The Role of Testosterone in Patients With Heart Failure: A Systematic Review
The objective of this systematic review was to assess the efficacy (mortality, hospitalization, cardiac function, and quality of life) and safety of testosterone in HF patients. The Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines were followed. Four electronic databases were searched from inception until November 30, 2019. The initial search yielded 1308 articles, and 10 randomized controlled trials with exogenous testosterone in patients with HF were included after exclusion criteria were applied. One study evaluated the impact of testosterone on mortality and HF hospitalization; no ...
Source: Cardiology in Review - April 17, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Loeffler’s Endocarditis and Hypereosinophilic Syndrome
Loeffler’s endocarditis and hypereosinophilic syndromes are a unique group of infiltrative disorders characterized by hypereosinophilia, inflammatory thrombotic, and ultimately, fibrotic involvement of the heart leading to multiple complications including valve involvement, thromboembolic phenomena, heart failure. Clinical recognition, comprehensive laboratory and multimodality imaging diagnostic workup, and early initiation of treatment have been shown to slow down the progression and promote remission. This review addresses a detailed analysis of Loeffler’s endocarditis and hypereosinophilic syndromes. (Sourc...
Source: Cardiology in Review - April 17, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular and Cerebrovascular Complications With COVID-19
The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 has affected the health of people across the globe. Cardiovascular diseases (CVDs) have a significant relationship with COVID-19, both as a risk factor and prognostic indicator, and as a complication of the disease itself. In addition to predisposing to CVD complications, the ongoing pandemic has severely affected the delivery of timely and appropriate care for cardiovascular conditions resulting in increased mortality. The etiology behind the cardiac injury associated with severe acute respiratory syndrome coronavirus-2 i...
Source: Cardiology in Review - April 17, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Arrhythmia in Cardiac Sarcoidosis
Cardiac sarcoidosis (CS) is a complex disease that can manifest as a diverse array of arrhythmias. CS patients may be at higher risk for sudden cardiac death (SCD), and, in some cases, SCD may be the first presenting symptom of the underlying disease. As such, identification, risk stratification, and management of CS-related arrhythmia are crucial in the care of these patients. Left untreated, CS carries significant arrhythmogenic morbidity and mortality. Cardiac manifestations of CS are a consequence of an inflammatory process resulting in the myocardial deposition of noncaseating granulomas. Endomyocardial biopsy remains...
Source: Cardiology in Review - April 17, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Direct-Acting Oral Anticoagulants in Atrial Fibrillation: What’s New in the Literature
Atrial fibrillation (AF) is considered the most common sustained cardiac arrhythmia, and it is associated with a significant risk of adverse events, especially ischemic stroke. Oral anticoagulation is the cornerstone for stroke prevention in AF; for many years, only vitamin K antagonists were used for this purpose, with an absolute risk reduction>60%. However, these agents have limitations, such as narrow therapeutic margins and drug–food and drug–drug interactions. More recently, 4 direct-acting oral anticoagulants (DOACs)—non–vitamin K antagonists—have become available for patients with A...
Source: Cardiology in Review - April 17, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Treatment of Peripheral Pulmonary Artery Stenosis
Peripheral pulmonary artery stenosis (PAS) is an abnormal narrowing of the pulmonary vasculature and can form anywhere within the pulmonary artery tree. PAS is a congenital or an acquired disease, and its severity depends on the etiology, location, and number of stenoses. Most often seen in infants and young children, some symptoms include shortness of breath, fatigue, and tachycardia. Symptoms can progressively worsen over time as right ventricular pressure increases, leading to further complications including pulmonary artery hypertension and systolic and diastolic dysfunctions. The current treatment options for PAS incl...
Source: Cardiology in Review - April 17, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Myocardial Infarction With Nonobstructive Coronary Arteries
Myocardial infarction with nonobstructive coronary arteries (MINOCA) is the current term used to describe patients who have a myocardial infarction but have normal, non-obstructed coronary arteries on a coronary angiogram. There is still much debate over the definition, diagnosis, management and treatment of MINOCA. However, MINOCA is not a benign condition; prompt recognition and diagnosis can lead to better management and treatment and thus improve patient outcomes. This review article will update the most recent definition of MINOCA, discuss epidemiology and etiology, and review the diagnostic workup and management opti...
Source: Cardiology in Review - April 17, 2021 Category: Cardiology Tags: Review Articles Source Type: research

