De-escalation from Prasugrel or Ticagrelor to Clopidogrel in Patients with Acute Coronary Syndrome Managed with Percutaneous Coronary Intervention: An Updated Meta-analysis of Randomized Clinical Trials
ConclusionAmong patients with ACS treated with PCI, a de-escalation strategy (prasugrel or ticagrelor to clopidogrel) is associated with lower ischemic and bleeding events (net clinical benefits) and lower BARC type 2 or higher bleeding; however, due to the limited number of included studies, further high-quality studies are needed to establish the clinical efficacy of the de-escalation strategy. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - October 15, 2021 Category: Cardiology Source Type: research

Dapagliflozin: A Review in Symptomatic Heart Failure with Reduced Ejection Fraction
In conclusion, dapagliflozin is an effective and generally well-tolerated treatment that represents a valuable new addition to the options available for symptomatic HFrEF. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - October 15, 2021 Category: Cardiology Source Type: research

Acknowledgement to Referees
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - October 15, 2021 Category: Cardiology Source Type: research

Direct Oral Anticoagulants and Warfarin for Atrial Fibrillation Treatment: Rural and Urban Trends in Medicare Beneficiaries
ConclusionAmong Medicare beneficiaries with AF, anticoagulation use was low but increased over time with the introduction of DOACs. Rural beneficiaries were less likely to receive a DOAC. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - October 11, 2021 Category: Cardiology Source Type: research

Is it Time for Single-Pill Combinations in Dyslipidemia?
AbstractDespite the availability of lipid-lowering therapies (LLTs) that are safe and effective, the overall rate of low-density lipoprotein cholesterol (LDL-C) control at a population level in real-life studies is low. Higher-intensity treatment, earlier intervention, and longer-term treatment have all been shown to improve outcomes. However, in clinical practice, actual exposure to LLT is a product of the duration and intensity of, and adherence to, the treatment. To increase exposure to LLTs, the European Society of Cardiology guidelines recommended a stepwise optimization of LLTs by increasing statin intensity to the m...
Source: American Journal of Cardiovascular Drugs - September 22, 2021 Category: Cardiology Source Type: research

Lipid-Lowering Drug Therapy: Critical Approach for Implementation in Clinical Practice
AbstractIncreased levels of low-density lipoprotein cholesterol (LDL-C) are recognized as a primary risk factor for atherosclerotic cardiovascular disease, which remains the leading cause of death worldwide. Lowering LDL-C levels clearly reduces the risk of cardiovascular events, with benefits related to both absolute reduction and duration of treatment; however, a threshold below which low LDL-C levels can be dangerous has never been established. Since the discovery of statins, cardiovascular research has focused on developing new lipid-lowering agents. Ezetimibe and proprotein convertase subtilisin –kexin type 9 in...
Source: American Journal of Cardiovascular Drugs - September 13, 2021 Category: Cardiology Source Type: research

A  Review of the Clinical Pharmacology of Pelacarsen: A Lipoprotein(a)-Lowering Agent
AbstractPatients with genetically associated elevated lipoprotein(a) [Lp(a)] levels are at greater risk for coronary artery disease, heart attack, stroke, and peripheral arterial disease. To date, there are no US FDA-approved drug therapies that are designed to target Lp(a) with the goal of lowering the Lp(a) level in patients who have increased risk. The American College of Cardiology (ACC) has provided guidelines on how to use traditional lipid profiles to assess the risk of atherosclerotic cardiovascular disease (ASCVD); however, even with the emergence of statin add-on therapies such as ezetimibe and proprotein convert...
Source: American Journal of Cardiovascular Drugs - September 7, 2021 Category: Cardiology Source Type: research

Cost Effectiveness of a CYP2C19 Genotype-Guided Strategy in Patients with Acute Myocardial Infarction: Results from the POPular Genetics Trial
ConclusionIn patients undergoing primary PCI, aCYP2C19 genotype-guided strategy compared with standard treatment with ticagrelor or prasugrel resulted in QALYs gained and cost savings.Trial RegistrationClinicaltrials.gov number: NCT01761786, Netherlands trial register number: NL2872 (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - September 7, 2021 Category: Cardiology Source Type: research

