy.","authors":"Emily Margolin, Lily K Stern, Alessia Argiro, Julie L Rosenthal, Marcus A Urey, Kevin M Alexander","doi":"10.1007/s40119-025-00424-6","DOIUrl":"https://doi.org/10.1007/s40119-025-00424-6","url":null,"abstract":"<p><p>Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive disease caused by the deposition of insoluble amyloid fibrils derived from misfolded transthyretin (TTR). The treatment landscape is rapidly evolving, with disease-modifying therapies now targeting distinct steps in disease progression. Management requires both disease-modifying treatment and symptom-guided treatment of heart failure and arrhythmias, along with device therapy and consideration of advanced heart failure interventions (i.e., heart transplantation) in select patients. Therapeutic advances have significantly increased treatment possibilities, selection of appropriate therapy, switching between therapies, combination strategies, and how to monitor treatment response over time. This review summarizes available and investigational therapies for ATTR-CM and considers practical questions that guide clinical decision-making, with the goal of helping clinicians navigate the evolving therapeutic landscape.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Arterial Stiffness and Carotid Intima-Media Thickness on Subclinical Atherosclerosis and Cardiovascular Risk Assessment.","authors":"Verónica Fernández-Alvarez, Miriam Linares-Sánchez, Fernando López, Alessandra Rinaldo, Alfio Ferlito","doi":"10.1007/s40119-025-00428-2","DOIUrl":"https://doi.org/10.1007/s40119-025-00428-2","url":null,"abstract":"<p><p>Subclinical atherosclerosis precedes overt cardiovascular disease and can be detected through surrogate markers such as arterial stiffness (AS) and carotid intima-media thickness (CIMT). This review examines the diagnostic and prognostic roles of AS and CIMT, highlighting their potential to improve cardiovascular risk stratification. Although traditional risk prediction models remain the cornerstone of primary prevention, they often fail to identify individuals at risk who lack conventional risk factors. Emerging evidence suggests that integrating CIMT and AS into risk assessment may improve the reclassification of individuals with intermediate risk. However, their routine use remains controversial due to methodological heterogeneity, variability in predictive value, and the prioritization of alternative imaging biomarkers such as carotid plaque or coronary artery calcium (CAC). This article critically assesses the strengths and limitations of AS and CIMT, discussing their potential utility as biomarkers, explores their application into clinical practice, and comprehensively summarizes the latest research.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Healthcare Resource Utilization Among Patients with Hypertrophic Cardiomyopathy Hospitalized for Heart Failure in Japan.","authors":"Yuika Ikeda, Bruno Casaes Teixeira, Thomas Laurent, Tsunehisa Yamamoto","doi":"10.1007/s40119-025-00427-3","DOIUrl":"https://doi.org/10.1007/s40119-025-00427-3","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) is one of the most common complications in patients with hypertrophic cardiomyopathy (HCM); however, there are limited data on HCM burden in Japan. We evaluated the burden of HF hospitalization and factors that predispose patients with HCM to HF hospitalization.</p><p><strong>Methods: </strong>This retrospective observational database study used a hospital-based claims database from January 01, 2011, to December 31, 2023, provided by Medical Data Vision Co., Ltd. The primary objective of the study was to calculate the incidence of first HF hospitalization after HCM diagnosis. A nested case-control design compared patients with or without hospitalization to identify factors associated with HF hospitalization. Hospitalization costs and outcomes after discharge were also described.