Choosing the right therapy for a patient with asymptomatic carotid stenosis.
Authors: Bogiatzi C, Azarpazhooh MR, Spence JD Abstract Introduction: Most patients with asymptomatic carotid stenosis (ACS) now have a lower risk with intensive medical therapy than with stenting (CAS) or endarterectomy (CEA); the annual risk of stroke or death with intensive medical therapy is ~ 0.5%, vs. a periprocedural risk with CAS of ~ 2.5-4.1% with CAS, and ~ 1.4-1.8% with CEA. The excess risk of CAS is greater in older patients.Areas covered: Discussed are the need for intensive medical therapy, the nature of intensive medical therapy, approaches to identifying the few patients with ACS who could benefit f...
Source: Expert Review of Cardiovascular Therapy - February 12, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Intravenous fluids for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography and cardiac catheterization.
This article reviews the data supporting the current practice of prophylactic periprocedural intravenous isotonic saline for lowering the incidence of contrast-induced nephropathy. We reviewed PubMed to search primarily for the latest clinical trials and meta-analyses pertaining to contrast-induced nephropathy and the use of prophylactic measures, specifically intravenous infusion of isotonic salineExpert opinion: Currently, there are no universally-accepted methods for the prevention of contrast-induced nephropathy. The best evidence for contrast-induced nephropathy prophylaxis is the administration of intravenous isotoni...
Source: Expert Review of Cardiovascular Therapy - February 2, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Assessing platelet reactivity after drug eluting stent implantation: state of the art.
Authors: Tantry US, Timilsina S, Rout A, Bliden K, Gurbel PA Abstract Introduction: Platelets play a pivotal role in the occurrence of recurrent ischemic events in coronary artery disease patients who are treated with drug-eluting stents and are on dual antiplatelet therapy (DAPT).Areas covered: High platelet reactivity (HPR) to adenosine diphosphate during clopidogrel therapy is a strong predictor of post-stenting ischemic event occurrences. However, uniform use of these potent P2Y12 receptors blockers to overcome HPR is associated with elevated bleeding risk. Selective de-escalation of P2Y12 receptor blocker ther...
Source: Expert Review of Cardiovascular Therapy - February 2, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Outcomes of percutaneous coronary interventions in cancer patients.
Authors: Bharadwaj AS, Swamy PM, Mamas MA Abstract Introduction: There are numerous shared risk factors in the etiopathogenesis of coronary artery disease (CAD) and cancer both at the epidemiologic and molecular level. Additionally, the different modalities of treatment of cancer such as radiation, chemotherapy, immunotherapy and hormonal therapies further increase the risk of CAD and acute coronary syndrome. Most large database analysis and single center experiences have shown that cancer patients undergoing PCI are at an increased risk of in-hospital mortality, bleeding repeat revascularization.Areas covered: In ...
Source: Expert Review of Cardiovascular Therapy - January 19, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Improving adherence to cardiovascular guidelines: realistic transition from paper to patient.
This article outlines barriers that impede guideline adherence and possible strategies to overcome such barriers. Barriers intrinsic and extrinsic to clinicians are discussed. The structured process of guideline implementation including guideline adoption, diffusion, and dissemination is discussed. Lastly, the authors review in detail the current and potential future elements of guideline diffusion and dissemination.Expert opinion: Improving guideline adherence remains challenging as it requires understanding of and navigation through various barriers. However, further research specific to cardiovascular medicine guideline...
Source: Expert Review of Cardiovascular Therapy - January 17, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Lower LDL is better - can this be achieved with CETP inhibition therapy?
Authors: Rashid S PMID: 31937166 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - January 16, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Current clinical management of dysfunctional bioprosthetic pulmonary valves.