The Current Role of Clevidipine in the Management of Hypertension
AbstractAcute hypertension, which may damage blood vessels, causes irreversible organ damage to the vasculature, central nervous system, kidney, and heart. Clevidipine, the first third-generation calcium channel antagonist approved by the Food and Drug Administration (FDA) in the past 20 years, is an ultra-short-acting calcium channel blocker that inhibits L-type calcium channels with high clearance and low distribution, can be rapidly metabolized into the corresponding inactive acid, and is rapidly hydrolyzed into inactive metabolites by esterase in arterial blood. Clevidipine is the same as nicardipine in that the main p...
Source: American Journal of Cardiovascular Drugs - September 2, 2021 Category: Cardiology Source Type: research

SGLT2 Inhibitors: The Dawn of a New Era in Cardio-Metabolic Therapeutics
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - August 30, 2021 Category: Cardiology Source Type: research

The Association Between the Use of Statins and Clinical Outcomes in Patients with COVID-19: A Systematic Review and Meta-analysis
ConclusionStatin use is associated with a better prognosis in patients with COVID-19. Our findings provide a rationale to investigate the use of statins among patients with COVID-19 in large scale clinical  trials. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - August 3, 2021 Category: Cardiology Source Type: research

Cost-Consequence Analysis of Using Cangrelor in High Angiographic Risk Percutaneous Coronary Intervention Patients: A US Hospital Perspective
ConclusionUse of cangrelor in patients with two or more angiographic HRFs may improve outcomes and lower hospital budgets, mainly from avoiding surgery delays necessitated by oral P2Y12 inhibitor pretreatment. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 31, 2021 Category: Cardiology Source Type: research

The Cost Implications of Dabigatran in Patients with Myocardial Injury After Non-Cardiac Surgery
ConclusionDabigatran 110  mg twice daily was cost neutral for patients in the MANAGE trial. Our cost findings support the use of dabigatran 110 mg twice daily in patients with MINS.Trial RegistrationClinicalTrials.gov identifier number NCT01661101. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 26, 2021 Category: Cardiology Source Type: research

Association Between Vitamin D and Statin-Related Myopathy: A Meta-analysis
AbstractBackgroundMyopathy is the most widely reported statin-associated adverse event. Several studies have linked vitamin D deficiency with statin-related myopathy.ObjectiveThis meta-analysis aimed to investigate whether adult patients with statin-related myopathy have a lower 25-hydroxyvitamin D (25OHD) level than patients without myopathy and whether statin-related myopathy in vitamin D-deficient patients can be improved by vitamin D supplementation.MethodsPubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until 28 September 2020. Original studies comparing the 25OHD levels of patients...
Source: American Journal of Cardiovascular Drugs - July 23, 2021 Category: Cardiology Source Type: research

Outpatient Initiation of Sotalol in Patients with Atrial Fibrillation: Utility of Cardiac Implantable Electronic Devices for Therapy Monitoring
ConclusionsEffective and safe outpatient initiation and maintenance of sotalol therapy is possible in select patients who have CIEDs for continuous remote monitoring and surveillance capabilities. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 22, 2021 Category: Cardiology Source Type: research

Modulating the Intensity of Oral Anticoagulation Therapy with Direct Oral Anticoagulants: Feasible or Not?
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 13, 2021 Category: Cardiology Source Type: research

Comparative Efficacy of Five SGLT2i on Cardiorenal Events: A Network Meta-analysis Based on Ten CVOTs
ConclusionsCanagliflozin, dapagliflozin, empagliflozin, ertugliflozin, and sotagliflozin versus placebo reduce HHF but none reduces MI and stroke. Canagliflozin is most effective in reducing MACE and HHF, and empagliflozin is most effective in reducing CVD, CVD or HHF, KFP, and ACD. These findings will guide the use of specific SGLT2i in the prevention of different cardiorenal events. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - July 7, 2021 Category: Cardiology Source Type: research

