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 13, 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 13, 2020 Category: Cardiology Source Type: research

Defining the Role of Icosapent Ethyl in Clinical Practice
This article summarizes the current status and future perspective of icosapent ethyl in clinical practice in light of REDUCE-IT. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 11, 2020 Category: Cardiology Source Type: research

Pharmacologic Management of Gout in Patients with Cardiovascular Disease and Heart Failure
AbstractGout is the most common inflammatory arthritis and is often comorbid with cardiovascular disease (CVD). Hyperuricemia and gout are also independent risk factors for cardiovascular events, worsening heart failure (HF), and death. The recommended treatment modalities for gout have important implications for patients with CVD because of varying degrees of cardiovascular and HF benefit and risk. Therefore, it is critical to both manage hyperuricemia with urate-lowering therapy (ULT) and treat acute gout flares while minimizing the risk of adverse cardiovascular events. In this review, the evidence for the safety of pha...
Source: American Journal of Cardiovascular Drugs - February 24, 2020 Category: Cardiology Source Type: research

Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Alirocumab in Healthy Chinese Subjects: A Randomized, Double-Blind, Placebo-Controlled, Ascending Single-Dose Study
ConclusionsIn Chinese subjects, alirocumab 75, 150, and 300  mg was safe and well-tolerated. Pharmacokinetic/pharmacodynamic parameters, including clinically meaningful reductions in LDL-C and other lipids/lipoproteins, were consistent with data from Japanese and Western populations.Clinicaltrials.gov identifier: NCT02979015. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 21, 2020 Category: Cardiology Source Type: research

Potentially Harmful Medication Use Among Medicare Patients with Heart Failure
ConclusionsOver one-half of patients with HF were prescribed one or more potentially harmful medication(s). Automated monitoring of prescription claims and implementation of alerts in electronic health records in primary care is warranted to reduce potentially harmful medication use among Medicare MTM-eligible patients. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 21, 2020 Category: Cardiology Source Type: research

Risk of Cardiovascular Outcomes and Antihypertensive Triple Combination Therapy Among Elderly Patients with Hypertension Enrolled in a Medicare Advantage Plan (MAP)
ConclusionSingle-pill triple combination therapy was significantly associated with a lower risk of CVD hospitalizations in comparison to other types of triple combination therapy. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 11, 2020 Category: Cardiology Source Type: research

Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors for Cardiovascular Disease Prevention
AbstractCardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Because of these associated risks, managing diabetes and CVD, including heart failure (HF), has become a joint effort to reduce the risk of adverse outcomes. Although many patients with T2DM are receiving preventive therapies for CVD, their residual risk remains high for atherosclerotic CVD (ASCVD). Recent data regarding the use of antidiabetic medications to prevent negative cardiovascular outcomes has revealed a positive association with reduced major adverse cardiovascular events (MACE)....
Source: American Journal of Cardiovascular Drugs - February 11, 2020 Category: Cardiology Source Type: research

Evaluation of the Safety and Effectiveness of Direct-Acting Oral Anticoagulants in Patients with Atrial Fibrillation and Coexisting Valvular Heart Disease
ConclusionsIn patients with AF and VHD, rates of major bleeding were similar among the DOACs and valve types; however, more patients receiving dabigatran experienced SSE. Further studies are needed to validate these findings. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 11, 2020 Category: Cardiology Source Type: research

Effects of Blood Pressure Lowering Agents on Cardiovascular Outcomes in Weight Excess Patients: A Systematic Review and Meta-analysis
ConclusionsIn hypertensive subjects with excess weight, diuretics are more effective for preventing HF and stroke than CCB and ACEI, respectively. CCB are a good first-line choice for prevention of cardiovascular disease, except HF. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - January 3, 2020 Category: Cardiology Source Type: research

Evolution of Patients with Pulmonary Arterial Hypertension Starting Macitentan After the Discontinuation of Other Endothelin-Receptor Antagonists: Results of a Retrospective Study
ConclusionsOur results suggest that switching to macitentan in patients with PAH who discontinued bosentan/ambrisentan was well-tolerated and effective. Further studies are needed to confirm these observations. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - December 27, 2019 Category: Cardiology Source Type: research

Statins, LDL Cholesterol Control, Cardiovascular Disease Prevention, and Atherosclerosis Progression: A Clinical Perspective
AbstractDespite the longstanding and widespread use of statins, they are used quite inefficiently in everyday clinical practice. This might be because of a lack of robust evidence or the wide variety of different guidelines that are frequently changed. Using data from clinical trials and some simple mathematical modeling, we sought to expand upon the relation between low-density lipoprotein cholesterol (LDL-C) control and cardiovascular risk to offer a firm basis for independent decision making in everyday clinical practice. Analysis of the dose –response curves of different statins indicated that doubling the dose w...
Source: American Journal of Cardiovascular Drugs - December 16, 2019 Category: Cardiology Source Type: research