Authors: Aggarwal V, Spigel Z, Hiremath G, Binsalamah Z, Qureshi AM Abstract Introduction: As with any bioprosthetic valve, bioprosthetic valves in the pulmonary position have a finite life span and patients with bioprosthetic pulmonary valves require lifetime management to treat valve dysfunction.Areas covered: In this article, authors discuss the current medical management for treatment of dysfunctional bioprosthetic valves. This review is based on both an extensive review of the recent cardiac surgical/interventional cardiology literature (PubMed and MEDLINE database searches from 1958 - 2019) and personal exper...
Source: Expert Review of Cardiovascular Therapy - January 15, 2020 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Response to letter to the editor "Statin use in patients with diabetes: one drug, multiple benefits".
Response to letter to the editor "Statin use in patients with diabetes: one drug, multiple benefits". Expert Rev Cardiovasc Ther. 2019 Dec 26;:1 Authors: Khalil S, Alraies MC PMID: 31875740 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - December 27, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Developments in transcatheter aortic bioprosthesis durability.
Authors: Petronio AS, Giannini C Abstract Introduction: Valve durability represents a main concern, as the target population for transcatheter aortic valve implantation (TAVI) evolves to include lower risk and younger patients who are likely to survive for a number of years after the procedure.Areas covered: The purpose of this review article is to provide an overview of potential mechanisms and rates of structural valve deterioration (SVD) of transcatheter bioprostheses.Expert opinion: Recently the standardized definitions of SVD proposed by European Association of Percutaneous Cardiovascular Interventions (EAPCI)...
Source: Expert Review of Cardiovascular Therapy - December 20, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Targeted therapy for solid tumors and risk of hypertension: a meta-analysis of 68077 patients from 93 phase III studies.
Conclusion: According to these data, monitoring this class of toxicities is of primary importance to avoid hypertension worsening and, thus, the risk of major cardiovascular events. PMID: 31829045 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - December 14, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Early detection of transcatheter heart valve dysfunction.
Authors: Valvo R, Criscione E, Reddavid C, Barbanti M Abstract Introduction: Transcatheter aortic valve implantation therapy is spreading rapidly, representing the standard of care in inoperable and high-risk patients, and a valid alternative in intermediate- and low-risk patients with severe symptomatic aortic stenosis. In this subset, the development and validation of noninvasive, quantitative, in vivo imaging modality, to monitor possible valve dysfunction is mandatory, in order to plan timely therapeutic interventions before the onset of symptoms.Areas covered: The implantation of transcatheter heart valves (TH...
Source: Expert Review of Cardiovascular Therapy - December 14, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Features of Marfan syndrome not listed in the Ghent nosology - The Dark Side of the Disease.
Authors: von Kodolitsch Y, Demolder A, Girdauskas E, Kaemmerer H, Kornhuber K, Muino Mosquera L, Morris S, Neptune E, Pyeritz R, Rand-Hendriksen S, Rahman A, Riise N, Robert L, Staufenbiel I, Szöcs K, Vanem TT, Linke SJ, Vogler M, Yetman A, De Backer J Abstract Introduction: The revised Ghent nosology presents classical features of Marfan syndrome. However, behind its familiar face, Marfan syndrome hides less well-known features.Areas covered: The German Marfan Organization listed unusual symptoms and clinical experts reviewed the literature on clinical features of Marfan syndrome not listed in the Ghent nosol...
Source: Expert Review of Cardiovascular Therapy - December 14, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Treatment strategies for mixed aortic valve disease in nonelderly patients.
Authors: von Stumm M, Petersen J, Westermann D, Reichenspurner H, Girdauskas E Abstract Introduction: Mixed aortic valve disease (MAVD) is defined by simultaneously occurrence of aortic stenosis (AS) and aortic regurgitation (AR). In our review, we focus on treatment options for nonelderly MAVD patients (age
Source: Expert Review of Cardiovascular Therapy - December 11, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Developments in transcatheter tricuspid valve therapies.