The 11th Trial of a Cardiovascular Clinical Trialist: Coronavirus-2: Part 5
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - April 17, 2021 Category: Cardiology Tags: Editorial Source Type: research

Semaglutide: A Novel Oral Glucagon-Like Peptide Receptor Agonist for the Treatment of Type 2 Diabetes Mellitus
This article will provide an overview of the GLP-1 receptor agonists, including the pharmacology of semaglutide, its clinical evidence and role in therapy in type 2 DM. (Source: Cardiology in Review)
Source: Cardiology in Review - February 14, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Transcatheter Mitral Valve Replacement: Procedural Planning, Utility, and Applicability
Since the first native transcatheter mitral valve implantation in 2012, transcatheter mitral valve replacement (TMVR) has expanded its use to degenerated bioprostheses, failed annuloplasty ring repair, and mitral annular calcification. However, high-screen failure rates in trials have persisted due to predicted left ventricular outflow tract obstruction and unfavorable anatomy. Preprocedural planning in this patient population with multidetector computed tomography and transesophageal echocardiography is paramount to intraprocedural success. In patients with favorable left ventricular outflow tract anatomy who are not surg...
Source: Cardiology in Review - February 14, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Pulmonary Artery Denervation as an Innovative Treatment for Pulmonary Hypertension With and Without Heart Failure
Pulmonary hypertension (PH) is categorized into 5 groups based on etiology. The 2 most prevalent forms are pulmonary arterial hypertension (PAH) and PH due to left heart disease (PH-LHD). Therapeutic options do exist for PAH to decrease symptoms and improve functional capacity; however, the mortality rate remains high and clinical improvements are limited. PH-LHD is the most common cause of PH; however, no treatment exists and the use of PAH-therapies is discouraged. Pulmonary artery denervation (PADN) is an innovative catheter-based ablation technique targeting the afferent and efferent fibers of a baroreceptor reflex in ...
Source: Cardiology in Review - February 14, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Diastolic Heart Failure: A Review of Current and Future Treatment Options
This article will review the epidemiology and pathophysiology of HFpEF, and discuss the current therapeutic modalities, and clinical trials. In addition, we will discuss an ongoing clinical trial and the impact it may hold on future treatment options. (Source: Cardiology in Review)
Source: Cardiology in Review - February 14, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Diuretic Resistance in Heart Failure
Decompensated heart failure accounts for approximately 1 million hospitalizations in the United States annually, and this number is expected to increase significantly in the near future. Diuretics provide the initial management in most patients with fluid overload. However, the development of diuretic resistance remains a significant challenge in the treatment of heart failure. Due to the lack of a standard definition, the prevalence of this phenomenon remains difficult to determine, with some estimates suggesting that 25–30% of patients with heart failure have diuretic resistance. Certain characteristics, including ...
Source: Cardiology in Review - February 14, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Proarrhythmic Manifestations of Neuromuscular Dystrophinopathies
Muscular dystrophy has been an elusive term ever since it was first described in the 19th century. Introduced in 1891 by Wilhelm Heinrich Erb, muscular dystrophy has been classified as part of a larger group of genetically determined, progressive degenerative neuromuscular disorders termed “dystrophinopathies.” Cardiac arrhythmias may occur during the neurologic course of the disease. Although descriptions of the dystrophinopathies have been reported in the literature, few articles address the use of antiarrhythmic pharmacotherapy in patients with muscular dystrophy. We discuss the pathophysiology of the most c...
Source: Cardiology in Review - February 14, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Timing of Repair in Tetralogy of Fallot: Effects on Outcomes and Myocardial Health
In conclusion, we emphasize the importance of myocardial health and the relationship to early repair and advocate for the use of magnetic resonance imaging in adult patients with repaired ToF to detect myocardial fibrosis. (Source: Cardiology in Review)
Source: Cardiology in Review - February 14, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Acute Aortic Occlusion and Its Sequelae: Metabolic, Pathologic Etiology, and Management
Acute occlusion of the abdominal aorta is a catastrophic occurrence that results in high risk of limb loss and death. The etiology has historically been either acute embolism obstructing the aortic bifurcation in 8% to 75% of patients, or thrombosis of existing aorta-iliac occlusive disease in 35% to 84% of patients. Other etiologies include thrombosis of either a previously placed endograft or aortic graft or acute dissection. The most common symptoms are severe pain in almost 100% of patients or lower extremity paralysis/paresis in up to 80% of patients. Evaluation in the past was by angiography, but presently, computed ...
Source: Cardiology in Review - February 14, 2021 Category: Cardiology Tags: Review Articles Source Type: research

