Efficacy and Safety of Clopidogrel, Prasugrel and Ticagrelor in ACS Patients Treated with PCI: A Propensity Score Analysis of the RENAMI and BleeMACS Registries
AbstractIntroductionReal-life data comparing clopidogrel, prasugrel, and ticagrelor for unselected patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) are lacking, as are data for the temporal distribution of ischemic and bleeding risks.MethodsA total of 19,825 patients were enrolled from the RENAMI and BleeMACS registries. Both were multicenter, retrospective, observational registries including the data and outcomes of consecutive patients with ACS who underwent primary PCI and were discharged with dual antiplatelet therapy (DAPT). We evaluated the long-term outcome stratified by...
Source: American Journal of Cardiovascular Drugs - October 5, 2019 Category: Cardiology Source Type: research

Obesity Paradox in Atrial Fibrillation: Implications for Outcomes and Relationship with Oral Anticoagulant Drugs
AbstractIn the last 40  years, concern about the obesity epidemic has increased. Data from the current literature highlight a strong relationship between obesity and atrial fibrillation (AF), particularly in relation to an increased risk for incident and recurrent AF. A phenomenon called the “obesity paradox” has eme rged: the apparently counterintuitive evidence from epidemiological data indicating that overweight and obese patients may have a better prognosis than healthy-weight patients. A differential impact of oral anticoagulants (OACs) in terms of effectiveness and safety in the various body mass ind...
Source: American Journal of Cardiovascular Drugs - October 4, 2019 Category: Cardiology Source Type: research

Adherence to Anticoagulation and Risk of Stroke Among Medicare Beneficiaries Newly Diagnosed with Atrial Fibrillation
The objective of this study was to compare the risk of stroke in atrial fibrillation (AF) with adherent use of oral anticoagulation (OAC), non-adherent use, and non-use of OAC.MethodsUsing 2013 –2016 Medicare claims data, we identified patients newly diagnosed with AF in 2014–2015 and collected prescriptions filled for OAC in the 12 months after AF diagnosis (n = 39,272). We categorized participants each day into three time-dependent exposures: adherent use (≥ 80% of the previous 30 days covered with OAC), non-adherent use (0–80% covered with OAC), and non-use (0%). We co...
Source: American Journal of Cardiovascular Drugs - September 16, 2019 Category: Cardiology Source Type: research

Impact of Perioperative Levosimendan Administration on Risk of Bleeding After Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials
ConclusionThe analyzed parameters, including reoperations due to bleeding, postoperative chest drainage and the requirement for blood products, revealed that levosimendan did not increase postoperative bleeding risk. More studies with a larger sample size are needed to address a more reliable conclusion due to study limitations. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - September 16, 2019 Category: Cardiology Source Type: research

Postoperative Atrial Fibrillation Following Cardiac Surgery: From Pathogenesis to Potential Therapies
AbstractPostoperative atrial fibrillation (POAF) is a major complication after cardiac surgery which can lead to high rates of morbidity and mortality, an enhanced length of hospital stay, and an increased cost of care. POAF is postulated to be a multifactorial phenomenon; however, some major pathogeneses have been proposed, including inflammatory pathways, oxidative stress, and autonomic dysfunction. Genetic studies also showed that inflammatory pathways, beta-1 adrenoreceptor variants, G protein-coupled receptor  kinase 5 gene variants, and non-coding single-nucleotide polymorphisms in the 4q25 chromosomal locus are...
Source: American Journal of Cardiovascular Drugs - September 10, 2019 Category: Cardiology Source Type: research

Non-vitamin K Antagonist Oral Anticoagulants Versus Warfarin in Patients with Atrial Fibrillation and Liver Disease: A Meta-Analysis and Systematic Review
ConclusionsBased on current publications, the use of NOACs is at least non-inferior to warfarin in patients with AF and liver disease. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - September 4, 2019 Category: Cardiology Source Type: research

High-Dose Omega-3 Fatty Acids in Cardiovascular Prevention: Finally Living Up to Their Potential?
AbstractDespite the widespread use of statins in the setting of high cardiovascular risk, many patients continue to experience clinical events. This highlights the need to identify additional therapeutic strategies for high-risk patients. Interest in the use of omega-3 polyunsaturated fatty acids to prevent cardiovascular disease has been high for several decades. Despite promising results from before the statin era, many clinical trials have produced disappointing findings regarding products containing conventional doses of omega-3 fatty acids. More recent clinical trials using high doses of omega-3 fatty acids in targete...
Source: American Journal of Cardiovascular Drugs - September 4, 2019 Category: Cardiology Source Type: research