Bleeding in the Elderly: Risk Factors and Impact on Clinical Outcomes After an Acute Coronary Syndrome, a Sub-study of the Randomized ANTARCTIC Trial
AbstractBackgroundElderly patients are at high-risk of bleeding, but are under-represented in clinical trials.ObjectivesThe aims were to determine the incidence and the predictive factors of bleeding and to assess the impact of bleeding on further ischemic outcomes in elderly patients after acute coronary syndrome (ACS) treated with percutaneous coronary intervention.MethodsFrom the 877 patients aged ≥ 75 years included in the ANTARCTIC randomized trial, data on Bleeding Academic Research Consortium (BARC) bleeding complications and major adverse cardiovascular events (MACE), defined as the composite of cardio...
Source: American Journal of Cardiovascular Drugs - June 30, 2021 Category: Cardiology Source Type: research

Diabetes, Heart Failure and Beyond: Elucidating the Cardioprotective Mechanisms of Sodium Glucose Cotransporter 2 (SGLT2) Inhibitors
AbstractApproximately 5 million individuals in the US are living with congestive heart failure (CHF), with 650,000 new cases being diagnosed every year. CHF has a multifactorial etiology, ranging from coronary artery disease, hypertension, valvular abnormalities and diabetes mellitus. Currently, guidelines by the American College of Cardiology advocate the use of angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, β-blockers, diuretics, aldosterone antagonists, and inotropes for the medical management of heart failure. The sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of d...
Source: American Journal of Cardiovascular Drugs - June 30, 2021 Category: Cardiology Source Type: research

Safety and Efficacy of Colchicine in Patients with Stable CAD and ACS: A Systematic Review and Meta-analysis
ConclusionIn patients presenting with ACS, low-dose colchicine might reduce the incidence of MACE, stroke, and the need for revascularization at long follow-up durations. Colchicine might offer no benefits in reducing the risk of ischemic events in patients with stable angina. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - June 21, 2021 Category: Cardiology Source Type: research

The sGC-cGMP Signaling Pathway as a Potential Therapeutic Target in Doxorubicin-Induced Heart Failure: A Narrative Review
AbstractThe anti-cancer agent doxorubicin (DOX) has high cardiotoxicity that is linked to DOX-mediated increase in oxidative stress, mitochondrial iron overload, DNA damage, autophagy, necrosis, and apoptosis, all of which are also associated with secondary tumorigenicity. This limits the clinical application of DOX therapies. Previous studies have attributed DOX-mediated cardiotoxicity to mitochondrial iron accumulation and the production of reactive oxygen species (ROS), which seem to be independent of its anti-tumor DNA damaging effects. Chemo-sensitization of soluble guanylate cyclase (sGC) in the cyclic guanosine mono...
Source: American Journal of Cardiovascular Drugs - June 21, 2021 Category: Cardiology Source Type: research

Target Drug-Calibrated Anti-Xa Activity Assays and Expected Peak –Trough Levels in an Asian Population: A Multicenter Study
AbstractBackgroundFor patients taking factor Xa (FXa) inhibitors who have life-threatening bleeding, emergency surgery, drug interactions, etc., a rapid and precise assay is needed to monitor for potential medication failure, to assess safety during periprocedural anticoagulation management, and to manage the care of chronically anticoagulated patients. Anti-factor Xa (anti-Xa) activity assays have been recommended in guidelines, but the evaluation of different calibrations of anti-Xa activity assays and the data on the recommended range are still limited, especially in the Asian population.MethodsThis is a nationwide mult...
Source: American Journal of Cardiovascular Drugs - June 18, 2021 Category: Cardiology Source Type: research

Use of Flecainide in Stable Coronary Artery Disease: An Analysis of Its Safety in Both Nonobstructive and Obstructive Coronary Artery Disease
ConclusionFlecainide use is not associated with an increase in either all-cause mortality or ventricular arrhythmias in low-risk patients with stable nonobstructive CAD. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - June 18, 2021 Category: Cardiology Source Type: research

Management of Acute Coronary Syndrome in Patients with Liver Cirrhosis
AbstractLiver cirrhosis (LC) is becoming increasingly common among patients presenting with acute coronary syndromes (ACS) and is associated with significant cardiovascular morbidity and mortality. Management of such patients is complicated by LC related complications. Literature is scarce on the safety of antithrombotic regimens and invasive strategies for ACS in patients with LC, especially those undergoing liver transplant evaluation. Recently there has been evidence that cirrhosis is an independent risk factor for adverse outcomes in ACS. As patients with LC are generally excluded from large randomized trials, definiti...
Source: American Journal of Cardiovascular Drugs - May 29, 2021 Category: Cardiology Source Type: research