</p><p><strong>Results: </strong>Of 12,145 patients with newly diagnosed HCM without HF hospitalization, 525 were hospitalized with HF during the follow-up period. The mean age ± standard deviation (SD) of the overall study population at cohort entry date was 71.4 ± 14.0 years, and 45.8% were female patients. The incidence of HF hospitalization was 17.2 events/1000 patient-years. Patients with HCM hospitalized for HF had higher rates of comorbidities, including HF (45.9%), diabetes mellitus (28.6%), hypertension (23.0%), atrial fibrillation (AF; 21.3%), myocardial infarction (MI; 17.5%), arrhythmia except AF (15.0%), and dyslipidemia (13.1%), than patients without HF hospitalization. Significant predictors of hospitalization among patients with HCM were AF (odds ratio [OR] 1.63; 95% confidence interval [CI] 1.18-2.25; p = 0.003), MI (OR 1.68; 95% CI 1.20-2.35; p = 0.003), HF (OR 1.82; 95% CI 1.39-2.39; p < 0.001), chronic obstructive pulmonary disease (OR 2.30; 95% CI 1.08-4.89; p = 0.031), and loop diuretics (OR 4.35; 95% CI 3.33-5.69; p < 0.001). The average costs, length of hospital stay, and overall mortality rate associated with HF hospitalization were 1035 kJPY (~ 156,750 USD), 20.0 days, and 8.8%, respectively.</p><p><strong>Conclusions: </strong>HF hospitalization in patients with HCM imposes a significant clinical and economic burden.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Blood Sugar: A Scoping Review of GLP-1 Receptor Agonists in Cardiovascular Care.","authors":"Neil Gupta, Zaid Zayyad, Rohan Bhattaram, David Tiu, Jennifer Dau, Vidur Guburxani, Stephanie Dwyer Kalzuna, Adhir R Shroff","doi":"10.1007/s40119-025-00426-4","DOIUrl":"https://doi.org/10.1007/s40119-025-00426-4","url":null,"abstract":"<p><p>Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have emerged as a transformative class of therapies initially developed for glycemic control in type 2 diabetes mellitus. Now, they are also getting recognized for their broader cardiometabolic effects. In this review, we discuss the mechanism of action of GLP-1 RAs, focusing on their proposed cardiometabolic impact and the key clinical trials that have demonstrated improvement in cardiovascular outcomes. GLP-1 RAs have demonstrated benefits in coronary artery disease, heart failure, blood pressure, and atrial fibrillation irrespective of type 2 diabetes mellitus status, with new possible applications in peripheral arterial disease. Findings thus far have been translated into recommendations in clinical guidelines by the American College of Cardiology, American Heart Association, European Society of Cardiology, and American Diabetes Association. As GLP-1 RAs become more prevalent in treating diabetes and patients with cardiovascular disease (CVD) or risk factors for CVD, clinicians will ultimately manage the practical aspects of patient selection, dosing, special considerations, and side effects of these medications. Ongoing and future clinical trials are expected to further define the cardiovascular role of GLP-1 RAs, expand their therapeutic indications, and solidify their place in the evolving landscape of cardiovascular care.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival in a Contemporary, Real-World Cohort of Patients with Mixed-Phenotype Transthyretin Amyloid Cardiomyopathy Treated with Tafamidis: An Analysis from THAOS.","authors":"Jonas Wixner, Angela Dispenzieri, Leslie Amass, Martin Carlsson, Steve Riley, Evan Powers, Jeffery W Kelly","doi":"10.1007/s40119-025-00421-9","DOIUrl":"https://doi.org/10.1007/s40119-025-00421-9","url":null,"abstract":"<p><strong>Introduction: </strong>Tafamidis is approved to treat transthyretin amyloid cardiomyopathy (ATTR-CM). Many patients with ATTR-CM present with a mixed phenotype of both cardiac and neurologic symptoms, but real-world effectiveness studies of tafamidis in this population are lacking. This study assessed survival and other outcomes in a real-world, contemporary cohort of tafamidis-treated and untreated patients with mixed-phenotype ATTR-CM.</p><p><strong>Methods: </strong>The Transthyretin Amyloidosis Outcomes Survey (THAOS) was a longitudinal, observational, phase 4 study of patients with transthyretin amyloidosis and asymptomatic carriers of pathogenic transthyretin gene variants and was completed in June 2023. This analysis included a contemporary cohort of patients enrolled in THAOS in 2019-2023 who were characterized as having mixed-phenotype ATTR-CM at enrollment. The tafamidis-treated cohort received the approved dose of tafamidis (meglumine 80 mg/free acid 61 mg) throughout the study, and the untreated cohort never received tafamidis.