Adherence to Disease-Modifying Therapy in Patients Hospitalized for HF: Findings from a Community-Based Study
ConclusionsIn a real-world setting, medication adherence of patients with HF remains unsatisfactory, especially when in a polypharmacy setting. Irrespective of PDC and MPR, good patient adherence to polypharmacy was associated with a lower death rate. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - August 23, 2019 Category: Cardiology Source Type: research

Plasma Metabolites as Predictors of Warfarin Outcome in Atrial Fibrillation
Conclusions and ImplicationsWe have shown that the pharmacometabonomics technique was able to differentiate between unstable and stable INR with good accuracy. NMR-based pharmacometabonomics has the potential to identify novel biomarkers in plasma, which can be useful in individualizing treatment and controlling warfarin side effects, thus, minimizing undesirable effects in the future. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - August 22, 2019 Category: Cardiology Source Type: research

Current Evidence for Pharmacologic Reversal Using Direct Oral Anticoagulants: What ’s New?
We present the design and mechanisms of action of and the animal models, clinical trials, and current evidence supporting the use of these emerging reversal agents. Idarucizumab is approved in many countries, and andexanet alfa has been approved by the US FDA, whereas others are in clinical trials. In view of the results of clinical studies to date, the problems of safety, price and accessibility remain. Therefore, these antidotes are a significant step towards improving the field of urgent and emergency reversal. From a practical perspective, post-market surveillance will be crucial to monitor the safety and effectiveness...
Source: American Journal of Cardiovascular Drugs - August 22, 2019 Category: Cardiology Source Type: research

Effects of Intracoronary Nicorandil on Myocardial Microcirculation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Meta-Analysis of Randomized Controlled Trials
AbstractBackgroundThe amelioration of myocardial reperfusion in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PPCI) remains a significant issue.ObjectiveWe conducted a meta-analysis of randomized controlled trials (RCTs) to better assess the effects of intracoronary nicorandil administration on myocardial microcirculation and clinical outcomes in these patients.MethodsThe meta-analysis was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A literature search was performed in the PubMed, Embase, Cochrane ...
Source: American Journal of Cardiovascular Drugs - August 19, 2019 Category: Cardiology Source Type: research

Efficacy and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients with Atrial Fibrillation Across BMI Categories: A Systematic Review and Meta-Analysis
ConclusionsThere may be an obesity paradox in anticoagulated patients with AF. DOACs have better efficacy and safety profiles than warfarin in underweight, normal weight and overweight patients, and are not inferior to warfarin in obese patients. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 24, 2019 Category: Cardiology Source Type: research

Real World Outcomes Associated with Idarucizumab: Population-Based Retrospective Cohort Study
ConclusionsAmong a large nationally representative sample of adult patients with dabigatran-associated major bleeding in the United States, we found no difference in in-hospital mortality among patients with gastrointestinal bleeding associated with idarucizumab exposure. An excess risk of in-hospital mortality associated with idarucizumab exposure among participants with intracranial bleeding deserves further exploration. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 22, 2019 Category: Cardiology Source Type: research

Long-Term Quality of Prescription for ST-Segment Elevation Myocardial Infarction (STEMI) Patients: A Real World 1-Year Follow-Up Study
ConclusionThe present study showed a high prescription rate of guideline-recommended medications in a referral center for primary percutaneous coronary intervention. At discharge, women and co-morbid patients were at the highest risk of incomplete prescription of guideline medications, whereas long-term prescription was suboptimal for elderly. A drug lacking at time of discharge was rarely introduced within the year, which underscores the paramount importance of optimal prescription at time of discharge. Strategies like implementing a standardized prescription could reduce the proportion of suboptimal prescription. It coul...
Source: American Journal of Cardiovascular Drugs - July 12, 2019 Category: Cardiology Source Type: research

Role of Vitamin D in Patients with Heart Failure with Reduced Ejection Fraction
AbstractHeart failure (HF) with reduced ejection fraction (HFrEF) presents as the severest phenotype on the spectrum of HF. Although great progress has been made with respect to its treatment over the past 3 decades, morbidity and mortality remain high, posing a big burden on human health. Recent evidence suggests vitamin D has a critical role in maintaining heart health through activation of the vitamin D receptor expressed in cardiomyocytes, and vitamin D deficiency may be implicated in the pathophysiology of HFrEF through activation of the renin-angiotensin system, impaired calcium handling, exaggerated inflammation, se...
Source: American Journal of Cardiovascular Drugs - July 10, 2019 Category: Cardiology Source Type: research

