Myocardial Fibrosis in Heart Failure: Anti-Fibrotic Therapies and the Role of Cardiovascular Magnetic Resonance in Drug Trials
AbstractAll heart muscle diseases that cause chronic heart failure finally converge into one dreaded pathological process that is myocardial fibrosis. Myocardial fibrosis predicts major adverse cardiovascular events and death, yet we are still missing the targeted therapies capable of halting and/or reversing its progression. Fundamentally it is a problem of disproportionate extracellular collagen accumulation that is part of normal myocardial ageing and accentuated in certain disease states. In this article we discuss the role of cardiovascular magnetic resonance (CMR) imaging biomarkers to track fibrosis and collate resu...
Source: Cardiology and Therapy - August 29, 2020 Category: Cardiology Source Type: research
A Phase 4, Open-Label, Single-Arm Study Assessing the Efficacy and Safety of Ivabradine in African American Patients with Heart Failure and Reduced Ejection Fraction
ConclusionThese data support ivabradine use in African American patients with HF with reduced ejection fraction who meet typical treatment criteria.Trial RegistrationClinicalTrials.gov identifier, NCT03456856 (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - August 16, 2020 Category: Cardiology Source Type: research
Dual Antiplatelet Therapy in Coronary Artery Disease
AbstractAcute coronary syndrome (ACS) is principally driven by platelet aggregation. Dual antiplatelet therapy (DAPT) has demonstrated a reduction in recurrent ischemic events. The newer antiplatelets ticagrelor and prasugrel have demonstrated superiority over clopidogrel. While prasugrel demonstrated benefit in patients scheduled for percutaneous intervention (PCI), benefits of ticagrelor were seen irrespective of the treatment strategy. Current guidelines recommend the use of DAPT for 1 year in all patients with ACS. Ticagrelor 60 mg is recommended for up to 3 years in high-risk patients. DAPT and Predicting Bleeding ...
Source: Cardiology and Therapy - August 16, 2020 Category: Cardiology Source Type: research
Hypochloraemia in Patients with Heart Failure: Causes and Consequences
AbstractHypochloraemia is a common electrolyte abnormality in patients with heart failure (HF). It has a strong association with adverse outcome regardless of HF phenotype and independent of other prognostic markers. How hypochloraemia develops in a patient with HF and how it might influence outcome are not clear, and in this review we explore the possible mechanisms. Patients with HF and hypochloraemia almost invariably take higher doses of loop diuretic than patients with normal chloride levels. However, renal chloride and bicarbonate homeostasis are closely linked, and the latter may be influenced by neurohormonal activ...
Source: Cardiology and Therapy - August 8, 2020 Category: Cardiology Source Type: research
The Effect of Low-Dose Ticagrelor on Platelet Function Profiles in Patients With Stable Coronary Artery Disease in Trinidad: The TWIST Pilot Study
ConclusionsSignificantly attenuated platelet reactivity was seen on the low ticagrelor maintenance dose as compared to clopidogrel. This dedicated pharmacodynamic study could be applicable and informative for Trinidadian stable coronary artery disease patients. Further studies are required to confirm these exploratory findings.(Funded by the University of the West Indies, St. Augustine).Trial RegistrationClinicalTrials.gov number NCT04206176. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - August 5, 2020 Category: Cardiology Source Type: research
Vaccines Targeting PSCK9 for the Treatment of Hyperlipidemia
AbstractDespite progress in both primary and secondary prevention, cardiovascular diseases (CVD) are still the largest group of ailments contributing to morbidity and mortality worldwide. Atherosclerotic changes, the primary pathological substrate for CVD, are closely related to hypercholesterolemia. Therefore, the treatment of hypercholesterolemia is a key therapeutic strategy for CVD management. Statins, as the gold standard in the treatment of hypercholesterolemia, have shown enhanced cardiac outcomes in many randomized clinical trials. However, often despite the maximum allowed and tolerated dosage of statins, we are n...
