Efficiency of Hypertonic Saline in the Management of Decompensated Heart Failure: A Systematic Review and Meta-Analysis of Clinical Studies
AbstractIntroductionAcute decompensated heart failure (ADHF), with an incidence of 1 –2%, is a clinical syndrome with significant morbidity and mortality despite therapeutic advancements and ongoing clinical trials. A recent therapeutic approach to patients with ADHF includes combination therapy with hypertonic saline solution (HSS) and furosemide, based on the hypothesis that res istance to loop diuretics occurs because of achievement of plateau in water and sodium excretion in patients receiving long-term loop diuretic therapy.ObjectiveOur aim was to conduct a meta-analysis to evaluate the efficiency of combination...
Source: American Journal of Cardiovascular Drugs - November 19, 2020 Category: Cardiology Source Type: research

Acknowledgement to Referees
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - November 18, 2020 Category: Cardiology Source Type: research

Coronary Artery Disease in Patients with HIV Infection: An Update
AbstractPremature cardiovascular disease among the HIV-infected population is of great concern among clinicians. The increased life expectancy of HIV-infected individuals is mainly due to the early detection of infection and the advent of antiretroviral therapy. Once known as a deadly disease, HIV infection has transitioned into a chronic condition. Cardiovascular disease in this population is thought to progress early due to traditional and non-traditional risk factors. Early detection of subclinical atherosclerosis has become a center of focus in research as our complete understanding of this process it not yet well know...
Source: American Journal of Cardiovascular Drugs - November 13, 2020 Category: Cardiology Source Type: research

A Review of Bivalirudin for Pediatric and Adult Mechanical Circulatory Support
AbstractAs the use of mechanical circulatory support has increased in volume and complexity, anticoagulation remains an intricate component of a patient ’s pharmacotherapy plan. Traditionally, heparin has been the primary anticoagulant utilized because of its ease of titration and  familiarity of use. More recently, bivalirudin, a direct thrombin inhibitor, has attracted attention as a potential alternative to traditional therapy. While labeled f or use in percutaneous coronary interventions, it is utilized off-label for heparin-induced thrombocytopenia and mechanical circulatory support. A literature search ide...
Source: American Journal of Cardiovascular Drugs - November 10, 2020 Category: Cardiology Source Type: research

Weight-Based Dosing Versus a Fixed-Dose Regimen of 4-Factor Prothrombin Complex Concentrate in Obese Patients Requiring Vitamin K Antagonist Reversal
In this study, we aimed to compare the proportion of patients attaining international normalized ratio (INR) goals using a weight-based dosing strategy versus a fixed-dose regimen of 4F-PCC.MethodsThis was a retrospective study conducted in patients 18  years of age or older, weighing ≥ 100 kg, who received either a weight-based dose or fixed dose of 4F-PCC (2000 units) for the reversal of VKA, and had a documented baseline and post-treatment INR. The primary outcome was the proportion of patients achieving an INR of 
Source: American Journal of Cardiovascular Drugs - November 5, 2020 Category: Cardiology Source Type: research

Rivaroxaban Versus Warfarin in Patients with Mechanical Heart Valves: Open-Label, Proof-of-Concept trial —The RIWA study
ConclusionsIn this pilot study, rivaroxaban 15  mg twice daily had thromboembolic and bleeding events similar to warfarin in patients with mechanical heart valves. These data confirm the authors’ proof-of-concept and suggest that a larger trial with a similar design is not unreasonable.ClinicalTrial.gov identifierNCT03566303. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - November 5, 2020 Category: Cardiology Source Type: research

Questions and Answers on Practical Thrombotic Issues in SARS-CoV-2 Infection: A Guidance Document from the Italian Working Group on Atherosclerosis, Thrombosis and Vascular Biology
AbstractIn patients with coronavirus disease 2019 (COVID-19), the prevalence of pre-existing cardiovascular diseases is elevated. Moreover, various features, also including pro-thrombotic status, further predispose these patients to increased risk of ischemic cardiovascular events. Thus, the identification of optimal antithrombotic strategies in terms of the risk –benefit ratio and outcome improvement in this setting is crucial. However, debated issues on antithrombotic therapies in patients with COVID-19 are multiple and relevant. In this article, we provide ten questions and answers on risk stratification and antip...
Source: American Journal of Cardiovascular Drugs - November 3, 2020 Category: Cardiology Source Type: research