Spotlight from the American Society for Preventive Cardiology on Key Features of the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guidelines on the Management of Blood Cholesterol
AbstractThe 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol retains focus on recommendations for statin treatment in the original four statin-eligible groups [those with atherosclerotic cardiovascular disease (ASCVD), diabetes, low-density lipoprotein cholesterol (LDL-C) ≥ 190 mg/dL, and higher risk primary prevention] without the use of treatment initiation or target LDL-C levels from the earlier 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline, but has several new features. First, patients with primary preventio...
Source: American Journal of Cardiovascular Drugs - July 8, 2019 Category: Cardiology Source Type: research

Comparative Real-Life Effectiveness and Safety of Dabigatran or Rivaroxaban vs. Vitamin K Antagonists: A High-Dimensional Propensity Score Matched New Users Cohort Study in the French National Healthcare Data System SNDS
ConclusionConsistent with results from clinical trials and other observational studies, dabigatran and rivaroxaban were at least as effective and safer than VKAs for the prevention of thromboembolic events in NVAF over 1 year in the French population.Study registrationEuropean Medicines Agency EUPAS 13017 (www.encepp.eu) Clinicaltrials.gov id NCT02785354. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - June 29, 2019 Category: Cardiology Source Type: research

Educational Impact on Apixaban Adherence in Atrial Fibrillation (the AEGEAN STUDY): A Randomized Clinical Trial
ConclusionHigh implementation adherence and persistence with apixaban were observed in patients with NVAF receiving apixaban. The educational program did not show additional benefits.Clinical trial registrationThis study is registered at ClinicalTrials.gov [NCT01884350]. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - June 26, 2019 Category: Cardiology Source Type: research

Safety and Prognostic Impact of Early Treatment with Angiotensin-Converting Enzyme Inhibitors or Angiotensin Receptor Blockers in Patients with Acute Heart Failure
ConclusionsEarly initiation of ACEIs/ARBs within 48  h of admission for hospitalized patients with AHF was not associated with adverse events and correlated with improved outcomes at 1 year from admission. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - June 20, 2019 Category: Cardiology Source Type: research

Effect of Spironolactone on Atrial Fibrillation in Patients with Heart Failure with Preserved Ejection Fraction: Post-Hoc Analysis of the Randomized, Placebo-Controlled TOPCAT Trial
ConclusionSpironolactone does not reduce the risk of new-onset AF or AF recurrence in patients with HFpEF. This is in contrast to results in cohorts of patients with HF and a reduced ejection fraction.Clinical trial registrationClinicalTrials.gov identifier no. NCT00094302 (TOPCAT). (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - June 19, 2019 Category: Cardiology Source Type: research

Comparison of Venous Thromboembolism Prophylactic Measures Post Coronary Artery Bypass Graft Surgery
ConclusionsWe report no statistical difference in the rates of VTE or bleeding between chemical agents, but our results suggest enoxaparin may be a preferred agent over UFH. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - June 15, 2019 Category: Cardiology Source Type: research

Assessment and Management of Patients with Hyperlipidemia Referred for Initiation of PCSK9 Inhibitor Therapy: A Lipid Clinic Experience
ConclusionOur findings suggest that those physicians who referred patients to our lipid clinic specifically for initiation of a PCSK9 inhibitor were not aware of the established indications. By prescribing a PCSK9 inhibitor to only those patients meeting the established indications, 100% obtained approval. Therefore, to achieve higher insurance approval rates and utilization, it is essential that physicians understand the indications for PCSK9 inhibitor therapy and prescribe them only to patients meeting the established indications. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - May 23, 2019 Category: Cardiology Source Type: research

Correction to: Real-World Data of Prasugrel vs. Ticagrelor in Acute Myocardial Infarction: Results from the RENAMI Registry
The first author ’s name which previously read. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - May 20, 2019 Category: Cardiology Source Type: research

A Long-Term Cost-Effectiveness Analysis Comparing Radiofrequency Catheter Ablation with Antiarrhythmic Drugs in Treatment of Chinese Patients with Atrial Fibrillation
ConclusionCompared with AADs, RFCA significantly improves clinical outcomes and QALYs among patients with paroxysmal or persistent AF. From the Chinese payer ’s perspective, RFCA is a cost-effective therapy over long-term horizons. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - May 14, 2019 Category: Cardiology Source Type: research

