Cardiovascular Therapeutics最新文献

{"title":"Valsartan Attenuated Homocysteine-Induced Impaired Autophagy and ER Stress in Human Umbilical Vein Endothelial Cells","authors":"Xinyan Wu,&nbsp;Ani Wang,&nbsp;Long Xu,&nbsp;Meng Li,&nbsp;Qingxian Zhai,&nbsp;Weidong Wang,&nbsp;Chunling Li,&nbsp;Lizi Jin","doi":"10.1155/2023/8817431","DOIUrl":"10.1155/2023/8817431","url":null,"abstract":"<div>\u0000 <p>Hyperhomocysteinemia is a risk factor for various cardiovascular diseases. However, the mechanism underlying homocysteine- (Hcy-) induced vascular injury remains unclear. The purpose of the present study was to examine a potential mechanism by which Hcy induced injury in human umbilical vascular endothelial cells (HUVEC). The protein abundance of autophagy-related markers was markedly decreased after Hcy treatment, which was associated with endoplasmic reticulum (ER) stress and apoptosis in HUVECs. Protein expression level of angiotensin II type 1 receptor (AT1 receptor) was dramatically increased in response to Hcy. Valsartan, an AT1 receptor blocker, improved autophagy and prevented ER stress and apoptosis in HUVECs treated with Hcy. Consistent with this, silence of AT1 receptor with siRNA decreased the protein abundance of ER stress markers, prevented apoptosis, and promoted autophagy in HUVECs. Inhibition or knockdown of AT1 receptor was shown to be associated with suppression of p-GSK3<i>β</i>/GSK3<i>β</i>-p-mTOR/mTOR signaling pathway. Additionally, inhibition of autophagy by 3-MA aggravated Hcy-induced apoptosis, while amelioration of ER stress by 4-PBA prevented Hcy-induced injury in HUVECs. Hcy-induced HUVEC injury was likely attributed to AT1 receptor activation, leading to impaired autophagy, ER stress, and apoptosis.</p>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/8817431","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138579504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between β1-AA and AT1-AA and Cardiac Function in Patients with Hypertension Complicated with Left Ventricular Diastolic Function Limitation","authors":"Liang Wang,&nbsp;Xue-Bai Lv,&nbsp;Yu-Ting Yuan,&nbsp;Ning Wang,&nbsp;Hong-Ying Yao,&nbsp;Wen-Chao Zhang,&nbsp;Peng-Fei Yin,&nbsp;Xiao-Hui Liu","doi":"10.1155/2023/7611819","DOIUrl":"10.1155/2023/7611819","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. To investigate the association between <i>β</i>1 adrenergic receptor autoantibodies (<i>β</i>1-AA) and angiotensin II type-1 receptor autoantibodies (AT1-AA) and cardiac function in patients with hypertension complicated with left ventricular diastolic function limitation. <i>Methods</i>. A total of 120 patients with essential hypertension who were not taking drug treatment and were hospitalised in the Department of Cardiology at the authors’ hospital from April 2018 to December 2018 were enrolled in this study and divided into a diastolic dysfunction group (65 cases) and a normal diastolic group (55 cases) according to their left ventricular diastolic function. The levels of cardiac parameters, <i>β</i>1-AA, AT1-AA, and other indicators were compared. Logistic regression analysis was used to analyse the related factors affecting left ventricular diastolic dysfunction (LVDD). The diagnostic efficacy of related factors in the diagnosis of diastolic dysfunction was evaluated. <i>Results</i>. Univariate analysis demonstrated that the left ventricular posterior wall diameter (10.29 ± 1.23 vs. 9.12 ± 1.53), left ventricular systolic dysfunction (10.56 ± 1.37 vs. 9.43 ± 1.44), systolic blood pressure (152.37 ± 10.24 vs. 140.33 ± 5.99), diastolic blood pressure (95.66 ± 6.34 vs. 87.33 ± 7.28), <i>β</i>1-AA (33 vs. 9 cases), and AT1-AA (35 cases vs. 12 cases) were higher in the dysfunction group than in the control group (all <i>P</i> &lt; 0.05). Multivariate regression analysis showed that <i>β</i>1-AA (odds ratio (OR) = 1.96, 95% confidence interval (CI): 1.369–4.345) and AT1-AA (OR = 2.02, 95% CI: 1.332–6.720) were independent risk factors for cardiac diastolic dysfunction (<i>P</i> &lt; 0.05). Both autoimmune antibodies had a certain predictive value, and the combined prediction value of the two was the highest, with an area under the curve of 0.942 (95% CI: 0.881~0.985). <i>Conclusion</i>. The positive rate of <i>β</i>1-AA and AT1-AA in essential hypertension patients with LVDD was higher than that in the normal group. Both <i>β</i>1-AA and AT1-AA could be used as early markers of LVDD in essential hypertension patients.