Authors: Voci D, Pozzoli A, Miura M, Gavazzoni M, Gülmez G, Scianna S, Zuber M, Maisano F, Taramasso M Abstract Introduction: Transcatheter tricuspid valve (TV) procedures emerged as an alternative to surgery for symptomatic high-risk patients with severe tricuspid regurgitation.Areas covered: A literature search was performed using PubMed. Authors review clinical evidence in this field, the imaging features and the developments in TV transcatheter technologies. Currently, transcatheter devices for TV procedures can be allocated into four main groups: 1) those ones targeting leaflet malcoaptation, 2) those add...
Source: Expert Review of Cardiovascular Therapy - December 6, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Three-dimensional echocardiography to assess left ventricular geometry and function.
Authors: Guta AC, Badano LP, Ochoa-Jimenez RC, Genovese D, Previtero M, Civera S, Ruocco A, Bettella N, Parati G, Muraru D Abstract Introduction: Quantification of left ventricular (LV) size and function represents the most frequent indication for an echocardiographic study. New echocardiographic techniques have been developed over the last decades in an attempt to provide a more comprehensive, accurate and reproducible assessment of LV function.Areas covered: Although two-dimensional echocardiography (2DE) is the recommended imaging modality to evaluate the LV, three-dimensional echocardiography (3DE) has proven t...
Source: Expert Review of Cardiovascular Therapy - November 27, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Cardiac remodeling in obesity and after bariatric and metabolic surgery; is there a role for gastro-intestinal hormones?
Authors: Sanches E, Timmermans M, Topal B, Celik A, Sundbom M, Ribeiro R, Parmar C, Ugale S, Proczko M, Stepaniak PS, Pujol Rafols J, Mahawar K, Buise MP, Neimark A, Severin R, Pouwels S Abstract Introduction: Obesity is associated with various diseases such as type 2 diabetes, hypertension, obstructive sleep apnea syndrome (OSAS), metabolic syndrome, and cardiovascular diseases. It affects several organ systems, including the pulmonary and cardiac systems. Furthermore, it induces pulmonary and cardiac changes that can result in right and/or left heart failure.Areas covered: In this review, authors provide an overv...
Source: Expert Review of Cardiovascular Therapy - November 21, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Aortic wall stiffness as a side-effect of anti-cancer medication.
Authors: Solomou E, Aznaouridis K, Masoura C, Cutajar I, Toutouzas K, Vlachopoulos C, Tousoulis D Abstract Introduction: Malignancies and cardiovascular disease are the two leading causes of mortality worldwide. There is a growing concern that anti-cancer drugs may lead to increased cardiovascular morbidity among cancer survivors. This may be the result of direct effects of the cancer treatment on heart function, or due to an indirect acceleration of atherosclerosis.Areas covered: We searched two bibliographic databases [PubMed, Scopus] and one full-text database (Google-Scholar) for publications on chemotherapy an...
Source: Expert Review of Cardiovascular Therapy - November 14, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Contemporary diagnosis and treatment of recurrent pericarditis.
Authors: Andreis A, Imazio M, De Ferrari GM Abstract Introduction: Acute pericarditis is frequently complicated with recurrences, which represent a diagnostic and therapeutic challenge for the physician, a bothersome trouble for patients. An incorrect treatment of pericarditis may cause further recurrence of symptoms, while an incorrect diagnosis may cause either a prolonged symptoms course with a possible risk of chronic constriction, or useless and potentially harmful treatments.Areas covered: This review will focus on the most useful and recent diagnostic tools for recurrent pericarditis. Medline/Pubmed Library ...
Source: Expert Review of Cardiovascular Therapy - November 13, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

The pulseless radial artery in transradial catheterization: challenges and solutions.
The objective of this paper is to give an approach to tackle forearm access when there appears to be no palpable radial pulse. Preservation of radial flow is paramount while alternative forearm means to vascular access may help avoid the need to access the femoral artery. PMID: 31710251 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - November 13, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Approach to asymptomatic intermediate risk individuals with high coronary artery calcium scores.