Comparison of the Efficacy and Safety of Direct Oral Anticoagulants and Vitamin K Antagonists in Patients with Atrial Fibrillation and Concomitant Liver Cirrhosis: A Systematic Review and Meta-Analysis
AbstractBackgroundPatients with atrial fibrillation (AF) have a higher risk of developing thromboembolic events. Current guidelines recommend the use of oral anticoagulants for stroke prevention in these patients. Several clinical trials demonstrated that direct oral anticoagulants (DOACs) have similar efficacy and are safer alternatives to traditional oral anticoagulants. However, patients with concomitant liver cirrhosis were excluded from these trials.ObjectiveWe aimed to systematically identify and review published clinical studies on the use of DOACs in patients with AF and liver cirrhosis and assess the efficacy and ...
Source: American Journal of Cardiovascular Drugs - May 19, 2021 Category: Cardiology Source Type: research

A Brief Overview of Recurrent Pericarditis Management and the Potential of Rilonacept as a New Therapeutic Option
AbstractRecurrent pericarditis affects 15 –30% of patients after acute pericarditis. A large number of the patients with recurrent pericarditis can become corticosteroid dependent, leading to disease chronicity and drug dependence, with additional morbidity from long-term steroid use. Recent randomized trials indicate the efficacy of the interleukin-1 inhibitors anakinra and rilonacept in recurrent pericarditis, including colchicine-resistant and corticosteroid-dependent cases. In particular, rilonacept was assessed in the RHAPSODY clinical trial and found to be a potential treatment option that would decrease recurr...
Source: American Journal of Cardiovascular Drugs - May 19, 2021 Category: Cardiology Source Type: research

Evolocumab ’s Long-Term Mortality Risk Unclear Due to Shortened Follow-Up of FOURIER
AbstractThe FOURIER (Further Cardiovascular Outcomes Research with PCSK9 inhibition in Subjects with Elevated Risk) trial was conducted to study cardiovascular outcomes of treatment with evolocumab. The trial was terminated after a median follow-up of 2.2 years instead of the planned 3.6 years. We question this decision. According to the investigators, the event rate was 50% higher than expected. However, the accrued number of key secondary events (1829) was only 12% higher than the targeted number (1630). Also, around one-third of the events consisted of non-atherosclerotic myocardial infarctions, hemorrhagic strokes, and...
Source: American Journal of Cardiovascular Drugs - May 19, 2021 Category: Cardiology Source Type: research

A Critical Review of the Efficacy and Safety of Inclisiran
AbstractThe association between low-density cholesterol (LDL-C) and cardiovascular disease (CVD) is well-established, with an emphasis on lowering LDL-C levels to reduce cardiovascular events. Statin therapy has been the traditional treatment for LDL-C reduction, in addition to lifestyle modifications, but studies have shown that a substantial proportion of patients does not reach target LDL-C goals despite receiving maximally tolerated statin medications. Additionally, statin therapy is associated with a few shortcomings as many patients initiated on these medications discontinue treatment within 1 year because of lack of...
Source: American Journal of Cardiovascular Drugs - May 6, 2021 Category: Cardiology Source Type: research

Joint Latent Class Analysis of Oral Anticoagulation Use and Risk of Stroke or Systemic Thromboembolism in Patients with Atrial Fibrillation
ConclusionLate initiators and late discontinuers had a higher risk of stroke or TE than continuous users. Early initiation and continuous OAC use is important in preventing stroke and TE among patients diagnosed with AF. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - April 12, 2021 Category: Cardiology Source Type: research

Comparison of the Safety and Efficacy of Direct Oral Anticoagulants and Warfarin in Atrial Fibrillation or Venous Thromboembolism in Patients with Renal Impairment: Systematic Review, Meta-Analysis and Network Meta-Analysis.
Conclusions and RelevanceIn the systematic review and meta-analysis, for AF or VTE patients with RI, direct oral anticoagulants performed comparably to or better than warfarin with regard to safety and effects. The network meta-analysis indicated that for patients with mild RI, apixaban might be safer for patients with a lower risk of ischemic events, while rivaroxaban might be suitable for patients with a lower risk of bleeding events. For patients with moderate RI, apixaban could reduce the risk of ischemic events without increasing the risk of bleeding events. For AF patients with severe RI, apixaban, rivaroxaban, and w...
Source: American Journal of Cardiovascular Drugs - April 4, 2021 Category: Cardiology Source Type: research