</p><p><strong>Results: </strong>In tafamidis-treated (n = 116) and untreated patients (n = 223), respectively, median age at enrollment was 77.8 and 72.8 years, and 42.2% and 77.6% had variant ATTR-CM. Survival rates at 30 months were 81.5% (95% CI 66.7-90.2) in tafamidis-treated patients and 75.1% (95% CI 66.1-82.0) in untreated patients. Median yearly incidence of cardiovascular-related hospitalizations was 0.89 for tafamidis-treated and 1.70 for untreated patients, and median duration of cardiovascular-related hospitalizations was 7.0 and 11.5 days, respectively. There were 13 (11.2%) and 40 (17.9%) deaths in the respective groups.</p><p><strong>Conclusion: </strong>Patients with mixed-phenotype ATTR-CM treated with the approved dose of tafamidis had numerically higher survival rates, a numerically lower rate of cardiovascular-related hospitalizations, and fewer deaths than untreated patients. These data parallel recent results for patients with predominantly cardiac ATTR-CM from THAOS and extend results of ATTR-ACT to a contemporary, real-world, mixed-phenotype population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT00628745.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Effectiveness of Apixaban in Very Elderly Patients with Atrial Fibrillation: A Retrospective Analysis of Japanese Administrative Claims Data.","authors":"Ako Matsuo-Ohsawa, Jun Katada, Shun Kohsaka","doi":"10.1007/s40119-025-00420-w","DOIUrl":"https://doi.org/10.1007/s40119-025-00420-w","url":null,"abstract":"<p><strong>Introduction: </strong>Anticoagulation is a well-established treatment for patients with atrial fibrillation (AF) for the prevention of stroke/systemic embolism (SE). However, although nearly all elderly patients with AF are at risk for thrombotic events, they also have a heightened risk of bleeding, and evidence regarding the optimal anticoagulation regimen in very elderly patients remains limited. This study aimed to evaluate the safety and effectiveness of apixaban versus warfarin in a cohort of very elderly patients with AF in Japan.</p><p><strong>Methods: </strong>This was a retrospective analysis of administrative claims for patients with AF newly initiated on apixaban or warfarin from acute care hospitals. Clinical and demographic characteristics were balanced between cohorts using an inverse probability of treatment weighting with stabilized weights (s-IPTW) method. Prespecified subgroup analyses were also conducted to assess treatment interaction with some baseline/demographic factors.</p><p><strong>Results: </strong>A total of 77,814 eligible patients with AF were balanced between the apixaban group (N = 33,834) and warfarin group (N = 43,671) using s-IPTW. The incidence of stroke/SE-primary effectiveness outcome-was 55.8 and 75.2 per 1000 person-years and that of major bleeding-primary safety outcome-was 17.3 and 25.3 per 1000 person-years in the apixaban and warfarin groups, respectively. Apixaban was associated with a significantly lower risk of stroke/SE (hazard ratio [HR], 0.75; 95% confidence interval [CI] [0.71-0.80], P < 0.001) and major bleeding (HR, 0.69; 95% CI [0.62-0.76], P < 0.001). Consistent trends were observed across all prespecified secondary outcomes. Additionally, there was no evidence of interaction between treatment and the variables examined, such as age, number of medications, Charlson Comorbidity Index, and activities of daily living.</p><p><strong>Conclusions: </strong>In very elderly patients with AF, apixaban was associated with a significantly lower risk of stroke/SE and bleeding compared with warfarin.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT05438888.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cracking the Zip Code: Uncovering the Link Between Socioeconomic Status and Transcatheter Aortic Valve Replacement Outcomes.","authors":"Helena Dickens, Adhir Shroff, Khaled Abdelhady, Siddharth Bhayani","doi":"10.1007/s40119-025-00425-5","DOIUrl":"https://doi.org/10.1007/s40119-025-00425-5","url":null,"abstract":"<p><strong>Introduction: </strong>There is a well-known correlation between lower socioeconomic status and health outcomes. Patient zip codes and the Centers for Disease Control and Prevention's (CDC) Social Vulnerability Index (SVI) can be surrogates for income and socioeconomic status to compare outcomes following transcatheter aortic valve replacement (TAVR).