Authors: German C, Yeboah J PMID: 31703538 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - November 11, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Update on complications and their management during transradial cardiac catheterization.
Authors: Aoun J, Hattar L, Dgaily K, Wong G, Bhat T Abstract Introduction: Transradial cardiac catheterization (TRA) was introduced in 1989 and has been universally used as an alternative approach to the traditional transfermoral access (TFA). Complications of TRA include asymptomatic and less likely symptomatic radial artery occlusion, nonocclusive radial artery injury, radial artery spasm, radial arterial perforation, radial artery pseudoaneurysm, arteriovenous fistula, granuloma formation, access-site bleeding, nerve damage, complex regional pain syndrome along with other rare complications. Areas covered: A lit...
Source: Expert Review of Cardiovascular Therapy - October 15, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Aortic valve-related aortopathy: assessing optimal timing of surgical intervention.
This article aims to give an overview on the most recent literature addressing the different forms of valve-related aortopathies and the optimal timing of surgical intervention. It highlights the valve morphotype-dependent (BAV vs. TAV) and the valve lesion-dependent aortopathies (stenosis vs. regurgitation) and outlines the current treatment options of those pathologies. Further, this review discusses novel serological and rheological markers, potentially helping in the decision-making process in valve-related aortopathy. Systematic literature searches were performed using PubMed and Embase up to July 2019. Expert opinion...
Source: Expert Review of Cardiovascular Therapy - October 10, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Chronic kidney disease and coronary atherosclerosis: evidences from intravascular imaging.
Authors: Iwai T, Kataoka Y, Otsuka F, Asaumi Y, Nicholls SJ, Noguchi T, Yasuda S Abstract Introduction: In CKD subjects, atherosclerotic cardiovascular disease (ASCVD) is a major cause of their morbidity and mortality (1-3). Current therapeutic guidelines recommend lowering LDL-C level to prevent ASCVD (4, 5). However, it remains uncertain how this therapeutic approach effectively modifies atherosclerosis of CKD. These findings suggest the need to further understand pathophysiology of atherosclerosis. Given that intravascular imaging modalities have contributed to characterize the natural history of coronary athero...
Source: Expert Review of Cardiovascular Therapy - October 10, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

P2Y12 Inhibitors for the treatment of acute coronary syndrome patients undergoing percutaneous coronary intervention: current understanding and outcomes.
Authors: Alexopoulos D, Varlamos C, Mpahara A, Lianos I Abstract Introduction: Inhibition of P2Y12 platelet receptors consists a crucial target of pharmacologic treatment in acute coronary syndrome patients. Several controversial issues however still remain and these are analyzed. Areas covered: The significance of early and strong platelet inhibition in the early phase of STEMI and the role of pretreatment are discussed. Concerns regarding morphine administration are raised. The role of crushing integral tablets to expedite the onset of action of oral P2Y12 inhibitors is emphasized. New data on the intravenous can...
Source: Expert Review of Cardiovascular Therapy - October 5, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Newly approved devices for endovascular treatment of femoropopliteal disease: a review of clinical evidence.
Authors: Giannopoulos S, Armstrong EJ Abstract Introduction: Femoropopliteal lesions account for a significant proportion of endovascular interventions for peripheral artery disease. In this manuscript we review the literature on the application of newly approved devices in the treatment of atherosclerotic lesions at this segment. Areas covered: New drug-coating technologies provide sustained drug-eluting over time and better scaffolds are more resistant to the increased biomechanical stress at the femoropopliteal segment. Thus, the newer drug-eluting stents (i.e.Eluvia®), nitinol interwoven stents (i.e.Supera&...
Source: Expert Review of Cardiovascular Therapy - October 4, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

High sensitivity troponin assays: development and utility in a modern healthcare system.