Sacubitril/Valsartan in the Management of Heart Failure Patients with Cardiac Implantable Electronic Devices
AbstractFor heart failure patients with cardiac implantable electronic devices (CIEDs), especially those who remain symptomatic after implantation, the best management strategy is still unclear. Although there are several concerns regarding the clinical utilization of sacubitril/valsartan, it has improved the prognosis of patients with heart failure compared with the use of renin-angiotensin system inhibitors in recent years. Recent real-world observational studies and post hoc analyses demonstrated that sacubitril/valsartan might have effects in patients with CIEDs. Given its potential underlying mechanisms, sacubitril/va...
Source: American Journal of Cardiovascular Drugs - October 28, 2020 Category: Cardiology Source Type: research

Effect of Sacubitril/Valsartan on Neurocognitive Function: Current Status and Future Directions
AbstractSacubitril/valsartan is a new medication approved for the treatment of heart failure with reduced ejection fraction. While the drug failed to meet the primary endpoint in patients with heart failure with preserved ejection fraction in the PARAGON-HF trial, improvements were noted in several secondary endpoints. Valsartan is an angiotensin receptor blocker and sacubitril is a neprilysin inhibitor. Neprilysin is postulated to have a role in the degradation of beta-amyloid in the brain; therefore, sacubitril could theoretically increase beta-amyloid plaque deposition in the brain and potentially increase the risk of A...
Source: American Journal of Cardiovascular Drugs - October 16, 2020 Category: Cardiology Source Type: research

The Restricted Mean Survival Time as a Tool for Ranking Comparative Outcomes in a Narrative Review that Evaluates a Network of Randomized Trials: An Example Based on PCSK9 Inhibitors
ConclusionThe experience presented herein indicates that a framework of evidence assessment focused on the RMST is a worthwhile option. Our study is in line with the growing literature that has recently emphasized the methodological advantages of the RMST. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - October 7, 2020 Category: Cardiology Source Type: research

Long-Term Outcomes and Improvements in Quality of Life in Patients with Atrial Fibrillation Treated with Catheter Ablation vs. Antiarrhythmic Drugs
ConclusionsIn the treatment of AF, CA appeared to be superior to AADs, decreasing the risk of all-cause death and cardiovascular hospitalization and improving the long-term QoL of patients with AF. CA was better tolerated and more effective than pharmacological therapy and allowed for improved QoL. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - September 30, 2020 Category: Cardiology Source Type: research

Effects of Dapagliflozin on Cardiovascular Events, Death, and Safety Outcomes in Patients with Heart Failure: A Meta-Analysis
AbstractBackgroundSeveral clinical trials of dapagliflozin in patients with type 2 diabetes mellitus (T2DM) at elevated cardiovascular risk have observed reduced hospitalization for heart failure (HHF). Several studies have also suggested cardiovascular benefits for patients with HF regardless of whether or not they have T2DM.ObjectiveThis meta-analysis was conducted to evaluate the therapeutic effects of dapagliflozin in patients with HF.MethodsThe PubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched from database inception to 15 February 2020. Clinical studies of dapagliflozin use i...
Source: American Journal of Cardiovascular Drugs - September 30, 2020 Category: Cardiology Source Type: research

The AWAKE-HF Study: Sacubitril/Valsartan Impact on Daily Physical Activity and Sleep in Heart Failure
ConclusionsIn AWAKE-HF, no detectable differences in activity and sleep were observed when comparing sacubitril/valsartan with enalapril in patients with HFrEF using a wearable biosensor.Clinical trial registrationClinicalTrials.gov, NCT02970669. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - September 25, 2020 Category: Cardiology Source Type: research