Association Between Digoxin Use and Adverse Outcomes Among Patients in the Chinese Atrial Fibrillation Registry
DiscussionIn this Chinese AF cohort, for patients who had not undergone ablation, digoxin use was associated with a significant increase in adverse outcomes. Although residual confounders may exist, and serum concentrations of digoxin were unavailable, digoxin should be used with caution in clinical practice, and its effects need to be critically evaluated in randomized trials.Clinical trial registrationURL:http://www.chictr.org.cn/showproj.aspx?proj=5831. Unique identifier: ChiCTR-OCH-13003729. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - May 11, 2019 Category: Cardiology Source Type: research

The Effects of Clarithromycin on the Pharmacokinetics of Apixaban in Healthy Volunteers: A Single-Sequence Crossover Study
ConclusionsApixabanCmax and AUC(INF) increased 30% and 60%, respectively, when multiple doses of clarithromycin were coadministered with apixaban versus administration of apixaban alone. The increase in apixabanCmax and AUC(INF) with concomitant clarithromycin was less than that which has been observed when apixaban was given with ketoconazole. Administration of apixaban alone and in combination with clarithromycin bid was safe and generally well-tolerated by the healthy adult subjects in this study.Clinical Trial RegistrationClinicalTrials.gov identifier number NCT02912234. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - April 27, 2019 Category: Cardiology Source Type: research

Real-World Data of Prasugrel vs. Ticagrelor in Acute Myocardial Infarction: Results from the RENAMI Registry
ConclusionsComparison of these drugs suggested that prasugrel is safer and more efficacious than ticagrelor in combination with aspirin after NSTEMI but not STEMI. No differences were found for events occurring after 12  months. The nonrandomized design of the present research means further studies are required to support these findings. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - April 27, 2019 Category: Cardiology Source Type: research

Prasugrel and Ticagrelor: the Romulus and Remus of Antiplatelet Therapy?
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - April 27, 2019 Category: Cardiology Source Type: research

Effect of Warfarin on Ischemic Stroke, Bleeding, and Mortality in Patients with Atrial Fibrillation Receiving Peritoneal Dialysis
ConclusionThere is no significant association between warfarin treatment with risks of mortality, ischemic stroke or bleeding in patients with atrial fibrillation receiving peritoneal dialysis. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - April 23, 2019 Category: Cardiology Source Type: research

Adenosine and the Cardiovascular System
AbstractAdenosine is an endogenous nucleoside with a short half-life that regulates many physiological functions involving the heart and cardiovascular system. Among the cardioprotective properties of adenosine are its ability to improve cholesterol homeostasis, impact platelet aggregation and inhibit the inflammatory response. Through modulation of forward and reverse cholesterol transport pathways, adenosine can improve cholesterol balance and thereby protect macrophages from lipid overload and foam cell transformation. The function of adenosine is controlled through four G-protein coupled receptors: A1, A2A, A2B an...
Source: American Journal of Cardiovascular Drugs - April 10, 2019 Category: Cardiology Source Type: research

Effects of Statins to Reduce All-Cause Mortality in Heart Failure Patients: Findings from the EPICAL2 Cohort Study
ConclusionIn patients with HF (and reduced or preserved ejection fraction), the prescription of statins did not appear to be associated with better survival after 1  year of follow-up in the EPICAL2 cohort. We cannot exclude that a subpopulation of HF patients may have some benefits compared with the whole HF population or that there might be a lack of power to show such effect.Clinical Trial RegistrationNCT02880358. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - April 10, 2019 Category: Cardiology Source Type: research

Review of Direct Oral Anticoagulants and Guide for Effective Drug Utilization
AbstractDirect oral anticoagulants (DOACs) have been developed as a viable and in some cases superior alternative to warfarin. These agents have overcome some of the limitations of warfarin, which has a narrow therapeutic window and many food and drug interactions. DOACs have been demonstrated to have a more predictable and reliable pharmacology and, unlike warfarin, do not require frequent monitoring of anticoagulant effect. For these reasons, the use of DOACs is increasing. Despite the many positive attributes of these agents, limitations and contraindications do exist. An understanding of the pharmacology, indications, ...
Source: American Journal of Cardiovascular Drugs - April 3, 2019 Category: Cardiology Source Type: research