The First Woman in Cardiac Surgery: The Life and Legacy of Dr. Nina Starr-Braunwald
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - February 14, 2021 Category: Cardiology Tags: Editorial Source Type: research

Myocarditis in Multisystem Inflammatory Syndrome in Children Associated With Coronavirus Disease 2019: Erratum
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Errata Source Type: research

Diagnosis, Treatment, and Management of Orthotopic Liver Transplant Candidates With Portopulmonary Hypertension: Erratum.
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Errata Source Type: research

Nonpharmacologic Treatment for Heart Failure: A Review of Implantable Carotid Baroreceptor Stimulators As a Therapeutic Option
There has been significant interest in research for the development of device-based therapy as a treatment option of heart failure (HF), whether it is with reduced or preserved ejection fraction. This is due to the high morbidity and mortality rate in patients with HF despite recent advances in pharmacologic treatment. Following the success of cardiac resynchronization therapy, baroreceptor activation therapy has emerged as another novel device-based treatment for HF. The Barostim neo was developed by CVRx Minneapolis, MN for the treatment of mild to severe HF. The device works by electrically activating the baroreceptor r...
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Thrombotic Complications of COVID-19 Infection: A Review
The novel coronavirus (severe acute respiratory syndrome CoV-2 [SARS-CoV-2]), also known as COVID-19, is a single-stranded enveloped RNA virus that created a Public Health Emergency of International Concern in January 2020, with a global case burden of over 15 million in just 7 months. Infected patients develop a wide range of clinical manifestations—typically presenting with fever, cough, myalgia, and fatigue. Severely ill patients may fall victim to acute respiratory distress syndrome, acute heart injuries, neurological manifestations, or complications due to secondary infections. These critically ill patients are ...
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Characteristics and Outcomes of Patients 80 Years and Older Hospitalized With Coronavirus Disease 2019 (COVID-19)
Patients older than 65 years hospitalized with COVID-19 have higher rates of intensive care unit admission and death when compared with younger patients. Cardiovascular conditions associated with COVID-19 include myocardial injury, acute myocarditis, cardiac arrhythmias, cardiomyopathies, cardiogenic shock, thromboembolic disease, and cardiac arrest. Few studies have described the clinical course of those at the upper extreme of age. We characterize the clinical course and outcomes of 73 patients with 80 years of age or older hospitalized at an academic center between March 15 and May 13, 2020. These patients had multiple ...
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Management of Small Unruptured Intracranial Aneurysms: To Treat or Not to Treat?
Unruptured intracranial aneurysms measuring (Source: Cardiology in Review)
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Westchester Neurovascular Symposium: Advances in Stroke Care. Westchester Medical Center, Valhalla, NY, November 15, 2019. Guest Editors: Justin Santarelli MD and Ramandeep Sahni MD Source Type: research