Source: Cardiology and Therapy - July 30, 2020 Category: Cardiology Source Type: research
Massive Left Atrial Myxoma Presenting With Troponin-Positive Chest Pain
AbstractAtrial myxomas are the most prevalent primary cardiac tumors. The clinical presentation is variable and often poses a diagnostic challenge. Here we describe the case of a 52-year-old woman who presented with troponin-positive chest pain, exertional dizziness, and dyspnea as a consequence of a massive left atrial myxoma, which was successfully treated with surgical resection. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - July 26, 2020 Category: Cardiology Source Type: research
In-Hospital Outcomes of Patients With Pulmonary Hypertension and Cirrhosis: A 6-Year Population Cohort Study of Over One Million Patients
ConclusionsPatients with pulmonary hypertension and cirrhosis have increased mortality and hospital utilization compared to patients with only pulmonary hypertension. We identified key drivers for these outcomes. Targeted interventions, such as novel medications, right-to-left shunts, more evaluations for lung transplantation, and reversal of pulmonary vacular remodeling, are needed for the subgroups identified in this study in order to improve outcomes. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - July 19, 2020 Category: Cardiology Source Type: research
Clinical Characteristics and In-Hospital Mortality for COVID-19 Across The Globe
ConclusionsThere is a significant variation in the clinical characteristics in patients diagnosed with COVID-19 across the globe. In-hospital mortality is similar between America and Europe, but considerably higher than Asia. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - July 17, 2020 Category: Cardiology Source Type: research
Overuse of Cardiac Troponin Among Hospitalized Patients: A Cohort Study of Biomarker “Superusers”
(Source: Cardiology and Therapy)
Source: Cardiology and Therapy - July 15, 2020 Category: Cardiology Source Type: research
A Call for a New Paradigm for Diabetes Care in the Era of Sodium –Glucose Cotransporter 2 Inhibitors (SGLT2i)
This article is based on previously conducted studies and the authors disclose their roles in relevant trials in the Acknowledgements. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - July 12, 2020 Category: Cardiology Source Type: research
Use, Persistence, Efficacy, and Safety of Apixaban in Patients with Non-Valvular Atrial Fibrillation in Unselected Patients in Germany. Results of the Prospective Apixaban in Atrial Fibrillation (APAF) Registry
ConclusionsIn this prospective experience in unselected patients with atrial fibrillation, persistence to apixaban was high, and efficacy and safety were comparable to the results in clinical trials, supporting its use in clinical practice. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - July 7, 2020 Category: Cardiology Source Type: research
A Comparison of Ezetimibe and Evolocumab for Atherogenic Lipid Reduction in Four Patient Populations: A Pooled Efficacy and Safety Analysis of Three Phase 3 Studies
ConclusionsEvolocumab outperformed ezetimibe in efficacy and lipid goal attainment. Both products demonstrated good safety/tolerability. These data may help guide access decisions for high-risk patients with inadequate treatment response or intolerance to statin therapy. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - June 19, 2020 Category: Cardiology Source Type: research
Optical Coherence Tomography: Current Applications for the Assessment of Coronary Artery Disease and Guidance of Percutaneous Coronary Interventions
AbstractIntroductionCoronary angiography (CAG) is the standard modality for assessment of coronary stenoses and intraprocedural guidance of percutaneous coronary interventions (PCI). However, the limitations of CAG are well recognized. Intracoronary imaging (ICI) can potentially overcome these limitations. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are the main ICI techniques utilized in clinical practice.AimThis narrative literature review addresses the current clinical applications of OCT in relation to IVUS and CAG in patients with coronary artery disease (CAD). Items reviewed are: technical ...
Source: Cardiology and Therapy - June 19, 2020 Category: Cardiology Source Type: research
Home-Based Cardiac Rehabilitation (HBCR) In Post-TAVR Patients: A Prospective, Single-Center, Cohort, Pilot Study
ConclusionsIn conclusion, our pilot study offers novel insight into the role of HBCR in improving physical health and well-being in post-TAVR patients while eliminating the barriers of transportation and access to cardiac rehabilitation programs. (Source: Cardiology and Therapy)
Source: Cardiology and Therapy - June 12, 2020 Category: Cardiology Source Type: research