</p>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/2023/7611819","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138579418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequencies of VKORC1-1639G>A and rs397509427 in Patients on Warfarin and Healthy Syrian Subjects","authors":"Yara Altawil,&nbsp;Lama A. Youssef","doi":"10.1155/2023/8898922","DOIUrl":"10.1155/2023/8898922","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Vitamin K epoxide reductase complex subunit 1 (<i>VKORC1</i>) gene encodes a key enzyme with multiple cellular activities, namely, the reduction of vitamin K to its active form. <i>VKORC1</i>-1639G&gt;A (rs9923231) is a common single nucleotide polymorphism with a crucial impact on warfarin dosing and possibly other physiological functions. This study aimed at investigating the frequencies of <i>VKORC1</i>-1639G&gt;A alleles and genotypes in Syrian healthy subjects and patients on warfarin for different indications. <i>Methods</i>. A total of 138 individuals were enrolled in this cross-sectional study. Genomic DNA was extracted from both patients on warfarin and healthy subjects, and polymerase chain reaction (PCR) specific amplicons were genotyped via standard sequencing which also allowed the detection of rs397509427. Comparisons of -1639G&gt;A frequency with other populations were drawn. <i>Results</i>. Of 94 patients on warfarin, 53 (56.38%) were with idiopathic venous thromboembolism (VTE). Despite comparable frequencies of the -1639A allele (47% and 50%), the AA and GA genotypes were at disparate frequencies of 93.2% versus 79.8% in the healthy subjects (<i>n</i> = 44) versus patients on warfarin, respectively. Carriers of the GG genotype were at a four-fold increased risk of VTE in comparison with those of the AA and GA genotypes (odds ratio (OR) = 4, 95% CI = 1.105 − 13.6, <i>P</i> = 0.0469). All study subjects were wild-type for the rs397509427 variant. <i>Conclusions</i>. Our results prove a high -1639A prevalence in Syrian healthy subjects and patients on warfarin at frequencies comparable to other Mediterranean and Middle Eastern populations. The A allele carriers are at a lower VTE risk, whereas a global prevalence gradient of the G allele is suggested to be associated with VTE risk.</p>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10689069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138476839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Thrombolysis on Circulating Microparticles in Patients with ST-Segment Elevation Myocardial Infarction","authors":"Zhe Li,&nbsp;Wei Zhang,&nbsp;Qun-Rang Wang,&nbsp;Yu-juan Yang,&nbsp;Xin-Hong Liu,&nbsp;Gong Cheng,&nbsp;Feng-Jun Chang","doi":"10.1155/2023/5559368","DOIUrl":"10.1155/2023/5559368","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. We demonstrated that circulating microparticles (MPs) are increased in patients with coronary heart disease (both chronic coronary syndrome (CCS) and acute coronary syndrome). Whether thrombolysis affects MPs in patients with ST-segment elevation myocardial infarction (STEMI) with or without percutaneous coronary intervention (PCI) is unknown. <i>Methods</i>. This study was divided into three groups: STEMI patients with thrombolysis (<i>n</i> = 18) were group T, patients with chronic coronary syndrome (<i>n</i> = 20) were group CCS, and healthy volunteers (<i>n</i> = 20) were the control group. Fasting venous blood was extracted from patients in the CCS and control groups, and venous blood was extracted from patients in the T group before (pre-T) and 2 hours after (post-T) thrombolysis. MPs from each group were obtained by centrifugation. After determining the concentration, the effects of MPs on endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) in rat myocardial tissue in vitro were detected by immunohistochemistry and western blotting. Changes in nitric oxide (NO) and oxygen free radicals (O₂^•–) were also