This article reviews the history and development of high sensitivity troponin assays and their application to clinical practice and current evidence base. It also discusses both the positive and negative aspects of the continuing increasing sensitivity of biochemical assays and the translation of this into clinical practice. Potential future developments are also discussed. Expert commentary: It is clear that there are many benefits to detecting extremely low concentration of cardiac troponin including the development of rapid rule out algorithms and the cost and time saving advantages associated with the quicker movement ...
Source: Expert Review of Cardiovascular Therapy - October 3, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Echocardiographic prediction of surgical reparability in degenerative mitral regurgitation due to leaflet prolapse: a review.
Authors: Mantovani F, Bursi F, Di Giannuario G, Barbieri A Abstract Introduction. Despite current guidelines provide recommendations for the optimal management of degenerative mitral regurgitation (MR), this condition remains often undertreated with delay in surgical referral and dismal effect on outcomes. Areas covered. This review focuses on the role of echocardiography in guiding mitral valve (MV) surgical repair in degenerative MR due to leaflet prolapse. Expert opinion. A stepwise protocol-driven echocardiography shared by referring physician and surgeon may help to guide referral to surgical repair in degener...
Source: Expert Review of Cardiovascular Therapy - September 5, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Cyclocreatine protects against ischemic injury and enhances cardiac recovery during early reperfusion.
Authors: Elgebaly SA, Poston R, Todd R, Helmy T, Taegtmeyer H, Almaghraby AM, Elbayoumi T, Kreutzer DL Abstract Introduction: A critical mechanism of how hypoxia/ischemia causes irreversible myocardial injury is through the exhaustion of adenosine triphosphate (ATP). Cyclocreatine (CCr) and its water-soluble salt Cyclocreatine-Phosphate (CCrP) are potent bioenergetic agents that preserve high levels of ATP during ischemia. Areas covered: CCr and CCrP treatment prior to the onset of ischemia, preserved high levels of ATP in ischemic myocardium, reduced myocardial cell injury, exerted anti-inflammatory and anti-apopt...
Source: Expert Review of Cardiovascular Therapy - September 5, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Current state of leadless pacemakers: state of the art review.
Authors: Afzal MR, Shah N, Daoud G, Houmsse M Abstract Introduction: Leadless pacemakers (LPs) are the latest advancement in the field of pacing. Experience from pivotal trials and post-marketing studies has proven the feasibility and safety of these devices. The LPs obviate the need of pulse generator pocket and leads, which translates into lower incidence of lead related complications and pocket related infections. This review will summarize the existing literature on the LPs, specifically indications; implant procedure, unique situations and long- term follow up. Areas covered: This review will summarize the res...
Source: Expert Review of Cardiovascular Therapy - September 5, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Amyloid transthyretin cardiac amyloidosis: diagnosis and management.
This article will review ATTR cardiac amyloidosis to provide physicians with the tools they need to establish a definitive diagnosis when there is a clinical suspicion of amyloidosis and provide the most appropriate care. Expert commentary: Increased awareness and improved diagnostic techniques will lead to earlier diagnosis and a greater understanding of the clinical presentation. The anticipated increases in the prevalence of this disease due to increased clinical awareness will require, and in-part, facilitate the development of new therapies to manage this patient population. PMID: 31478389 [PubMed - as supplied by...
Source: Expert Review of Cardiovascular Therapy - September 4, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Risk stratification for ventricular arrhythmias and sudden cardiac death in arrhythmogenic right ventricular cardiomyopathy: an update.
Authors: Cadrin-Tourigny J, Bosman LP, Tadros R, Talajic M, Rivard L, James CA, Khairy P Abstract Introduction: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetically determined disease associated with a significant risk of ventricular arrhythmias and sudden cardiac death (SCD). Implantable cardioverter-defibrillators (ICDs) are the only effective preventive measure. Over the past 30 years, much effort has been invested in determining predictors of adverse arrhythmic events in these patients. Areas covered: This review summarizes available evidence on risk stratification for ARVC, with an emphasis ...
Source: Expert Review of Cardiovascular Therapy - August 21, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Multimodality imaging for the diagnosis and treatment of constrictive pericarditis.
