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

Real-World Comparative Effectiveness and Cost Comparison of Thromboprophylactic Use of Enoxaparin versus Unfractionated Heparin in 376,858 Medically Ill Hospitalized US Patients
ConclusionsThromboprophylaxis with enoxaparin was associated with significantly reduced in-hospital VTE events, death, and major bleeding and lower hospital costs compared with UFH in hospitalized medically ill patients. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - December 14, 2020 Category: Cardiology Source Type: research

Aspirin Therapy in Cardiovascular Disease with Glucose-6-Phosphate Dehydrogenase Deficiency, Safe or Not?
AbstractGlucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect, which may present as acute hemolysis, neonatal jaundice, or chronic hemolysis. Ingestion of fava beans, as well as infection and certain drugs, are the most typical causes of acute hemolysis in people with G6PD deficiency. Aspirin, the cornerstone in current therapies for the prevention of cardiovascular disease (CVD), is occasionally reported to induce acute hemolysis in G6PD-deficient individuals. G6PD deficiency is typically asymptomatic and many CVD patients with this enzyme defect start to take long-term aspirin therapy...
Source: American Journal of Cardiovascular Drugs - December 14, 2020 Category: Cardiology Source Type: research

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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