Dosing of Direct Oral Anticoagulants in Patients with Moderate Chronic Kidney Disease in US Clinical Practice: Results from the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF II)
ConclusionIn routine clinical practice, prescribing of DOACs in patients with AF with moderate CKD is often inconsistent with drug labeling, with up to one-third of patients being inappropriately dosed. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 31, 2021 Category: Cardiology Source Type: research

Effectiveness and Safety of Direct Oral Anticoagulants in Patients with Nonvalvular Atrial Fibrillation and Weighing ≥ 120 Kilograms versus 60–120 Kilograms
AbstractBackgroundDirect oral anticoagulants (DOACs) have become favorable choices for anticoagulation due to their fixed-dose schedule, limited need for monitoring, and non-inferiority or superiority to warfarin. DOACs are currently not recommended in patients with a body weight ≥ 120 kg or body mass index ≥ 40 kg/m2 due to limited data regarding safety and efficacy.ObjectiveThe aim of this study was to compare the safety and efficacy of DOACs in patients with nonvalvular atrial fibrillation (NVAF) and weighing ≥ 120 kg with those weighing
Source: American Journal of Cardiovascular Drugs - March 30, 2021 Category: Cardiology Source Type: research

Modeling of Survival and Frequency of Cardiovascular-Related Hospitalization in Patients with Transthyretin Amyloid Cardiomyopathy Treated with Tafamidis
ConclusionsTafamidis reduced cumulative mortality and hospitalization risk versus placebo in patients with ATTR-CM. Baseline predictors of outcome were consistent with the cardiovascular nature of the disease and suggested that earlier treatment may improve outcomes.Clinical Trials.gov IdentifierNCT01994889 (date of registration: November 26, 2013). (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 26, 2021 Category: Cardiology Source Type: research

Impact of the COVID-19 Pandemic on Global Anticoagulant Sales: A Cross-Sectional Analysis Across 39 Countries
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 26, 2021 Category: Cardiology Source Type: research

Renin Angiotensin Aldosterone System Inhibitors in Chronic Kidney Disease: A Difficult Equation
AbstractChronic kidney disease (CKD) is a global health problem and is strongly associated with hypertension (HTN) and impaired quality of life. Managing HTN with agents that block the renin angiotensin aldosterone system (RAAS) remains the gold standard, however there is a misleading impression that patients with impaired renal function or those receiving hemodialysis should not be treated with RAAS inhibitors. To date, only a few data in this field are available, given that this population subset is systematically excluded from many major clinical trials. The purpose of this review was to solve the difficult equation reg...
Source: American Journal of Cardiovascular Drugs - March 23, 2021 Category: Cardiology Source Type: research

Medical Therapies for Marfan Syndrome and Other Thoracic Aortic Dilatation in Adults: A Contemporary Review
AbstractThoracic aortic dilatation often has an asymptomatic course but may present with lethal complications such as aortic rupture or dissection, particularly when the thoracic aorta is aneurysmally enlarged; therefore, appropriate diagnosis, surveillance, and management are vital. Recommendations regarding imaging and surgical management are outlined in contemporary clinical practice guidelines. Dedicated guidelines regarding medical therapies for the management of thoracic aortic dilatation are lacking. Most of the medical treatment strategies, especially recommendations regarding pharmacological medical therapies rela...
Source: American Journal of Cardiovascular Drugs - March 22, 2021 Category: Cardiology Source Type: research

Treating Acute Decompensated Heart Failure in Patients with COVID-19 Using Intravenous Nitroglycerin in 5% Glutathione
AbstractThe purpose of this current opinion article is to illustrate a novel approach to the treatment of acute decompensated heart failure (ADHF) in coronavirus disease 2019 (COVID-19) patients. The approach described herein relies on a reformulation of intravenous nitroglycerin in 5% glutathione, itself novel, and is felt to have the potential to not only improve the rate of resolution of ADHF, but also reduce the risk of complications of heart failure seen in patients with COVID-19. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - March 22, 2021 Category: Cardiology Source Type: research