Emerging Pharmacotherapy to Reduce Elevated Lipoprotein(a) Plasma Levels
AbstractLipoprotein(a) is a unique form of low-density lipoprotein. It is associated with a high incidence of premature atherosclerotic disease such as coronary artery disease, myocardial infarction, and stroke. Plasma levels of this lipoprotein and its activities are highly variable. This is because of a wide variability in the size of the apolipoprotein A moiety, which is determined by the number of repeats of cysteine-rich domains known as “kringles.” Although the exact mechanism of lipoprotein(a)-induced atherogenicity is unknown, the lipoprotein has been found in the arterial walls of atherosclerotic plaqu...
Source: American Journal of Cardiovascular Drugs - September 14, 2020 Category: Cardiology Source Type: research

Efficacy and Safety of Long-Term Oral Bosentan in Different Types of Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis
AbstractObjectiveThis systematic review and meta-analysis was conducted to identify if long-term bosentan is an effective and safe treatment for pulmonary arterial hypertension (PAH) regardless of type, including idiopathic PAH (IPAH), and PAH associated with congenital heart disease (APAH-CHD), connective tissue disease (APAH-CTD), and human immunodeficiency virus (APAH-HIV).MethodsAll relevant observations were systematically searched by two independent investigators and obtained from three databases, including PubMed, EMBASE and the Cochrane Library, from the inception of each database to February 2020. Currently, long-...
Source: American Journal of Cardiovascular Drugs - September 11, 2020 Category: Cardiology Source Type: research

Mortality and Disease Severity Among COVID-19 Patients Receiving Renin-Angiotensin System Inhibitors: A Systematic Review and Meta-analysis
DiscussionSince there was no increased risk of harm, the use of RAS inhibitors for hypertension and other established clinical indications can be maintained in COVID-19 patients. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - September 11, 2020 Category: Cardiology Source Type: research

Potential Therapeutic Roles for Direct Factor Xa Inhibitors in Coronavirus Infections
AbstractHuman factor Xa (FXa) is a serine protease of the common coagulation pathway. FXa is known to activate prothrombin to thrombin, which eventually leads to the formation of cross-linked blood clots. While this process is important in maintaining hemostasis, excessive thrombin generation results in a host of thrombotic conditions. FXa has also been linked to inflammation via protease-activated receptors. Together, coagulopathy and inflammation have been implicated in the pathogenesis of viral infections, including the current coronavirus pandemic. Direct FXa inhibitors have been shown to possess anti-inflammatory and ...
Source: American Journal of Cardiovascular Drugs - September 11, 2020 Category: Cardiology Source Type: research

Meta-Analysis Comparing Potent Oral P2Y 12 Inhibitors versus Clopidogrel in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention
ConclusionsIn patients receiving OAC therapy for AF after a recent PCI, potent oral P2Y12 inhibitors increase the risk of clinically relevant bleeding compared with clopidogrel, with no evident benefit in terms of MACE reduction. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - September 7, 2020 Category: Cardiology Source Type: research

Utilization of Sacubitril/Valsartan in Real-World Settings
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - August 24, 2020 Category: Cardiology Source Type: research

Clinical Impact of Weight-Loss Pharmacotherapy in Patients with Atherosclerotic Cardiovascular Disease
AbstractObesity is associated with the development and progression of multiple cardiovascular risk factors, such as hypertension, dyslipidemia, and type 2 diabetes mellitus, and is an important contributor to the global burden of atherosclerotic cardiovascular disease (CVD). Guidelines suggest that clinicians provide lifestyle counseling and promote lifestyle modifications before considering weight-loss surgery. However, despite lifestyle modifications and increased physical activity, most patients with obesity will not lose significant weight or will experience weight regain. Weight-loss pharmacotherapy added to lifestyle...
Source: American Journal of Cardiovascular Drugs - August 18, 2020 Category: Cardiology Source Type: research

