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
The 11th Trial of a Cardiovascular Clinical Trialist: Coronavirus-2: Part 2
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - August 13, 2020 Category: Cardiology Tags: Editorial Source Type: research
Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Patients With Coronavirus Disease 2019: Friend or Foe?
This article is to examine and summarize the 2 opposing viewpoints and provide guideline recommendations to support the use or discontinuation of ACE inhibitors and ARBs in patients with COVID-19. (Source: Cardiology in Review)
Source: Cardiology in Review - June 4, 2020 Category: Cardiology Tags: Feature Curbside Consult Source Type: research
The Firehawk Stent: A Review of a Novel Abluminal Groove-Filled Biodegradable Polymer Sirolimus-Eluting Stent
This article provides a review of the current clinical evidence concerning the Firehawk stent. (Source: Cardiology in Review)
Source: Cardiology in Review - June 4, 2020 Category: Cardiology Tags: New Therapy Update Source Type: research
Sudden Cardiac Death in Brugada Syndrome
The Brugada syndrome is an inherited channelopathy that alters the main transmembrane ion currents that constitute the cardiac action potential. These changes not only modify the resting electrocardiogram but also predispose patients to develop malignant ventricular tachyarrhythmias that can lead to syncope, cardiac arrest, and sudden cardiac death. This syndrome is responsible for nearly 20% of all sudden cardiac deaths in patients with structurally normal hearts and up to 12% of all sudden cardiac deaths. Brugada syndrome is diagnosed by its characteristic electrocardiogram consisting of a coved-type ST-segment elevation...
Source: Cardiology in Review - June 4, 2020 Category: Cardiology Tags: Review Articles Source Type: research
Sarcopenia and Cardiac Dysfunction
Although muscle loss is part of the natural course of human aging, sarcopenia has been associated with an increased risk of physical disability and mortality in older patients. Many heart failure patients concomitantly develop deficits in muscle mass and strength, resulting in decreased quality of life and exercise capacity. An underlying state of inflammation is central to the development of sarcopenia and muscle wasting in heart failure; however, additional research in human models is needed to further delineate the pathophysiology of muscle wasting in these patients. Previous studies have shed light on many of the poten...
Source: Cardiology in Review - June 4, 2020 Category: Cardiology Tags: Review Articles Source Type: research
Restarting Oral Anticoagulation in Patients With Atrial Fibrillation After an Intracranial Hemorrhage
Atrial fibrillation is the most common sustained cardiac arrhythmia in the general population. In western countries with aging populations, atrial fibrillation poses a significant health concern, as it is associated with a high risk of thromboembolism, stroke, congestive heart failure, and myocardial infarction. Thrombi are generated in the left atrial appendage, and subsequent embolism into the cerebral circulation is a major cause of ischemic stroke. Therefore, patients have a lifetime risk of stroke, and those at high risk, defined as a CHA2DS2-VASc2 (congestive heart failure, hypertension, age>75 years, diabetes mellit...
Source: Cardiology in Review - June 4, 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 1
Cardiovascular disease (CVD) is a major contributor to the morbidity and mortality associated with type 2 diabetes mellitus (T2DM). With T2DM growing in pandemic proportions, there will be profound healthcare implications of CVD in person with diabetes. The ideal drugs to improve outcomes in T2DM are those having antiglycemic efficacy in addition to cardiovascular (CV) safety, which has to be determined in appropriately designed CV outcome trials as mandated by regulatory agencies. Available evidence is largely supportive of metformin’s CV safety and potential CVD risk reduction effects, whereas sulfonylureas are either ...
Source: Cardiology in Review - June 4, 2020 Category: Cardiology Tags: Review Articles Source Type: research
The Novel Coronavirus Disease (COVID-19) and Its Impact on Cardiovascular Disease
The coronavirus disease 2019 (COVID-19) pandemic has placed a significant strain on healthcare providers. As the number of patients continue to surge, healthcare workers are now forced to find different approaches to practicing medicine that may affect patient care. In addition, COVID-19 has many cardiovascular complications that affect the clinical course of patients. In this article, we summarize the cardiovascular impact of COVID-19 and some of the challenges that patients and the healthcare system will face during this pandemic. (Source: Cardiology in Review)
Source: Cardiology in Review - June 4, 2020 Category: Cardiology Tags: Review Articles Source Type: research
The 11th Trial of a Cardiovascular Clinical Trialist: Coronavirus-2: Part 1
No abstract available (Source: Cardiology in Review)
Source: Cardiology in Review - June 4, 2020 Category: Cardiology Tags: Editorial Source Type: research
Tafamidis: A Novel Treatment for Transthyretin Amyloid Cardiomyopathy
Transthyretin (TTR) amyloid cardiomyopathy is a life-threatening condition in which amyloid fibrils accumulate in the heart, eventually leading to cardiac symptomatology and death. To date, treatment of this condition has been directed at symptom relief due to a lack of effective treatment options which target the cause of the disease. The discovery that amyloid deposition was a result of dissociation of the TTR protein structure allowed for the development of tafamidis, which acts by stabilizing the TTR tetramer. Due to the rare nature of the disease, there is limited clinical trial data with tafamidis, with the largest c...
Source: Cardiology in Review - April 2, 2020 Category: Cardiology Tags: New Therapy Update Source Type: research