detected. The effect of MPs on vasodilation in isolated rat thoracic aortae was detected. <i>Results</i>. Compared with that in the control group (2.60 ± 0.38 mg/ml), the concentration of MPs was increased in patients with CCS (3.49 ± 0.72 mg/ml) and in STEMI patients before thrombolysis (4.17 ± 0.58 mg/ml). However, thrombolysis did not further increase MP levels (post-T, 4.23 ± 1.01 mg/ml) compared with those in STEMI patients before thrombolysis. Compared with those in the control group, MPs in both CCS and STEMI patients before thrombolysis inhibited the expression of eNOS (both immunohistochemistry and western blot analysis of phosphorylation at Ser1177), NO production in the isolated myocardium and vasodilation in vitro and stimulated the expression of iNOS (immunohistochemistry and western blot analysis of phosphorylation at Thr495), and the generation of O₂^•– in the isolated myocardium. The effects of MPs were further enhanced by MPs from STEMI patients 2 hours after thrombolysis. <i>Conclusion</i>. Changes in MP function after thrombolysis may be one of the mechanisms leading to ischemia–reperfusion after thrombolysis.</p>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2023-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10676276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of K+ and Ca2+ Channels in the Vasodilator Effects of Plectranthus barbatus (Brazilian Boldo) in Hypertensive Rats","authors":"Jeniffer Cristóvão Moser,&nbsp;Rita de Cássia Vilhena da Silva,&nbsp;Philipe Costa,&nbsp;Luisa Mota da Silva,&nbsp;Nadla Soares Cassemiro,&nbsp;Arquimedes Gasparotto Junior,&nbsp;Denise Brentan Silva,&nbsp;Priscila de Souza","doi":"10.1155/2023/9948707","DOIUrl":"10.1155/2023/9948707","url":null,"abstract":"<div>\u0000 <p><i>Plectranthus barbatus</i>, popularly known as Brazilian boldo, is used in Brazilian folk medicine to treat cardiovascular disorders including hypertension. This study investigated the chemical profile by UFLC-DAD-MS and the relaxant effect by using an isolated organ bath of the hydroethanolic extract of <i>P. barbatus</i> (HEPB) leaves on the aorta of spontaneously hypertensive rats (SHR). A total of nineteen compounds were annotated from HEPB, and the main metabolite classes found were flavonoids, diterpenoids, cinnamic acid derivatives, and organic acids. The HEPB promoted an endothelium-dependent vasodilator effect (~100%; EC50 ~347.10 <i>μ</i>g/mL). Incubation of L-NAME (a nonselective nitric oxide synthase inhibitor; EC50 ~417.20 <i>μ</i>g/mL), ODQ (a selective inhibitor of the soluble guanylate cyclase enzyme; EC50 ~426.00 <i>μ</i>g/mL), propranolol (a nonselective <i>α</i>-adrenergic receptor antagonist; EC50 ~448.90 <i>μ</i>g/mL), or indomethacin (a nonselective cyclooxygenase enzyme inhibitor; EC50 ~398.70 <i>μ</i>g/mL) could not significantly affect the relaxation evoked by HEPB. However, in the presence of atropine (a nonselective muscarinic receptor antagonist), there was a slight reduction in its vasorelaxant effect (EC50 ~476.40 <i>μ</i>g/mL). The addition of tetraethylammonium (a blocker of Ca²⁺-activated K⁺ channels; EC50 ~611.60 <i>μ</i>g/mL) or 4-aminopyridine (a voltage-dependent K⁺ channel blocker; EC50 ~380.50 <i>μ</i>g/mL) significantly reduced the relaxation effect of the extract without the interference of glibenclamide (an ATP-sensitive K⁺ channel blocker; EC50 ~344.60 <i>μ</i>g/mL) or barium chloride (an influx rectifying K⁺ channel blocker; EC50 ~360.80 <i>μ</i>g/mL). The extract inhibited the contractile response against phenylephrine, CaCl₂, KCl, or caffeine, similar to the results obtained with nifedipine (voltage-dependent calcium channel blocker). Together, the HEPB showed a vasorelaxant effect on the thoracic aorta of SHR, exclusively dependent on the endothelium with the participation of muscarinic receptors and K⁺ and Ca²⁺ channels.