The Use of Aspirin in Contemporary Primary Prevention of Atherosclerotic Cardiovascular Diseases Revisited: The Increasing Need and Call for a Personalized Therapeutic Approach
AbstractThe use of aspirin has been widely accepted for the secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in all patient populations, as the benefits linked to the reduction of clinical events outweigh the risk of major bleeding. However, despite the undisputable, though modest, potential of aspirin to reduce atherothrombotic events, its overall efficacy and safety in primary ASCVD prevention remains debatable, despite being used for this purpose for decades. The net clinical benefit of aspirin was brought into question by three recent large contemporary randomized controlled trials evaluating its ...
Source: American Journal of Cardiovascular Drugs - August 17, 2020 Category: Cardiology Source Type: research

The Pharmacology, Efficacy, and Safety of Rivaroxaban in Obese Patient Populations
In conclusion, rivaroxaban ’s overall pharmacological and clinical profile remained consistent in obese adults when assessed in both drug development and postmarketing studies, supporting the premise that higher weight does not necessitate adjustment in either dose strength or regimen. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - August 16, 2020 Category: Cardiology Source Type: research

Optimal Medical Therapy Prescription in Patients with Acute Coronary Syndrome in the Netherlands: A Multicenter Pilot Registry
AbstractBackgroundUnlike neighboring countries, the Netherlands does not have a national acute coronary syndrome (ACS) registry to evaluate quality of care.ObjectiveWe conducted a pilot registry in two hospitals to assess the prescription of guideline-recommended therapies in Dutch patients with ACS.MethodsWe included all consecutive patients with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) (n = 1309) admitted to two Dutch percutaneous coronary intervention centers between March 2015 and February 2016. We collected follow-up medication use and reasons for discontinuation at discharge and 1, ...
Source: American Journal of Cardiovascular Drugs - August 11, 2020 Category: Cardiology Source Type: research

Blood Pressure-Lowering Effect of Newer Antihyperglycemic Agents (SGLT-2 Inhibitors, GLP-1 Receptor Agonists, and DPP-4 Inhibitors)
AbstractThe prevalence of arterial hypertension is high in patients with diabetes mellitus (DM). When DM and hypertension coexist, they constitute a dual cardiovascular threat and should be adequately controlled. Novel antihyperglycemic agents, including sodium-glucose co-transporter 2 (SGLT-2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and dipeptidyl peptidase-4 (DPP-4) inhibitors, have recently been used in the treatment of DM. Beyond their glucose-lowering effects, these drugs have shown beneficial pleiotropic cardiovascular effects, including lowering of arterial blood pressure (BP), as acknowle...
Source: American Journal of Cardiovascular Drugs - August 10, 2020 Category: Cardiology Source Type: research

Toward Brief Dual Antiplatelet Therapy and P2Y12 Inhibitors for Monotherapy After PCI
AbstractThe optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention remains a controversial topic. The European Society of Cardiology and the American College of Cardiology/American Heart Association recommend at least 6 and 12  months of DAPT after PCI in patients with stable coronary artery disease or acute coronary syndrome, respectively. Although prolonging DAPT duration reduces ischemic events, it is associated with higher rates of bleeding and possible fatal outcomes. The DAPT score can be an important tool to ident ify patients who may still benefit from prolonged therapy. ...
Source: American Journal of Cardiovascular Drugs - August 10, 2020 Category: Cardiology Source Type: research

Author ’s Reply to Vaz et al.: “Non-vitamin K Antagonist Oral Anticoagulants Versus Warfarin in Patients with Atrial Fibrillation and Liver Disease”
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - August 10, 2020 Category: Cardiology Source Type: research

Comment on: Non-vitamin K Antagonist Oral Anticoagulants Versus Warfarin in Patients with Atrial Fibrillation and Liver Disease
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - August 10, 2020 Category: Cardiology Source Type: research

Current Overview on Hypercoagulability in COVID-19
AbstractThe coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has brought many unique pathologies, such as coagulopathy, prompting a desperate need for effective management. COVID-19-associated coagulopathy (CAC) can cause various thromboembolic complications, especially in critically ill patients. The pathogenesis is likely due to endothelial injury, immobilization, and an increase in circulating prothrombotic factors. Data on treatment are limited, although prophylactic anticoagulation is advised in all hospitalized patients. Herein, we have comprehensiv...
Source: American Journal of Cardiovascular Drugs - August 3, 2020 Category: Cardiology Source Type: research