Novel Oral Anticoagulants for the Prevention of Stroke in Patients with Atrial Fibrillation and Hypertension: A Meta-Analysis
ConclusionsOur findings suggest that NOACs can be recommended for the prevention of stroke or systemic embolism in patients with AF and hypertension. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - April 1, 2019 Category: Cardiology Source Type: research

Renin –Angiotensin System Blockade and Risk of Heart Failure After Myocardial Infarction Based on Left Ventricular Ejection Fraction: A Retrospective Cohort Study
ConclusionAmong hospitalized survivors of AMI, the use of ACEIs/ARBs was associated with a lower risk of follow-up HF in patients with LVEF  ≤ 40% but not in those with LVEF >  40%. Further prospective studies are needed to confirm our results. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 28, 2019 Category: Cardiology Source Type: research

Efficacy and Safety of Incremental Dosing of a New Single-Pill Formulation of Perindopril and Amlodipine in the Management of Hypertension
AbstractBackgroundAngiotensin-converting enzyme inhibitors and calcium channel blockers in combination are widely recommended in hypertension guidelines. The advantages of single-pill combinations (SPCs) are increasingly recognized, so a dosage-adapted combination of perindopril and amlodipine was developed for the initial management of hypertension.ObjectiveThis randomized trial evaluated the blood pressure (BP)-lowering efficacy of four incremental doses of perindopril/amlodipine SPC in adults with mild-to-severe hypertension.MethodsEligible patients (N = 1617) were randomized to SPC perindopril 3.5 mg...
Source: American Journal of Cardiovascular Drugs - March 28, 2019 Category: Cardiology Source Type: research

Clinical Performance of Apixaban vs. Vitamin K Antagonists in Patients with Atrial Fibrillation Undergoing Direct Electrical Current Cardioversion: A Prospective Propensity Score-Matched Cohort Study
ConclusionsNewly initiated anticoagulation with apixaban in patients with nonvalvular AF scheduled for TEE-guided DCC seems to be as effective and safe as uninterrupted VKA therapy during 12  months of follow-up. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 6, 2019 Category: Cardiology Source Type: research

Do Patients need Lifelong β-Blockers after an Uncomplicated Myocardial Infarction?
AbstractThe lifelong use of β-adrenoceptor antagonists (β-blockers) after a myocardial infarction (MI) has been the standard of care based on trials performed before the era of revascularization, when heart failure was common. Large randomized trials in the mid-1980s demonstrated that β-blockers played a major role in impro ving the in-hospital and long-term survival of patients admitted for MI. However, the implementation of rapid myocardial reperfusion led to a substantial survival benefit and a reduction of heart failure because of reduced infarct size. Modern large longitudinal registries did not provide...
Source: American Journal of Cardiovascular Drugs - March 4, 2019 Category: Cardiology Source Type: research

Prasugrel vs. Ticagrelor for Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis
ConclusionsThe present analysis suggests that prasugrel might have a better efficacy profile than ticagrelor in patients with ACS undergoing PCI. However, this advantage was only seen in pooled observational studies and is likely to be affected by selection bias. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 4, 2019 Category: Cardiology Source Type: research

Correction to: FDA Approval of Angiotensin II for the Treatment of Hypotension in Adults with Distributive Shock
The author name that previously read (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 1, 2019 Category: Cardiology Source Type: research

Anticoagulation in Venous Thromboembolism Prophylaxis in Medically Ill Patients: Potential Impact of NOACs
AbstractWhile substantial evidence supports the use of standard-duration injectable anticoagulants for venous thromboembolism (VTE) prophylaxis, consensus is mixed about which agents may be preferred in acutely ill patients with ongoing need of VTE prophylaxis past the first 10-day duration of hospital stay and post-discharge. Non-vitamin K antagonist oral anticoagulants (NOACs) provide Factor Xa inhibition to prevent the thrombin generation essential in thromboembolism development, but evidence for the efficacy and safety of most NOACs is conflicting regarding extended-duration prophylaxis. Enoxaparin, a preferred injecta...
Source: American Journal of Cardiovascular Drugs - February 27, 2019 Category: Cardiology Source Type: research

Pharmacoinvasive Approach with Streptokinase in Low to Intermediate Risk ST-Elevation Myocardial Infarction Patients: Insights from the Tamil Nadu-STEMI Initiative
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 23, 2019 Category: Cardiology Source Type: research