Time to Wake-Up: Extending the Window for Management of Unknown-Onset Strokes
The term “Wake-Up Stroke” is applied to a patient who displays no symptoms before sleep, but wakes with neurologic deficits suggestive of stroke. The current guidelines for acute ischemic stroke limit intravenous tissue plasminogen activator use to stroke patients in whom symptom onset or last known well is less than 4.5 hours. Approximately one-third of acute ischemic stroke patients present with unknown time of symptom onset and are often not eligible for intravenous reperfusion therapy in clinical practice. This review provides an overview of several earlier trials that used advanced neuroimaging to determin...
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Westchester Neurovascular Symposium: Advances in Stroke Care. Westchester Medical Center, Valhalla, NY, November 15, 2019. Guest Editors: Justin Santarelli MD and Ramandeep Sahni MD Source Type: research

Assessment of the Patient With Intracerebral Hemorrhage: A Review of the Literature
Spontaneous nontraumatic intracerebral hemorrhage is associated with high morbidity and mortality. Given the risk of rapid neurological deterioration, early identification with rapid neuroimaging is vital. Predictors of outcome, such as spot sign and intracerebral hemorrhage score, can help guide management goals. Management should be aimed at prevention of hematoma expansion, treatment of increased intracranial pressure, and prevention of secondary brain injury and medical complications. (Source: Cardiology in Review)
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Westchester Neurovascular Symposium: Advances in Stroke Care. Westchester Medical Center, Valhalla, NY, November 15, 2019. Guest Editors: Justin Santarelli MD and Ramandeep Sahni MD Source Type: research

Microsurgical Clipping of Intracranial Aneurysms in the Endovascular Era
The treatment of intracranial aneurysms (IA) began in the late 19th century. Some degree of controversy has always surrounded the best treatment modality for IA. Cushing and Dandy debated about cervical carotid ligation as the only surgical alternative before the introduction of microsurgical clipping. In the early 21st century, the debate has centered on surgical versus^ endovascular techniques. With the advent of newer endovascular techniques and devices, there has been a dramatic shift in treatment paradigms toward endovascular intervention that is preferred by both physicians and patients. However, there will always be...
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Westchester Neurovascular Symposium: Advances in Stroke Care. Westchester Medical Center, Valhalla, NY, November 15, 2019. Guest Editors: Justin Santarelli MD and Ramandeep Sahni MD Source Type: research

Decision-Making for Patients With Cerebral Arteriovenous Malformations
Cerebral arteriovenous malformations (AVMs) are a complex and heterogeneous pathology which require an understanding of the natural history of these lesions, as well as the potential treatment options in order to manage them safely. While treatment is the agreed upon strategy for most ruptured AVMs, the management of unruptured AVMs continues to be debated. More recently, this debate has been fueled by the A Randomized Trial of Unruptured Arteriovenous Malformations (ARUBA) trial which attempts to define the natural history and treatment risk of AVMs. However, the trial has significant shortcomings which limit its broad ap...
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Westchester Neurovascular Symposium: Advances in Stroke Care. Westchester Medical Center, Valhalla, NY, November 15, 2019. Guest Editors: Justin Santarelli MD and Ramandeep Sahni MD Source Type: research

Minimally Invasive Treatment Options for Managing Spontaneous Intracerebral Hemorrhage
We present here a select review of various minimally-invasive techniques for the evacuation of SICH. (Source: Cardiology in Review)
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Westchester Neurovascular Symposium: Advances in Stroke Care. Westchester Medical Center, Valhalla, NY, November 15, 2019. Guest Editors: Justin Santarelli MD and Ramandeep Sahni MD Source Type: research

End of an Era: A Tribute to Joanne Cioffi-Pryor
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Editorials Source Type: research