Inpatient Diuretic Management of Acute Heart Failure: A Practical Review
AbstractThe inpatient treatment of acute heart failure (AHF) is aimed at achieving euvolemia, relieving symptoms, and reducing rehospitalization. Adequate treatment of AHF is rooted in understanding the pharmacokinetics and pharmacodynamics of select diuretic agents used to achieve decongestion. While loop diuretics remain the primary treatment of AHF, the dosing strategies of loop diuretics and the use of adjunct diuretic classes to augment clinical response can be complex. This review examines the latest strategies for diuretic management in patients with AHF, including dosing and monitoring strategies, interaction of di...
Source: American Journal of Cardiovascular Drugs - March 12, 2021 Category: Cardiology Source Type: research

NSTE-ACS ESC Guidelines Recommend Prasugrel as the Preferred P2Y12 Inhibitor: A Contrarian View
AbstractIn the 2020 European Society of Cardiology guidelines on non-ST-segment elevation acute coronary syndromes (NSTE-ACS), the experts proposed to put an end to the equipoise of ticagrelor and prasugrel in addition to aspirin in patients with NSTE-ACS who proceed to percutaneous coronary intervention (PCI). They gave a strong level of recommendation (IIa) in favor of prasugrel over ticagrelor in these patients. We challenge this proposition, which was mainly driven by the results of ISAR-REACT 5, an open-label prospective head-to-head study of a prasugrel-based strategy compared with a ticagrelor-based strategy in pati...
Source: American Journal of Cardiovascular Drugs - March 6, 2021 Category: Cardiology Source Type: research

Meta-Analysis Comparing the Safety and Efficacy of Dual Versus Single Antiplatelet Therapy After Transcatheter Aortic Valve Implantation
(Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - February 26, 2021 Category: Cardiology Source Type: research

Antithrombotic Therapy in Peripheral Artery Disease: Stepping in the Right Direction
AbstractWe reviewed the various antithrombotic therapies available to treat peripheral artery disease (PAD). A literature review using the PubMed and MEDLINE databases used the following keywords: antithrombotic therapy, anticoagulation, peripheral artery disease, and peripheral vascular disease. Randomized studies written in English that assessed the use of antithrombotic therapy in patients with PAD were evaluated. PAD is a worldwide condition that limits blood flow in the lower extremities, leading to a risk of major adverse cardiovascular events and major adverse limb events. Antithrombotic therapy is necessary to prev...
Source: American Journal of Cardiovascular Drugs - February 21, 2021 Category: Cardiology Source Type: research

Long-Term Antithrombotic Therapy and Clinical Outcomes in Patients with Acute Coronary Syndrome and Renal Impairment: Insights from EPICOR and EPICOR Asia
AbstractBackgroundInformation is lacking on long-term management of patients with acute coronary syndrome (ACS) and chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR]
Source: American Journal of Cardiovascular Drugs - February 4, 2021 Category: Cardiology Source Type: research

Tafamidis: A Review in Transthyretin Amyloid Cardiomyopathy
AbstractTransthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive, life-threatening disease characterized by the aggregation and deposition of amyloidogenic misfolded transthyretin (TTR) in the myocardium. The gradual accumulation of insoluble TTR amyloid fibrils can result in restrictive cardiomyopathy and heart failure. Tafamidis (Vyndaqel®; Vyndamax®), a TTR stabilizer, has been approved for use in the treatment of adults with ATTR-CM in several countries. Tafamidis stabilizes both wild-type and mutant TTR, inhibiting the formation of TTR amyloid fibrils. In the pivotal phase III ATTR-ACT trial, tafamidis ...
Source: American Journal of Cardiovascular Drugs - January 20, 2021 Category: Cardiology Source Type: research

Use of Ranolazine for the Treatment of Coronary Microvascular Dysfunction
AbstractCoronary microvascular dysfunction (CMD) is defined as a mismatch of myocardial blood supply and oxygen consumption due to a dysfunction of the coronary microvessels. Up to 20 –30% of patients with CMD have progressive worsening of symptoms with significant impairment of quality of life. Large-scale randomized studies of the pharmacologic treatment of CMD are lacking. Classic anti-ischemic drugs are the initial form of treatment, but efficacy is often limited. Ranolazin e has a unique mechanism of action that does not affect blood pressure or heart rate. When added to existing anti-anginal agents, ranolazine ...
Source: American Journal of Cardiovascular Drugs - January 13, 2021 Category: Cardiology Source Type: research