This article gives an overview of the clinical spectrum of constrictive pericardial diseases and the role of multimodality imaging in the diagnosis of constrictive pericarditis. There is a focus on the emerging role of cardiac magnetic resonance (CMR) for the diagnosis, management and prognostication of patients with constrictive pericarditis based on more recent case series, retrospective and prospective studies, which have helped to define the role of CMR. Expert opinion: Advanced multimodality imaging assists with identification of both overt and subclinical pericardial inflammation. This allows the pericardiologist to ...
Source: Expert Review of Cardiovascular Therapy - August 21, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Predictors of adverse outcomes after transcatheter mitral valve replacement.
Authors: Overtchouk P, Piazza N, Granada JF, Modine T Abstract Introduction: Transcatheter mitral valve replacement (TMVR) is still a recent technology with numerous unknowns but also great promises. The risk of complications reported in observational studies have limited its adoption by interventional cardiology and surgical communities. Areas covered: Some of the major setbacks of TMVR are complications related to the devices and those related to the pathway. Device-related complications include left ventricle outflow tract (LVOT) obstruction, transcatheter heart valve (THV) dislocation or embolization, thrombosi...
Source: Expert Review of Cardiovascular Therapy - August 15, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Statin use in patients with diabetes: one drug, multiple benefits.
Authors: Katsiki N, Kotsa K, Athyros VG, Mikhailidis DP PMID: 31411083 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - August 15, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Coronary no reflow in the modern era: a review of advances in diagnostic techniques and contemporary management.
Authors: Kumar J, O'Connor CT, Kumar R, Arnous SK, Kiernan TJ Abstract Introduction: Atherosclerotic coronary artery disease, in particular acute myocardial infarction (AMI) is a leading cause of morbidity and mortality globally. Percutaneous coronary intervention (PCI) is the mainstay of treatment for obstructive coronary artery disease and AMI through the restoration of TIMI III flow. Despite good macrovascular flow, the myocardium can remain hypoperfusion due to poor microvascular perfusion, and this is referred to as "no-reflow". Various treatments have been studied with variable success in both preve...
Source: Expert Review of Cardiovascular Therapy - August 9, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Prevalence of comorbidities in heart failure patients and those treated with cellular therapeutics.
Authors: Broughton KM Abstract Introduction: Changes in our daily living, particularly in work routines, diet, and physical exercise, have influenced a worldwide crisis for life-threatening comorbidities and the likelihood of cardiovascular disease diagnosis. Cardiovascular regenerative medicine researchers continue to investigate new therapeutic approaches and reexamine completed clinical trials to design more effective future studies. As the frequency of cardiovascular disease diagnosis continues to rise, investigations of how to repair and regenerate the failing myocardium remains an essential mission for human ...
Source: Expert Review of Cardiovascular Therapy - August 8, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Aspirin for the primary prevention of cardiovascular disease: latest evidence.
This article aims to inform clinical practitioners by appraising the current body of evidence on the use of aspirin for primary CVD prevention, ranging from general pharmacology to clinical outcomes and future directions. Expert opinion: Based on meta-analyses incorporating latest trials in the field of primary prevention, the modest reduction in ischemic events with aspirin, if any, is offset by a modest increase in nonfatal bleeding. Improved control of CVD risk factors and broader use of statins may have reduced the thrombotic complications of atherosclerosis, thus limiting the opportunity for aspirin to prevent clinica...
Source: Expert Review of Cardiovascular Therapy - August 8, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Exercise training and cardiac rehabilitation in cardiovascular disease.
Authors: Kachur S, Lavie CJ, Morera R, Ozemek C, Milani R Abstract Introduction: The aim of this review is to introduce the audience to exercise training (ET) as a therapeutic tool in coronary heart disease (CHD) and to discuss the role of and advances in cardiac rehabilitation (CR) as a means of effectively delivering ET. Areas Covered: The physiological mechanisms behind ET effects on the cardiovascular (CV) system as well as the implementation of ET in CR and the effects of CR on CV morbidity, risk factor modification, and mortality will be reviewed. Additionally, the clinical and financial impact of CR in today...