A Special Issue
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Editorials Source Type: research

The 11th Trial of a Cardiovascular Clinical Trialist: Coronavirus-2, Part 4 Lessons Learned From the COVID-19 Pandemic
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - December 13, 2020 Category: Cardiology Tags: Editorials Source Type: research

A Review of Remdesivir for COVID-19: Data to Date
This article describes remdesivir’s historical background, pharmacology, key trials, adverse events, and issues regarding accessibility. (Source: Cardiology in Review)
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: New Therapy Update Source Type: research

Catecholaminergic Polymorphic Ventricular Tachycardia
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare congenital arrhythmogenic disorder induced by physical or emotional stress. It mainly affects children and younger adults and is characterized by rapid polymorphic and bidirectional ventricular tachycardia. Symptoms can include dizziness, palpitations, and presyncope, which may progress to syncope, hypotonia, convulsive movements, and sudden cardiac death. CPVT is the result of perturbations in Ca2+ ion handling in the sarcoplasmic reticulum of cardiac myocytes. Mutations in the cardiac ryanodine receptor gene and the calsequestrin isoform 2 gene are mo...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Arrhythmogenic Right Ventricular Cardiomyopathy Diagnosis
Arrhythmogenic right ventricular cardiomyopathy, formerly called “arrhythmogenic right ventricular dysplasia,” is an under-recognized clinical entity characterized by ventricular arrhythmias and a characteristic ventricular pathology. Diagnosis is often difficult due to the nonspecific nature of the disease and the broad spectrum of phenotypic variations. Therefore, consensus diagnostic criteria have been developed which combine electrocardiographic, echocardiographic, cardiac magnetic resonance imaging and histologic criteria. In 1994, an international task force first proposed the major and minor diagnostic c...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Heavy Metal Toxicity in Chronic Renal Failure and Cardiovascular Disease: Possible Role for Chelation Therapy
Exposure to heavy metals is common. This exposure is related to environmental contamination of air, water and soil, occupational exposure, accumulation in food, tobacco, and other factors. Cadmium and lead are notable for their widespread contamination, long-lasting effects in the body, and renal as well as cardiovascular toxicity. Acute toxicity due to high-level exposure, as well as chronic low-level exposure are now well-established pathogenic entities. Both chronic renal failure and ischemic heart disease patients have been treated separately in recent studies with ethylenediaminetetraacetic acid (EDTA) chelation thera...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Myocarditis in Multisystem Inflammatory Syndrome in Children Associated With Coronavirus Disease 2019
We present our initial experience managing children with coronavirus disease 2019–related acute myocardial injury. The 3 patients presented here represent a spectrum of the cardiac involvement noted in children with coronavirus disease 2019–related multisystem inflammatory syndrome, including myocarditis presenting as cardiogenic shock or heart failure with biventricular dysfunction, valvulitis, coronary artery changes, and pericardial effusion. (Source: Cardiology in Review)
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Use of Nonsteroidal Anti-inflammatory Drugs for COVID-19 Infection: Adjunct Therapy?
Severe acute respiratory distress syndrome coronavirus 2 (COVID-19) is the cause of the current pandemic, which remains a tremendous cause of morbidity and mortality worldwide. Although there are numerous trials underway, there is currently no medication known to cure the infection. Nonsteroidal anti-inflammatory drugs (NSAIDs) are inexpensive, widely available medications with antiviral and anti-inflammatory properties and may have utility as an adjunct therapy to improve outcomes in patients with severe COVID-19 infection. A thorough PubMed literature review on the therapeutic use of NSAID was conducted to provide a comp...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Elevated d-Dimer Levels Are Associated With Increased Risk of Mortality in Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
The 2019 novel coronavirus, declared a pandemic, has infected 2.6 million people as of April 27, 2020, and has resulted in the death of 181,938 people. d-dimer is an important prognostic tool, is often elevated in patients with severe coronavirus disease-19 (COVID-19) infection and in those who suffered death. In this systematic review, we aimed to investigate the prognostic role of d-dimer in COVID-19-infected patients. We searched PubMed, Medline, Embase, Ovid, and Cochrane for studies reporting admission d-dimer levels in COVID-19 patients and its effect on mortality. Eighteen studies (16 retrospective and 2 prospective...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Invited Review Articles Source Type: research