</p><p><strong>Methods: </strong>We performed a retrospective study among patients who underwent TAVR at the University of Illinois at Chicago (UIC) in Chicago, Illinois, between March 2018 and June 2023. Using income data from the Census Bureau and the SVI, we assigned patients to two income groups: lower (LIG) or higher (HIG). Primary outcomes were composite major adverse cardiac events (MACE) (consisting of cardiovascular death, myocardial infarction, or cerebrovascular accident) and all-cause death. Secondary outcomes included congestive heart failure exacerbations and major bleeding events. Outcomes were analyzed at 30 days, 6 months, and 12 months.</p><p><strong>Results: </strong>We analyzed 276 patients; the LIG comprised 222 (80%) of these patients. No significant differences between groups were found in the primary or secondary outcomes post-TAVR at the 6- or 12-month interval. There were significant differences in SVI between those experiencing bleeding events at 12 months. There were no differences in primary outcomes between racial groups in a subanalysis.</p><p><strong>Conclusion: </strong>Following TAVR, patients in the LIG and HIG had no differences in adverse events at 6 and 12 months post-TAVR. Patients in regions with higher SVI (more vulnerable regions) had higher periprocedural bleeding events.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Ventricular Mechanical Circulatory Support Devices for Cardiogenic Shock After Myocardial Infarction.","authors":"Duc M Giao, Robert P Giugliano","doi":"10.1007/s40119-025-00413-9","DOIUrl":"10.1007/s40119-025-00413-9","url":null,"abstract":"<p><p>Cardiogenic shock is the most common cause of mortality in patients with acute myocardial infarction (AMI). Historically, AMI complicated by cardiogenic shock was associated with in-hospital survival of only ~50%. Recent advances in mechanical circulatory support have allowed for improved survival rates compared with only conventional medical treatment. However, the management strategy for AMI-related cardiogenic shock remains largely empirical due to limited high-quality evidence-based studies. In this review, we provide an overview of the four types of left ventricular mechanical circulatory support currently available, review new guideline updates from the American College of Cardiology Foundation/American Heart Association and European Society of Cardiology, and discuss recent and ongoing studies and registries in cardiogenic shock following AMI.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"123-139"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Blood Pressure Control: A Randomized Comparative Trial of Losartan/Chlorthalidone vs. Losartan/Hydrochlorothiazide.","authors":"Isabel E Rucker-Joerg, Ernesto G Cardona-Muñoz, Francisco G Padilla-Padilla, Rodrigo Suarez-Otero, Yulia Romero-Antonio, Emmanuel Canales-Vázquez, Kevin F Rios-Brito, Ileana C Rodríguez-Vazquez, Jorge González-Canudas","doi":"10.1007/s40119-025-00407-7","DOIUrl":"10.1007/s40119-025-00407-7","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular diseases are a leading cause of global mortality, with hypertension as a major risk factor. Low control rates are often attributed to monotherapy, while evidence and clinical guidelines support the effectiveness of combination therapies. This study aimed to evaluate blood pressure changes and the achievement of target levels in patients treated with losartan/chlorthalidone (L/C) compared to losartan/hydrochlorothiazide (L/H).</p><p><strong>Methods: </strong>A randomized, double-blind, prospective, multicenter clinical trial was conducted. Patients were assigned to one of two treatment groups, starting with a lower dose (50/12.5 mg of losartan/chlorthalidone or losartan/hydrochlorothiazide). Blood pressure was evaluated at 30 days, and patients not meeting therapeutic goals were escalated to a higher dose (100/50 mg of losartan/chlorthalidone or losartan/hydrochlorothiazide) and followed until the study end (60 days).