Amiodarone in the COVID-19 Era: Treatment for Symptomatic Patients Only, or Drug to Prevent Infection?
We present the rationale of using amiodarone in the COVID-19 scenario, as well as whether or not amiodarone administration represents a potential strategy to prevent SARS-CoV-2 infection, rather than simply used to treat patients already symptomatic and/or with severe coronavirus disease 2019 (COVID-19), based on current evidence. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 31, 2020 Category: Cardiology Source Type: research

Author ’s Reply to Peverill: “Predictors of Left Ventricular Dysfunction in Friedreich’s Ataxia in a 16-Year Observational Study”
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 24, 2020 Category: Cardiology Source Type: research

Comment on: “Predictors of Left Ventricular Dysfunction in Friedreich Ataxia in a 16-Year Observational Study”
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 24, 2020 Category: Cardiology Source Type: research

Ex Ante Economic Evaluation of Arg389 Genetically Targeted Treatment with Bucindolol versus Empirical Treatment with Carvedilol in NYHA III/IV Heart Failure
ConclusionThis independent ex ante economic evaluation suggests that genetically targeted treatment with bucindolol is unlikely to yield clinicoeconomic benefits over empirical treatment with carvedilol in NYHA III/IV HF. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 24, 2020 Category: Cardiology Source Type: research

Nebivolol for the Treatment of Essential Systemic Arterial Hypertension: A Systematic Review and Meta-Analysis
ConclusionsNebivolol demonstrated at least similar control of blood pressure levels in hypertensive individuals when compared with drugs of the most used classes. In addition, in relation to the control of arterial hypertension, studies with clinical outcomes should be performed to ensure the use of this drug in detriment to others with these well-established results. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 24, 2020 Category: Cardiology Source Type: research

Rosuvastatin/Ezetimibe: A Review in Hypercholesterolemia
AbstractRosuvastatin/ezetimibe combines two lipid-lowering agents: rosuvastatin, an HMG-CoA reductase inhibitor (i.e. statin) with particularly strong inhibitory effects on hepatic cholesterol synthesis, and ezetimibe, which inhibits the intestinal absorption of cholesterol. A fixed-dose combination (FDC) of rosuvastatin/ezetimibe is indicated as an adjunctive therapy to diet for the management of primary hypercholesterolemia in adults in numerous countries worldwide. In well-designed clinical trials evaluating the therapeutic efficacy of rosuvastatin/ezetimibe administered as either separate agents or as an FDC, rosuvasta...
Source: American Journal of Cardiovascular Drugs - July 9, 2020 Category: Cardiology Source Type: research

COVID-19 Pandemic: Cardiovascular Complications and Future Implications
AbstractCoronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is now a global pandemic with the highest number of affected individuals in the modern era. Not only is the infection inflicting significant morbidity and mortality, but there has also been  a significant strain to the health care system and the economy. COVID-19 typically presents as viral pneumonia, occasionally leading to acute respiratory distress syndrome (ARDS) and death. However, emerging evidence suggests that it has a significant impact on the cardiovascular (CV) system by di rect myocardial da...
Source: American Journal of Cardiovascular Drugs - June 22, 2020 Category: Cardiology Source Type: research

Comparative Effectiveness and Costs of Enoxaparin Monotherapy Versus Unfractionated Heparin Monotherapy in Treating Acute Coronary Syndrome
ConclusionsEnoxaparin was associated with a lower risk of ischemic complications (including death), lower costs, and better safety than UFH among NSTEMI patients. Improving upstream selection of anticoagulants in appropriate populations may help optimize clinical outcomes and costs. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - June 22, 2020 Category: Cardiology Source Type: research