Valve-in-Valve Transcatheter Aortic Valve Replacement: A Review of Procedural Details, Safety, and Clinical Implications
Bioprosthetic valves are increasingly being used to treat young patients needing surgical intervention. The rising number of young patients undergoing bioprosthesis implantation also means that many of these patients will ultimately require reintervention due to the deteriorative nature of these valves. Recently, valve-in-valve transcatheter aortic valve replacement (ViV TAVR) has become the preferred procedure to treat high-risk patients requiring repeat surgical aortic valve replacement. Despite being less invasive, ViV TAVR is accompanied by risks, including coronary obstruction, valvular thrombosis, and postoperative r...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Westchester Cardiovascular Symposium: October 3-5, 2019 Guest Editors: Julio Panza MD, Steven Lansman MD, PhD Source Type: research

Noninvasive Radioablation of Ventricular Tachycardia
Ventricular tachycardia (VT) occurs most commonly in the presence of structural heart disease or myocardial scarring from prior infarction. It is associated with increased mortality, especially when it results in cardiac arrest outside of a hospital. When not due to reversible causes (such as acute ischemia/infarction), placement of an implantable cardioverter-defibrillator for prevention of future sudden death is indicated. The current standard of care for recurrent VT is medical management with antiarrhythmic agents followed by invasive catheter ablation for VT that persists despite appropriate medical therapy. Stereotac...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Westchester Cardiovascular Symposium: October 3-5, 2019 Guest Editors: Julio Panza MD, Steven Lansman MD, PhD Source Type: research

The Total Artificial Heart: Where Are We?
The total artificial heart (TAH) is a device that replaces the failing ventricles. There have been numerous TAHs designed over the last few decades, but the one with the largest patient experience is the SynCardia temporary TAH. The 50-mL and 70-mL sizes have been approved in the United States, Europe, and Canada as a bridge to transplantation. It is indicated in patients with severe biventricular failure or structural heart issues that preclude the use of a left ventricular assist device. The majority of the patients implanted are Interagency Registry for Mechanically Assisted Circulatory Support profile 1 or 2. The 1-yea...
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Westchester Cardiovascular Symposium: October 3-5, 2019 Guest Editors: Julio Panza MD, Steven Lansman MD, PhD Source Type: research

The 11th Trial of a Cardiovascular Clinical Trialist—Coronavirus-2, Part 3
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - October 6, 2020 Category: Cardiology Tags: Editorial Source Type: research

Chloroquine or Hydroxychloroquine for Management of Coronavirus Disease 2019: Friend or Foe?
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to be a threat to the health of many humans across the world as they confront coronavirus disease 2019 (COVID-19). Previous promising in vitro data that emerged after the SARS-CoV outbreak in 2003, along with the emergent need for pharmacologic management strategies in the fight against COVID-19, prompted interest in the use of chloroquine and hydroxychloroquine across the globe. Unfortunately, the in vitro activity of these drugs did not necessarily correlate with most in vivo studies, which showed no consistent efficacy. Safety is also a major concern...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Curbside Consult Source Type: research

Nitrosamine Impurities in Angiotensin Receptor Blockers
Nitrosamines are known carcinogens which have been recently discovered in several angiotensin receptor blockers (ARBs). This led to the recall of valsartan in the United States in 2018, and afterward, the recall of other ARBs as well as unrelated medications (e.g., ranitidine). The presence of nitrosamine in ARBs was likely a result of changes in the manufacturing process, although nitrosamine contamination is believed to occur by different mechanisms with other medications. The United States Food and Drug Administration has since taken steps to identify products affected by nitrosamine contamination and mitigate this conc...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Curbside Consult Source Type: research