</p><p><strong>Results: </strong>The study recruited 163 patients (83 for losartan/chlorthalidone [L/C] group and 80 for the losartan/hydrochlorothiazide [L/H] group), with a mean age of 53.1 years. Both treatment groups demonstrated significant reductions in systolic and diastolic blood pressure, with L/C achieving an average reduction in systolic blood pressure (SBP) of - 24.6 mmHg and - 13.3 mmHg for diastolic blood pressure (DBP), while L/H had reductions of - 25.3-mmHg and - 11.5 mmHg, respectively. The L/C group exhibited a higher likelihood of achieving blood pressure goals compared to the L/H. Adverse events were comparable between groups and were mostly mild.</p><p><strong>Conclusions: </strong>The study showed that both combinations are effective for hypertension, with losartan/chlorthalidone demonstrating greater efficacy in reducing diastolic blood pressure and achieving target levels. Both treatments exhibited similar and favorable safety profiles.</p><p><strong>Clinical trials registration: </strong>NCT04927299. Registered August 6, 2021- https://clinicaltrials.gov/study/NCT04927299.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"231-247"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and Tolerability of Trimetazidine 80 mg Once Daily in Patients with Chronic Coronary Syndrome in Brazil: The V-GOOD Observational Study.","authors":"Luís Henrique Wolff Gowdak, Paulo Magno Martins Dourado, Dalton Bertolim Précoma, César de Oliviera Lopes Dusilek, Francisco Maia da Silva, Juan Carlos Yugar-Toledo, Felipe Montes Pena, Domingos Antônio de Almeida Gomes, Elizabeth do Espírito Santo Cestário, Olavo Raimundo Guimarães, Conrado Roberto Hoffmann Filho, Carlos Filinto de Almeida, Flávio de Souza Brito, Gerez Fernandes Martins, Victor Rodrigues Ribeiro Ferreira, Marcella Chaves Flores, Mayara Lídia da Silva","doi":"10.1007/s40119-025-00405-9","DOIUrl":"10.1007/s40119-025-00405-9","url":null,"abstract":"<p><strong>Introduction: </strong>The V-GOOD study evaluated the effectiveness of trimetazidine modified-release (MR) 80 mg once daily (OD) in patients with chronic coronary syndrome (CCS) who remained symptomatic despite antianginal therapies in routine clinical practice.</p><p><strong>Methods: </strong>This prospective, observational study involved 1026 adult outpatients with symptomatic CCS from 70 sites in Brazil who were prescribed trimetazidine MR 80 mg OD plus background antianginal treatment. Data on number of angina attacks, short-acting nitrate consumption, prevalence of angina-free patients, severity of angina, patient-reported daily physical activity impairment, treatment adherence, tolerability, and cardiologist and patient satisfaction were collected at baseline (V1), then at 1 month (V2) and 3 months (V3).</p><p><strong>Results: </strong>Following the addition of trimetazidine MR 80 mg OD, the mean ± standard deviation number of angina attacks per week decreased from 3.1 ± 2.8 at V1 to 1.0 ± 2.1 at V2, and 0.7 ± 1.7 at V3, with concurrent reductions in short-acting nitrate consumption, patient-reported daily physical activity impairment and the proportion of patients with limiting angina (Canadian Cardiovascular Society class III or IV), and increases in the proportion of angina-free patients (all p < 0.001 vs. V1). Most cardiologists rated trimetazidine MR 80 mg OD as satisfactory/very satisfactory (90.7% for effectiveness and 94.8% for tolerability); most patients rated the treatment schedule as convenient/very convenient (97.2%) and satisfactory/very satisfactory (97.1%). Treatment was well tolerated.</p><p><strong>Conclusions: </strong>These data support the symptomatic benefits and good tolerability associated with adding trimetazidine MR 80 mg OD to other antianginal therapies in patients with persistent symptoms. Graphical abstract available for this article.</p><p><strong>Trial registration number: </strong>NCT06464276.</p>","PeriodicalId":9561,"journal":{"name":"Cardiology and Therapy","volume":" ","pages":"249-265"},"PeriodicalIF":3.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}