Evidence-Based Cardiovascular Risk Management in Diabetes
AbstractMultipronged risk management in diabetes has contributed to the recent decline in cardiovascular mortality. Few antihyperglycemic drugs have been conclusively shown to have cardioprotective effects. These include metformin, liraglutide, semaglutide, dulaglutide, and sodium-glucose cotransporter-2 inhibitors. Statins are the cornerstone of treatment for people with established coronary artery disease (CAD) or at risk of CAD. In patients with persistent low-density lipoprotein cholesterol (LDL-C) levels>  70 mg/dL, the addition of ezetimibe or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibit...
Source: American Journal of Cardiovascular Drugs - February 22, 2019 Category: Cardiology Source Type: research

Effects of Rosuvastatin and Aspirin on Retinal Vascular Structures in Hypercholesterolemic Patients with Low-to-Moderate Risk of Coronary Artery Disease
DiscussionFor patients with a low-to-moderate risk of CAD, we found a significant effect of rosuvastatin on retinal microvasculature, including AVR increase, venular constriction, and arteriolar dilation after 6 –12 months of treatment.Clinical Trial registrationChinese Clinical Trial Registry identifier number ChiCTR-IOR-15006664. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 22, 2019 Category: Cardiology Source Type: research

Pharmacotherapy of Obesity: Limits and Perspectives
AbstractObesity is a severe worldwide epidemic. Obesity comorbidities, such as type 2 diabetes mellitus, hypertension, and atherosclerosis, are costly for patients and governments. The treatment of obesity involves several facets, including lifestyle changes, bariatric surgery, and pharmacotherapy. As changes in lifestyle require considerable patient commitment that is sometimes unachievable, and surgery is expensive and invasive, pharmacotherapy is the primary option for most patients. This review describes the pharmacotherapy currently available in the USA, Europe, and Brazil, focusing on its limitations. We then analyze...
Source: American Journal of Cardiovascular Drugs - February 22, 2019 Category: Cardiology Source Type: research

Comment on: “Efficacy and Safety of Intravenous Tenecteplase Bolus in Acute Ischemic Stroke: Results of Two Open-Label, Multicenter Trials”
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 22, 2019 Category: Cardiology Source Type: research

Authors ’ Reply to Rana et al. “Efficacy and Safety of Intravenous Tenecteplase Bolus in Acute Ischemic Stroke: Results of Two Open-Label, Multicenter Trials”
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 22, 2019 Category: Cardiology Source Type: research

Clinical Outcomes at 2 Years Between Beta-Blockade with ACE Inhibitors or ARBs in Patients with AMI Who Underwent Successful PCI with DES: A Retrospective Analysis of 23,978 Patients in the Korea AMI Registry
ConclusionsThe BB  + ACEI group demonstrated reduced cumulative incidences of MACE, all-cause death, cardiac death, TVR, and TVF compared with the BB + ARB group in patients with AMI who underwent successful PCI with DES during a 2-year follow-up period. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 20, 2019 Category: Cardiology Source Type: research

The Efficacy and Safety of Aerosolized Iloprost in Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis
ConclusionIn this systematic review and meta-analysis, inhaled iloprost has been shown to be a safe and well-tolerated agent for PAH in the first 3  months after diagnosis. If used for a prolonged period, aerosol iloprost monotherapy could contribute to an unsatisfactory improvement in vascular remodeling and even a decreased event-free survival rate. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 19, 2019 Category: Cardiology Source Type: research

Cardiovascular Protection with Anti-hyperglycemic Agents
AbstractDiabetes mellitus is a major risk factor for cardiovascular (CV) disease. Conversely, CV disease is responsible for a majority of the deaths in patients with diabetes. Many drug trials have concentrated on blood glucose (hemoglobin A1c) reduction. This strategy, while reducing microvascular outcomes like nephropathy and neuropathy, has little or no effect on reducing macrovascular events like heart attack, stroke, and heart failure. It has been postulated that hypoglycemia may counterbalance some of the beneficial effects of anti-hyperglycemic agents, but this is not proven. Further, trial evidence for thiazolidine...
Source: American Journal of Cardiovascular Drugs - February 15, 2019 Category: Cardiology Source Type: research

Efficacy and Safety of Ticagrelor Compared with Clopidogrel in Patients with End-Stage Renal Disease with Acute Myocardial Infarction
ConclusionIn patients with ESRD and AMI, ticagrelor resulted in numerically fewer but statistically nonsignificant rates of in-hospital and 1-year cardiovascular events with no significant increase in bleeding events compared with clopidogrel. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 12, 2019 Category: Cardiology Source Type: research