Safety of Proprotein Convertase Subtilisin/Kexin Type 9 Monoclonal Antibodies in Regard to Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Controlled Trials
ConclusionCompared with placebo or any other comparator, PCSK9-mAb treatment was not associated with the adverse event of diabetes. However, evolocumab and alirocumab show high risk of incident diabetes when there is no interference from unbalanced use of statins. The imbalance in background lipid modifying therapy or different comparators used in the control arms of the studies might have masked the effect of PCSK9-mAb therapy on diabetes. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - December 11, 2019 Category: Cardiology Source Type: research

Effectiveness and Safety of Restarting Oral Anticoagulation in Patients with Atrial Fibrillation after an Intracranial Hemorrhage: Analysis of Medicare Part D Claims Data from 2010 –2016
ConclusionsIn AF patients who survived an ICH, restarting OAC was not associated with a greater risk of recurrent ICH. Evidence from randomized controlled studies is needed to further clarify the clinical benefit of restarting OAC in this high-risk population. Further evaluation of which individuals benefit from restarting OAC is also needed to provide more clinical guidance. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - December 6, 2019 Category: Cardiology Source Type: research

Renin –Angiotensin–Aldosterone System Optimization for Acute Decompensated Heart Failure Patients (ROAD-HF): Rationale and Design
ConclusionThis prospective clinical trial will prove if withholding ACEIs/ARBs will prevent AKI in ADHF. It will help us understand the complex interactions between the heart and kidney, and delineate the best treatment strategy for ADHF. Holding ACEIs/ARBs might help preserve renal function, and decrease hospital LOS, readmission rates, and cost of care in ADHF.RegistrationClinicalTrials.gov identifier: NCT03695120. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - December 4, 2019 Category: Cardiology Source Type: research

Abbreviated Dual Antiplatelet Therapy Followed by P2Y 12 Inhibitor Monotherapy versus 12 Months ’ Dual Antiplatelet Therapy Post Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis of Randomized Controlled Trials
AbstractIntroductionAn increased incidence of stent thrombosis after implantation of first-generation drug-eluting stents led to a recommendation of dual antiplatelet therapy (DAPT) for 12  months after the procedure. However, given the use of second-generation and newer drug-eluting stents, this recommendation needs to be revisited. Several randomized controlled trials (RCTs) have studied an abbreviated DAPT regimen of ≤ 3 months followed by P2Y12 inhibitor monotherapy, and results have been conflicting.ObjectiveWe performed a systematic review with meta-analysis of RCTs of abbreviated DAPT for ...
Source: American Journal of Cardiovascular Drugs - November 30, 2019 Category: Cardiology Source Type: research

Value of Galectin-3 in Acute Myocardial Infarction
AbstractGalectins are an ancient family of lectins characterized by evolutionarily conserved amino acid sequences and β-galactoside recognition and binding sites. Galectin-3 (Gal-3) is one of 15 known galectins. This protein has important functions in numerous biological activities, including cardiac fibrosis and heart failure. In recent years, many studies have shown that Gal-3 is closely associated with acute my ocardial infarction (AMI) and may be a promising biomarker for the assessment of severity as well as prognosis prediction in AMI patients, but controversy still exists. In this review, we summarize the lates...
Source: American Journal of Cardiovascular Drugs - November 30, 2019 Category: Cardiology Source Type: research

Dexmedetomidine Reduces Atrial Fibrillation After Adult Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials
AbstractBackgroundDexmedetomidine has been shown to have antiarrhythmic effects by exhibiting sympatholytic properties and activating the vagus nerve in preclinical studies. Results from clinical trials of dexmedetomidine on atrial fibrillation (AF) following adult cardiac surgery are controversial.Materials and methodsWe searched EMBASE, PubMed and Cochrane CENTRAL databases for randomized controlled trials (RCTs) comparing the antiarrhythmic effect of dexmedetomidine versus placebo or other anesthetic drugs in adult patients undergoing cardiac surgery. The primary outcome was the incidence of AF. The secondary outcomes w...
Source: American Journal of Cardiovascular Drugs - November 14, 2019 Category: Cardiology Source Type: research

Lipid-Lowering Efficacy of Ezetimibe in Patients with Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analyses
AbstractIntroductionPatients with atherosclerotic cardiovascular disease (ASCVD), especially those with recent (
Source: American Journal of Cardiovascular Drugs - November 14, 2019 Category: Cardiology Source Type: research

Tinzaparin Sodium Pharmacokinetics in Patients with Chronic Kidney Disease: Practical Implications
AbstractLow-molecular-weight heparins (LMWHs) are the mainstay of the prophylaxis and treatment of venous thromboembolism (VTE). Due to their renal elimination, the risk of accumulation with the related bleeding risk may represent a limitation for the use of LMWHs in patients with chronic kidney disease (CKD) as the risk of major bleeding is increased in patients with creatinine clearance (CrCl)
Source: American Journal of Cardiovascular Drugs - November 13, 2019 Category: Cardiology Source Type: research