</p>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10673663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating FABP-4 Levels in Patients with Atherosclerosis or Coronary Artery Disease: A Comprehensive Systematic Review and Meta-Analysis","authors":"Narges Jalilian,&nbsp;Reza Pakzad,&nbsp;Mahdi Shahbazi,&nbsp;Seyyed-Reza Edrisi,&nbsp;Karimeh Haghani,&nbsp;Mohsen Jalilian,&nbsp;Salar Bakhtiyari","doi":"10.1155/2023/1092263","DOIUrl":"10.1155/2023/1092263","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Cardiovascular diseases (CDs), notably coronary artery disease (CAD) due to atherosclerosis, impose substantial global health and economic burdens. Fatty acid-binding proteins (FABPs), including FABP-4, have been recently linked to CDs. This study conducted a systematic review and meta-analysis to examine FABP-4 levels in CAD and atherosclerosis patients, exploring their potential links to these conditions. <i>Methods</i>. A systematic review and meta-analysis were done based on the PRISMA guideline. The international databases including Medline, Embase, Cochrane Library, Scopus, Web of Science, and UpToDate were searched to find all related studies on the effect of FABP-4 on patients with CAD or atherosclerosis which were published till June 2022 without language restriction. The Cochran’s <i>Q</i>-test and <i>I</i>² statistic were applied to assess heterogeneity, a random effect model was used to estimate the pooled standardized mean difference (SMD), a metaregression method was utilized to investigate the factors affecting heterogeneity between studies, and Egger’s test was used to assess the publication bias. <i>Results</i>. Of 1051 studies, 9 studies with a sample size of 2327 were included in the systematic review and meta-analysis. The level of circulating FABP-4 in the patient groups was significantly higher than in the control groups (SMD = 0.60 (95% CI: 0.30 to 0.91, <i>I</i>²: 91.47%)). The SMD in female and male patients were 0.26 (95% CI: 0.01 to 0.52, <i>I</i>²: 0%) and 0.22 (95% CI: 0.08 to 0.35, <i>I</i>²: 44.7%), respectively. There was considerable heterogeneity between the studies. The countries had a positive relationship with heterogeneity (coefficient = 0.29, <i>p</i> &lt; 0.001); but BMI, lipid indices, gender, study design, and type of kit had no effect on the heterogeneity. No publication bias was observed (<i>p</i>: 0.137). <i>Conclusion</i>. In summary, this meta-analysis revealed elevated circulating FABP-4 levels in CDs, suggesting its potential as a biomarker for these conditions. Further research is warranted to explore its clinical relevance.</p>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10673666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138458095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Factors for Low-Risk Participation in Alternative Cardiac Rehabilitation Models for Patients with Coronary Heart Disease Using MI’S SCOREPAD","authors":"Eric J. Brandt,&nbsp;Joshua Garfein,&nbsp;Chih-Wen Pai,&nbsp;Joseph Bryant,&nbsp;Eva Kline-Rogers,&nbsp;Samantha Fink,&nbsp;Melvyn Rubenfire","doi":"10.1155/2023/7230325","DOIUrl":"10.1155/2023/7230325","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Although a recent joint society scientific statement (the American Association of Cardiovascular Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology) suggests home-based cardiac rehab (CR) is appropriate for low- and moderate-risk patients, there are no paradigms to define such individuals with coronary heart disease. <i>Methods</i>. We reviewed a decade of data from all patients with coronary heart disease enrolled in a single CR center (University of Michigan) to identify the prevalence of low-risk factors, which may inform on consideration for participation in alternative models of CR. Low-risk factors included not having any of the following: metabolic syndrome, presence of implantable cardioverter defibrillator or permanent pacemaker, active smoking, prior stroke, congestive heart failure, obesity, advanced renal disease, poor exercise capacity, peripheral arterial disease, angina, or clinical depression (MI’S SCOREPAD). We report on the proportion of participants with these risk factors and the proportion with all of these low-risk factors. <i>Results</i>. The mean age of CR participants (<i>n</i> = 1984) was 63 years; 25% were women, and 82% were non-Hispanic White. The mean number of low-risk factors was 8.5, which was similar in the 2011-2012 and 2018-2019 cohorts (8.5 vs. 8.3, respectively, <i>P</i> = 0.08). Additionally, 9.3% of the 2011-2012 cohort and 7.6% of the 2018-2019 cohort had all 11 of the low-risk factors. <i>Conclusion</i>. In this observational study, we provide a first paradigm of identifying factors among coronary heart disease patients that may be considered low-risk and likely high-gain for participation in alternative models of CR. Further work is needed to track clinical outcomes in patients with these factors to determine thresholds for enrolling participants in alternative forms of CR.