Safety and Effectiveness of Rivaroxaban in Combination with Various Antiarrhythmic Drugs in Patients with Non-Permanent Atrial Fibrillation
This study investigates the outcomes of concomitant rivaroxaban and AAD drug use in a real-world cohort.MethodsThis retrospective study included 1777 non-permanent AF patients taking rivaroxaban for ≥ 1 month between 2011 and 2016 from a multicenter cohort in Taiwan, and compared concomitant AAD use against clinical outcome endpoints for safety, effectiveness, and major adverse cardiac events (MACE). Multivariate Cox proportional hazard analyses were used to evaluate the association between c oncomitant AAD use and outcomes.ResultsPatients were divided into rivaroxaban alone (n = 1205) and with concomitant ami...
Source: American Journal of Cardiovascular Drugs - December 28, 2020 Category: Cardiology Source Type: research

Gout Pharmacotherapy in Cardiovascular Diseases: A Review of Utility and Outcomes
AbstractHyperuricemia and gout have been linked to an increased risk for cardiovascular (CV) disease, stroke, hypertension, heart failure, and chronic kidney disease, possibly through a proinflammatory milieu. However, not all the drugs used in gout treatment improve CV outcomes; colchicine has shown improved CV outcomes in patients with recent myocardial infarction and stable coronary artery disease independent of lipid-lowering effects. There is resurging interest in colchicine following publication of the COLCOT, LoDoCo, LoDoCo2, LoDoCo-MI trials,  and COLCORONA trial which will shed light on its utility in CO...
Source: American Journal of Cardiovascular Drugs - December 28, 2020 Category: Cardiology Source Type: research

Angiotensin-Converting Enzyme Inhibitors and Contrast-Associated Acute Kidney Injury After Coronary Angiography and Intervention
AbstractContrast-associated acute kidney injury has multiple definitions, but is generally described as worsening renal function after administration of iodinated contrast media. It is associated with high in-hospital mortality and poor long-term survival. Furthermore, patients undergoing coronary angiography commonly have comorbidities such as hypertension or congestive heart failure, which are often treated with renin-angiotensin-aldosterone system-blocking agents such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Trials assessing the effects of these renin-angiotensin-aldosterone system-...
Source: American Journal of Cardiovascular Drugs - December 28, 2020 Category: Cardiology Source Type: research

Non-adherence to Thromboprophylaxis Guidelines in Atrial Fibrillation: A Narrative Review of the Extent of and Factors in Guideline Non-adherence
AbstractAtrial fibrillation is the most common arrhythmia. It increases the risk of thromboembolism by up to fivefold. Guidelines provide evidence-based recommendations to effectively mitigate thromboembolic events using oral anticoagulants while minimizing the risk of bleeding. This review focuses on non-adherence to contemporary guidelines and the factors associated with guideline non-adherence. The extent of guideline non-adherence differs according to geographic region, healthcare setting, and risk stratification tools used. Guideline adherence has gradually improved over recent years, but a significant proportion of p...
Source: American Journal of Cardiovascular Drugs - December 28, 2020 Category: Cardiology Source Type: research

The Role of Direct Oral Anticoagulants Versus Vitamin K Antagonists in the Treatment of Left Ventricular Thrombi: A Meta-Analysis and Systematic Review
ConclusionIn patients with left ventricular thrombi, DOACs and VKAs are associated with similar rates of thrombus resolution, major bleeding, and SSE. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - December 23, 2020 Category: Cardiology Source Type: research

Comparison of Warfarin to Dual Antiplatelet Therapy Following Transcatheter Aortic Valve Replacement
ConclusionsIn this study, warfarin had similar effectiveness and safety, compared with DAPT, for antithrombotic management post-TAVR. For patients whom the provider deemed anticoagulation is indicated, our data suggest warfarin is a well-tolerated option following TAVR in intermediate- and high-risk STS score patients. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - December 23, 2020 Category: Cardiology Source Type: research