Effects of Metformin on Left Ventricular Size and Function in Hypertensive Patients with Type 2 Diabetes Mellitus: Results of a Randomized, Controlled, Multicenter, Phase IV Trial
ConclusionLV mass and diastolic function were not affected after 1  year of metformin treatment in patients with T2DM. However, we observed benefits in terms of reductions in both BMI and LDL-C levels and preservation of renal function.Trial RegistrationUMIN000006504. Registered 7 October 2011. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - November 13, 2019 Category: Cardiology Source Type: research

Ubiquinol Improves Endothelial Function in Patients with Heart Failure with Reduced Ejection Fraction: A Single-Center, Randomized Double-Blind Placebo-Controlled Crossover Pilot Study
ConclusionsUbiquinol 400  mg/day for 3 months led to significant improvement in peripheral endothelial function in patients with HFrEF. Ubiquinol may be a therapeutic option for individuals with HFrEF. Large-scale randomized controlled trials of CoQ10 supplementation in patients with HFrEF are needed.Clinical Trial RegistrationJapanese University Hospital Medical Information Network (UMIN-ICDR). Clinical Trial identifier number UMIN000012604. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - November 12, 2019 Category: Cardiology Source Type: research

Reversal of Apixaban and Rivaroxaban Using Activated Prothrombin Complex Concentrates in Patients with Major Bleeding
ConclusionsOur study suggests that aPCC could be an option in patients with major bleeding associated with apixaban or rivaroxaban. It may be an alternative for patients who need anticoagulation reversal if the specific antidote, andexanet alfa, is unavailable. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - November 11, 2019 Category: Cardiology Source Type: research

Acknowledgement to Referees
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - November 4, 2019 Category: Cardiology Source Type: research

Bioequivalence of a Newly Developed Dabigatran Etexilate Tablet Versus the Commercial Capsule and Impact of Rabeprazole-Induced Elevated Gastric pH on Exposure in Healthy Subjects
ConclusionThe DE tablet demonstrated BE to the capsule; however, at high gastric pH, BA of the tablet was reduced by approximately 70%, which may lead to reduced efficacy. Data indicate the importance of examining not only BE under standard conditions, but relative BA at elevated gastric pH. Such investigations may avoid the reduced BA at elevated pH that is quite common in the target population (the elderly and/or patients treated with gastric-acid modifying co-medications), and therefore reduce treatment failure with DE.Registration: ClinicalTrials.gov identifier numbers: NCT03070171, and NCT03143166 (Source: American Jo...
Source: American Journal of Cardiovascular Drugs - October 30, 2019 Category: Cardiology Source Type: research

Overall Mortality and LDL Cholesterol Reduction in Secondary Prevention Trials of Cardiovascular Disease
AbstractPooled data from randomized clinical trials on lipid-lowering therapy have provided valuable information and clinical insights. Although cardiovascular disease is a common cause of death, mortality data have rarely been prominent in key lipid trials. The 4S, LIPID and HPS trials were the first to demonstrate a reduction in overall mortality. Lower- versus higher-intensity statin trials and non-statin lipid-lowering trials with ezetimibe and proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors proved that additional lipid lowering significantly reduces the occurrence of cardiovascular events. However, on...
Source: American Journal of Cardiovascular Drugs - October 25, 2019 Category: Cardiology Source Type: research

Predictors of Left Ventricular Dysfunction in Friedreich ’s Ataxia in a 16-Year Observational Study
AbstractBackgroundFriedreich ’s ataxia (FRDA) is a cerebellar ataxia due to GAA repeat expansions in theFXN gene, and in affected patients, lower left ventricular ejection fraction (LVEF) leads to poorer prognosis. We aimed to identify patients likely to develop worsening LVEF at an early stage.MethodsWe included 115 FRDA patients aged 30  ± 10 years with 620 ± 238 GAA repeats on the shorter allele and disease onset of 15 ± 7 years.ResultsAt baseline, left ventricular (LV) hypertrophy was present in 53%, with LVEF 65  ± 7%, ...
Source: American Journal of Cardiovascular Drugs - October 25, 2019 Category: Cardiology Source Type: research

Non-inferiority Trial Design in Drug Development: A Primer for Cardiovascular Healthcare Professionals
AbstractNoninferiority trials, in which a new treatment is compared with a standard active treatment, are becoming increasingly popular in cardiovascular medicine. A noninferiority trial seeks to test whether the effect of a new drug is not unacceptably worse than that of an active comparator by more than a predefined noninferiority margin. Noninferiority trials are typically used when a new drug is anticipated to have an efficacy profile similar to its comparator and offers advantages over the existing drug (better toxicity profile, less expensive, less invasive, simpler regimen, shorter treatment duration, different resi...
Source: American Journal of Cardiovascular Drugs - October 24, 2019 Category: Cardiology Source Type: research

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