Source: Expert Review of Cardiovascular Therapy - August 2, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Should all diabetic patients be on aspirin for primary prevention?
Authors: Khalil S, Darmoch F, Shah Z, Alraies MC PMID: 31311357 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - July 19, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Management of patients with concomitant coronary and carotid artery disease.
Authors: Drakopoulou M, Oikonomou G, Soulaidopoulos S, Toutouzas K, Tousoulis D Abstract Introduction: Ideal management of concomitant carotid and coronary artery occlusive disease remains under investigation. Although researchers have advocated the potential benefits of varying treatment strategies based on either concomitant or staged surgical treatment, there is no consensus in treatment guidelines among national or international clinical societies. With emerging data suggesting favorable outcome of carotid artery stenting (CAS) compared to carotid endarterectomy (CEA) in patients with critical coronary artery d...
Source: Expert Review of Cardiovascular Therapy - July 16, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

An aspirin a day? Clinical utility of aspirin therapy for the primary prevention of cardiovascular disease.
This article provides a critical appraisal of both past and present data for aspirin in the primary prevention setting. PubMed and Cochrane Central Register databases were searched from inception to May 1st, 2019. Expert opinion: The decision to initiate or withdraw aspirin for primary prevention requires an understanding of the equilibrium between efficacy and safety. In adults greater than 70 years of age, low to moderate cardiovascular risk, controlled diabetes, or at high risk of bleeding, initiation of aspirin for primary prevention should generally be avoided. Instead, risk factor modification should be prioritized. ...
Source: Expert Review of Cardiovascular Therapy - July 16, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Defining the role of peritoneal dialysis in management of congestive heart failure.
Authors: Kazory A, Bargman JM Abstract Introduction: Congestion is an integral component of heart failure (HF) pathophysiology and portends an adverse impact on outcome. Peritoneal dialysis (PD) is a home-based therapeutic modality that has been used in the setting of refractory congestive HF to help optimize volume status. Not only does PD allow for customized sodium and water removal, but it also provides the opportunity for the patients to fully benefit from guideline-directed medical therapy for HF that could have otherwise been challenging to use. Areas covered: Authors provide an overview of the pathophysiolo...
Source: Expert Review of Cardiovascular Therapy - June 29, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Vitamin D status, gender and cardiovascular diseases: a systematic review of prospective epidemiological studies.
Authors: Kouvari M, Panagiotakos DB Abstract Introduction: Vitamin D deficiency is highly suggested as an emerging risk factor in primary and secondary cardiovascular disease (CVD) prevention. However, there remains controversy regarding the need for vitamin D supplementation in high CVD risk individuals to prevent cardiac episodes and to achieve a better prognosis. Another literature gap is the potential existence of sex-specific associations of this factor with major CVD events or surrogate markers. The interaction of vitamin D and its metabolites with gene-mediated paths as well as lifestyle parameters sets the ...
Source: Expert Review of Cardiovascular Therapy - June 28, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Spontaneous coronary artery dissection: etiology and recurrence.
Authors: Tan NY, Tweet MS Abstract Introduction: Spontaneous coronary artery dissection (SCAD) is an increasingly appreciated cause of acute myocardial infarction (AMI) and sudden cardiac death most often affecting young to middle-aged women with few conventional cardiovascular risk factors. Areas covered: A literature search was performed using MedLine, PubMed, and Google Scholar (dating to 04/30/2019). Authors review the key clinical features of SCAD and highlight what is known regarding its pathophysiology and associated factors. The relationship between SCAD and other systemic vasculopathies, notably fibromuscu...
Source: Expert Review of Cardiovascular Therapy - June 26, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Peripheral artery disease: the new frontiers of imaging techniques to evaluate the evolution of regenerative medicine.