The Safety and Efficacy of Rivaroxaban Compared with Warfarin in Patients with Atrial Fibrillation and Diabetes: A Systematic Review and Meta-analysis
AbstractAimsThis meta-analysis was conducted to compare the efficacy and safety of rivaroxaban with warfarin in patients with atrial fibrillation (AF) and diabetes mellitus.MethodsPubMed, Embase, Cochrane Library, and Web of Science databases were systematically searched from the establishment of databases up to 15 October 2019. Studies on efficacy and safety outcomes of rivaroxaban and warfarin were included. Efficacy and safety outcomes, including stroke, ischemic stroke, stroke or systemic embolism, myocardial infarction, major adverse cardiac events, major bleeding, intracranial hemorrhage, and major gastrointestinal b...
Source: American Journal of Cardiovascular Drugs - June 7, 2020 Category: Cardiology Source Type: research

PCSK9 Inhibitors in a German Single-Center Clinical Practice: Real-World Treatment of Patients at High Cardiovascular Risk Over 68 Weeks
AbstractAimsSeveral the use of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) for patients at high/very high cardiovascular risk who are inadequately treated with maximally tolerated lipid-lowering therapies (LLTs).ObjectivesWe assessed the effectiveness and safety of the PCSK9i alirocumab and evolocumab in a single-center clinical practice for up to 68  weeks.MethodsIn this prospective, open-label study conducted in Germany, 635 enrolled patients were treated with alirocumab [75 or 150  mg every 2 weeks (Q2W)] or evolocumab (140 mg Q2W) according to European Society of Cardiology/Eur...
Source: American Journal of Cardiovascular Drugs - June 7, 2020 Category: Cardiology Source Type: research

Levosimendan Can Improve the Level of B-Type Natriuretic Peptide and the Left Ventricular Ejection Fraction of Patients with Advanced Heart Failure: A Meta-analysis of Randomized Controlled Trials
ConclusionOur meta-analysis suggests that intravenous levosimendan can reduce BNP level and increase LVEF in patients with advanced heart failure to reduce the mortality at the shortest follow-up available. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - May 27, 2020 Category: Cardiology Source Type: research

Management of Outpatient Warfarin Therapy amid COVID-19 Pandemic: A Practical Guide
This article discusses a stepwise algorithm for the management of outpatient warfarin therapy. Alternative management strategies are presented and discussed, including alternative pharmacological therapy options and self-monitoring. Our algorithm aims to help clinicians safely optimize the treatment of patients requiring anticoagulation therapy in the context of the global response to the current pandemic. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - May 25, 2020 Category: Cardiology Source Type: research

Calcium Channel Blockers in Acute Care: The Links and Missing Links Between Hemodynamic Effects and Outcome Evidence
AbstractCalcium channel blockers (CCBs) exert profound hemodynamic effects via blockage of calcium flux through voltage-gated calcium channels. CCBs are widely used in acute care to treat concerning, debilitating, or life-threatening hemodynamic changes in many patients. The overall literature suggests that, for systemic hemodynamics, although CCBs decrease blood pressure, they normally increase cardiac output; for regional hemodynamics, although they impair pressure autoregulation, they normally increase organ blood flow and tissue oxygenation. In acute care, CCBs exert therapeutic efficacy or improve outcomes in patients...
Source: American Journal of Cardiovascular Drugs - May 14, 2020 Category: Cardiology Source Type: research

Complexity of Antiplatelet Therapy in Coronary Artery Disease Patients
AbstractPatients with coronary artery disease (CAD) presenting with acute coronary syndrome or undergoing coronary stenting are indicated to treatment with dual antiplatelet therapy (DAPT) combining aspirin with a P2Y12 receptor inhibitor. The management of patients with CAD who present with a complex clinical profile due to multiple comorbidities, and/or undergoing complex interventional procedures, remains challenging as a high risk for both ischemic and bleeding events is often present; hence, the risk –benefit balance on the optimal DAPT duration is difficult to evaluate. The complexity of antiplatelet therapy in...
Source: American Journal of Cardiovascular Drugs - May 11, 2020 Category: Cardiology Source Type: research

Once- versus Twice-Daily Aspirin in Patients at High Risk of Thrombotic Events: Systematic Review and Meta-Analysis
ConclusionsTwice-daily ASA was associated with a greater antiplatelet effect compared with standard once-daily ASA. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - May 10, 2020 Category: Cardiology Source Type: research