Myocardial Depression in Sepsis: Beneficial Adaptation or Sequelae that Requires Treatment?
Myocardial depression is a common yet reversible phenomenon that occurs in patients in septic shock. Initially, it was unclear whether this provided an adaptive survival benefit, as early studies showed decreased mortality in septic patients with myocardial depression. However, subsequent larger studies have debunked this myth. Given that no benefit exists, cardiac dysfunction in septic patients may be monitored via echocardiography and may be treated with inotropic agents. Beta-blockers provide a novel avenue of treatment as they aid in reducing adrenergic overstimulation and cytokine production, which may drive the patho...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Lipoprotein(a) Testing and Emerging Therapies
The study of lipoprotein(a) [Lp(a)] over the years has been a source of both enlightenment and frustration for the medical community. Accumulating evidence from large sample observational studies, Mendelian randomization studies, and genome-wide association studies has strengthened the association between Lp(a) and the development of atherosclerotic cardiovascular disease. This evidence supports the testing of Lp(a) in certain high-risk populations in order for clinicians to improve the risk profile of patients. Despite a variety of medical therapies that have been proven to reduce Lp(a) levels, the connection between the ...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Severe Hypoglycemia and Risk of Subsequent Cardiovascular Events: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Intensive glycemic control significantly increases the risk of hypoglycemia in patients with diabetes mellitus. Recent data have shown that hypoglycemia may also be a marker of cardiovascular disease in these patients. We performed a systemic review and a meta-analysis to evaluate the relationship between severe hypoglycemic events (SHEs) and the subsequent risk of mortality and major adverse cardiovascular events (MACE) in patients with diabetes mellitus. PubMed, Cochrane library, and Embase were searched for randomized controlled trials between January 2006 and December 17, 2018 that reported cardiovascular outcomes in d...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

A Practical Approach to Hybrid Coronary Revascularization
Combined surgical and percutaneous coronary revascularization, ie, hybrid coronary revascularization (HCR) consists of surgical left internal mammary artery (LIMA) bypass to the left anterior descending artery (LAD) and percutaneous revascularization of other diseased coronary arteries. Developed as a 1-stage procedure, HCR has not been widely adopted by the cardiovascular community. The recommended minimally invasive approach through a small left thoracotomy incision is technically demanding, and same-day percutaneous revascularization requires a hybrid operating room that is not available in most hospitals. In this revie...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Towards a Saphenous Vein Graft Moratorium
Atherosclerosis develops and rapidly progresses in saphenous veins grafts after coronary bypass surgery. In contrast to native coronary artery, percutaneous revascularization does not impede the progression of saphenous vein atherosclerosis and saphenous vein graft failure commonly ensues. The protracted patency of arterial grafts is likely to account for most of the long-term superiority of coronary artery bypass surgery over percutaneous revascularization in patients with complex coronary artery disease. Long-lasting, complete coronary revascularization may be best achieved by combining surgical arterial grafting of dise...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research

Cardiovascular Safety and Benefits of Noninsulin Antihyperglycemic Drugs for the Treatment of Type 2 Diabetes Mellitus: Part 2
Ideal drugs to improve outcomes in type 2 diabetes mellitus (T2DM) are those with antiglycemic efficacy, as well as cardiovascular safety that has to be determined in appropriately designed cardiovascular outcome trials as mandated by regulatory agencies. The more recent antihyperglycemic medications have shown promise with regards to cardiovascular disease (CVD) risk reduction in T2DM patients at a high cardiovascular risk. Sodium glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists are associated with better cardiovascular outcomes and mortality in T2DM patients than are dipeptidylpeptidase-4 ...
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Review Articles Source Type: research