Authors: Miceli M, Baldi D, Cavaliere C, Soricelli A, Salvatore M, Napoli C Abstract Introduction: Stem cells (ESC, iPSC, MSC) are known to have intrinsic regenerative properties. In the last decades numerous findings have favored the development of innovative therapeutic protocols based on the use of stem cells (Regenerative Medicine/Cell Therapy) for the treatment of numerous diseases including PAD, with promising results in preclinical studies. So far, several clinical studies have shown a general improvement of the patient's clinical outcome, however they possess many critical issues caused by the non-randomize...
Source: Expert Review of Cardiovascular Therapy - June 23, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Transradial access versus transfemoral access: a comparison of outcomes and efficacy in reducing hemorrhagic events.
Authors: Cesaro A, Moscarella E, Gragnano F, Perrotta R, Diana V, Pariggiano I, Concilio C, Alfieri A, Cesaro F, Mercone G, Falato S, Esposito A, Di Girolamo D, Limongelli G, Calabrò P Abstract Introduction: The radial artery is currently the most widely used access site for PCI procedures both acute and stable patient settings. Thanks to advantages in pharmacological therapy as well as in interventional devices, the rate of ischemic complications following PCI has significantly decreased. Nevertheless, this has been counterbalanced by an increased risk of periprocedural and late bleeding event, that can occ...
Source: Expert Review of Cardiovascular Therapy - June 20, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Mitral stenosis in 2019: changing approaches for changing times.
Authors: Lloyd G, Badiani S, Costa M, Armado K, Bhattacharyya S PMID: 31195847 [PubMed - as supplied by publisher] (Source: Expert Review of Cardiovascular Therapy)
Source: Expert Review of Cardiovascular Therapy - June 16, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Antithrombotic pharmacotherapy after transcatheter aortic valve implantation: an update.
Authors: Greco A, Capranzano P, Barbanti M, Tamburino C, Capodanno D Abstract Introduction: Transcatheter aortic valve implantation (TAVI) is the treatment of choice for a large proportion of patients with severe aortic stenosis. Despite numerous technological and clinical advances, TAVI remains associated with thrombotic complications requiring antithrombotic pharmacotherapy, which exposes to the risk of bleeding, especially in elderly individuals. The optimal antithrombotic regimen following TAVI is uncertain and several investigations are ongoing. Areas covered: Clinical guidelines are mostly driven by observati...
Source: Expert Review of Cardiovascular Therapy - June 16, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Closing the gap on patent foramen ovale and cryptogenic stroke.
Authors: Darmoch F, Al-Khadra Y, Bacha HM, Soud M, Alraies MC Abstract Introduction: The treatment options for prevention of recurrent of cryptogenic stroke in patients with patent foramen ovale (PFO) have been intensely debated in the recent decades. The suggested options were percutaneous closure of PFO versus medical therapy. However, up to these date there is a controversy regarding the indication of percutaneous closure. Multiple meta-analysis and recent randomized control trials showed the benefit of PFO closure when compared with medical therapy alone. Areas covered: The article reviews the prevalence, physi...
Source: Expert Review of Cardiovascular Therapy - June 13, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Utility of preoperative exercise therapy in reducing postoperative morbidity after surgery; a clinical overview of current evidence.
This article gives an overview of the effects of PET in various surgical fields and also what to account for and expect of PET after various types of surgery. A comprehensive literature search was performed in Pubmed, Embase, Medline, Cochrane Library, and PEDro database (from the earliest date of each database to March 2019) using search words 'Preoperative Exercise Therapy', 'Physical Therapy' and 'surgery'. Secondly, the literature searches were modified depending on the surgical specialty. Expert opinion: Evidence is growing that preoperative exercise therapy in various surgical specialties is well tolerated and effect...
Source: Expert Review of Cardiovascular Therapy - June 12, 2019 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research