</p>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10307536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Serum Total Bilirubin Might Indicate Poor Coronary Conditions for Unstable Angina Pectoris Patients beyond as a Cardiovascular Protector","authors":"Qi Liang,&nbsp;Yongjian Zhang,&nbsp;Jin Liang","doi":"10.1155/2023/5532917","DOIUrl":"10.1155/2023/5532917","url":null,"abstract":"<div>\u0000 <p><i>Backgrounds</i>. Serum total bilirubin (STB) is recently more regarded as an antioxidant with vascular protective effects. However, we noticed that elevated STB appeared in unstable angina pectoris (UAP) patients with diffused coronary lesions. We aimed to explore STB’s roles in UAP patients, which have not been reported by articles. <i>Methods and Results</i>. 1120 UAP patients were retrospectively screened, and 296 patients were finally enrolled. They were grouped by Canadian Cardiovascular Society (CCS) angina grades. The synergy between PCI with TAXUS stent and cardiac surgery score (SYNTAX score) and corrected thrombolysis in myocardial infarction flow count (CTFC) were adopted to profile coronary features. The results showed that STB, mean platelet volume (MPV), hs-CRP, fasting blood glucose (FBG), red blood cell width (RDW), and CTFC elevated significantly in the CCS high-risk group. STB (<i>B</i> = 0.59, 95% CI: 0.39-0.74, <i>P</i> &lt; 0.01) and MPV (<i>B</i> = 0.86, 95% CI: 0.42-1.31, <i>P</i> &lt; 0.01) could indicate SYNTAX score changes for these patients. STB (≥21.7 <i>μ</i>mol/L) could even indicate a coronary slow flow condition (AUC: 0.88, 95% CI: 0.84-0.93, <i>P</i> &lt; 0.01). Moreover, UAP patients with elevated STB had a lower event-free survival rate by the Kaplan-Meier curve. STB ≥21.7 <i>μ</i>mol/L could reflect a poor coronary flow status and indicate 1-year poor outcomes for these patients (HR: 2.01, 95% CI: 1.06-3.84, <i>P</i> &lt; 0.01). <i>Conclusion</i>. Elevated STB in UAP patients has a close relationship with changes in SYNTAX score. STB (over 21.7 <i>μ</i>mol/L) could even indicate a coronary slow flow condition and poor outcomes for the UAP patients.</p>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10497366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10260120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left Bundle Branch Area Pacing versus Right Ventricular Pacing in Patients with Atrioventricular Block: An Observational Cohort Study","authors":"Zhongxiu Chen,&nbsp;Yuanning Xu,&nbsp;Lingyun Jiang,&nbsp;Ran Zhang,&nbsp;Hongsen Zhao,&nbsp;Ran Liu,&nbsp;Lei Zhang,&nbsp;Yajiao Li,&nbsp;Xingbin Liu","doi":"10.1155/2023/6659048","DOIUrl":"10.1155/2023/6659048","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. We aim to conduct a comparison of the safety and effectiveness performance between left bundle branch area pacing (LBBAP) and right ventricular pacing (RVP) regimens for patients with atrioventricular block (AVB). <i>Methods</i>. This observational cohort study included patients who underwent pacemaker implantations with LBBAP or RVP for AVB indications from the 1st of January 2018 to the 18th of November 2021 at West China Hospital. The primary composite outcome included all-cause mortality, lead failure, or heart failure hospitalization (HFH). The secondary outcome included periprocedure complication, cardiac death, or recurrent unexplained syncope. A 1 : 1 propensity score–matched cohort was conducted for left ventricular (LV) function analysis. <i>Results</i>. A total of 903 patients met the inclusion criteria and completed clinical follow-up. After adjusting for the possible confounders, LBBAP was independently associated with a lower risk of the primary outcome (OR 0.48, 95% CI 0.28 to 0.83, <i>p</i> = 0.009), including a lower risk of all-cause mortality and HFH. No significant difference in the secondary outcome was detected between the groups except that LBBAP was independently associated with a lower risk of recurrent unexplained syncope. In the propensity-score matching cohort of echocardiographic analysis, the LV systolic dyssynchrony index was lower in LBBAP compared with that in RVP (5.68 ± 1.92 vs. 6.50 ± 2.28%, <i>p</i> = 0.012). <i>Conclusions</i>. Compared to conventional RVP, LBBAP is a feasible novel pacing model associated with a significant reduction in the primary composite outcome. Moreover, LBBAP significantly reduces the risk of recurrent unexplained syncope and improves LV systolic synchrony. This study is registered with ClinicalTrials.gov NCT05722379.</p>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10462439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10123414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Different Chronic Maintenance Antithrombotic Strategies in Patients with Coronary Artery Disease: A Systematic Review and Network Meta-Analysis","authors":"Junyan Zhang,&nbsp;Zhongxiu Chen,&nbsp;Yujia Cai,&nbsp;Chen Li,&nbsp;Yong He","doi":"10.1155/2023/5446271","DOIUrl":"10.1155/2023/5446271","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Optimal antithrombotic therapy during the chronic maintenance period in patients with coronary artery disease (CAD) is unknown. We compared five kinds of mainstream chronic maintenance antithrombotic strategies at least one year after the acute phase: aspirin alone, clopidogrel alone, ticagrelor alone, continued dual antiplatelet therapy (DAPT) for a period of time, and maintenance with aspirin combined with a low-dose anticoagulant such as rivaroxaban. <i>Methods</i>. Ten randomized, controlled trials were selected using PubMed, Ovid MEDLINE, Embase, and Cochrane library through February 2023. The primary outcome was main adverse cardiac events (MACEs), and secondary outcomes include net adverse clinical events (NACEs), cardiac death, all-cause death, ischemic stroke, stent thrombosis, total bleeding, and major bleeding. A network meta-analysis was conducted with a random-effects model. Data extraction was performed by three independent reviewers. <i>Results</i>. Our search identified ten eligible randomized controlled trials enrolling a total of 82,084 patients comparing different chronic maintenance antithrombotic strategies. As for the primary endpoint, there was no statistical difference in MACE outcomes between any two of the five methods. As for the secondary endpoint, there was no statistical difference in NACE, major bleeding, all-cause death, cardiac death, and stent thrombosis between any two methods. The aspirin plus low-dose rivaroxaban group had a lower incidence of ischemic stroke compared to the aspirin group (OR = 0.49, 95% CrI 0.26-0.91). And the prolonged DAPT group had a higher total bleeding rate compared to aspirin group (OR = 2.4, 95% CrI 1.1-5.9). <i>Conclusions</i>. In terms of MACE, NACE, all-cause death, cardiac death, stent thrombosis, and major bleeding, there were no significant differences between using aspirin alone, clopidogrel alone, and ticagrelor alone; extending DAPT duration; and using aspirin combined with low-dose rivaroxaban for chronic maintenance antithrombotic regimens. However, choosing aspirin combined with low-dose rivaroxaban can reduce the incidence of ischemic stroke, and prolonged DAPT may have a higher rate of total bleeding. However, it is important to note that this study is based on indirect comparisons, and there is currently a lack of direct evidence comparing various maintenance antiplatelet therapy regimens. Further high-quality studies are needed to address this gap and provide more conclusive evidence on the comparative effectiveness of different maintenance antiplatelet strategies.</p>\u0000 </div>","PeriodicalId":9582,"journal":{"name":"Cardiovascular Therapeutics","volume":"2023 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10449594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10464596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}