Inflammation May be the Future of Cardiovascular Risk Reduction: Does Colchicine have a Current Indication?
AbstractInflammation as a cardiovascular risk factor has attracted increasing attention . The current standard of care for decreasing the occurrence of cardiovascular events includes controlling risk factors such as hypertension and maximizing the lowering of low-density lipoprotein cholesterol (LDL-C). However, a recent study demonstrated decreased cardiovascular risk with the anti-inflammatory agent canakinumab and created more interest in decreasing cardiovascular risk by decreasing inflammation. Canakinumab is not yet approved and will undoubtedly be very expensive, so interest in an established medication such as colc...
Source: American Journal of Cardiovascular Drugs - April 29, 2020 Category: Cardiology Source Type: research

Cardiovascular Disease and Use of Renin-Angiotensin System Inhibitors in COVID-19
This article aims to summarize the evidence on the use of RAS inhibitors in CVD patients with COVID-19, focusing on safety issues of the RAS inhibitors and their relationship with COVID-19. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - April 12, 2020 Category: Cardiology Source Type: research

Association Between Statin Use, Intensity and Acute Liver Injury in Human Immunodeficiency Virus, Hepatitis C Virus, and Uninfected US Veterans
ConclusionsStatin initiators had a lower risk of any ALI outcome compared with non-users within 18  months regardless of HIV and/or HCV status. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 31, 2020 Category: Cardiology Source Type: research

Exploring Medication Adherence with P2Y 12 Inhibitors Using Conditional and Unconditional Quantile Regression Approaches
ConclusionsUsing CQR and UQR allowed for heterogenous assessment of covariates along the adherence distribution, which is not possible with the traditional logistic regression method. The UQR framework revealed patients who initiate prasugrel or ticagrelor generally have lower adherence compared to those treated with branded clopidogrel, especially around the 30th quantile. Using these methods in other types of data sets, such as electronic health records, could help strengthen our results to develop policies to improve antiplatelet adherence in a targeted population. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 29, 2020 Category: Cardiology Source Type: research

Double or Triple Antithrombotic Treatment in Atrial Fibrillation Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention
AbstractPatients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) have traditionally received triple antithrombotic therapy (TAT) consisting of aspirin and a P2Y12 inhibitor plus an oral anticoagulant (OAC) to reduce atherothrombotic events, even though this strategy is associated with a high risk of severe bleeding. Recent trials have indicated that dual antithrombotic therapy (DAT), consisting of a P2Y12 inhibitor plus an OAC, may be superior to TAT in terms of bleeding risk; however, the  trade-off regarding ischemic complications may be questionable. Patients who have had a myocard...
Source: American Journal of Cardiovascular Drugs - March 13, 2020 Category: Cardiology Source Type: research

Amiodarone: A Comprehensive Guide for Clinicians
AbstractAmiodarone is an effective antiarrhythmic medication frequently used in practice for both ventricular and atrial arrhythmias. Though classified as a class III antiarrhythmic, it affects all phases of the cardiac action potential. However, the drug has several side effects, including thyroid abnormalities, pulmonary fibrosis, and transaminitis, for which routine monitoring is recommended. It also interacts with several medications, such as warfarin, simvastatin, and atorvastatin, and many HIV antiretroviral medications. Given the common use of this medication in medical practice, it is vital that clinicians understa...
Source: American Journal of Cardiovascular Drugs - March 12, 2020 Category: Cardiology Source Type: research

A Review of the Efficacy and Tolerability of Bempedoic Acid in the Treatment of Hypercholesterolemia
AbstractDespite the widespread use of statins and ezetimibe to decrease low-density lipoprotein cholesterol (LDL-C) levels and associated atherosclerotic cardiovascular disease (ASCVD), many patients do not achieve adequate LDL-C lowering as per the recommended American College of Cardiology (ACC)/American Heart Association (AHA) and European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines and demonstrate residual cardiovascular risk. The introduction of proprotein convertase subtilisin/kexin type 9 (PCSK-9) inhibitors in 2015 was a promising addition to hypercholesterolemia therapies, but the...
Source: American Journal of Cardiovascular Drugs - March 12, 2020 Category: Cardiology Source Type: research