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Stroke Prevention with Extracranial Carotid Artery Disease
This article reviews contemporary treatments for carotid artery stenosis, the underlying evidence, and areas of uncertainties.Recent FindingsSpecific recommendations are available to guide the standard of care of carotid artery stenosis. Nonetheless, significant uncertainties are noted in patient selection for surgical treatment of asymptomatic carotid stenosis and in optimal treatment targets for pharmacological therapies. Advanced imaging has been used to predict future risk of ipsilateral stroke and clarify mechanisms of actions of pharmacological therapies, primarily in observational studies.SummaryPharmacological and ...
Source: Current Cardiology Reports - October 1, 2021 Category: Cardiology Source Type: research

Stroke Prevention After Intracerebral Hemorrhage: Where Are We Now?
The objective of this article is to review the current guidelines on stroke prevention measures after ICH as well as the new findings and controversies for future guidance.Recent FindingsIntensive blood pressure reduction might benefit ICH survivors significantly. Cholesterol levels and the risk of ICH have an inverse relationship, but statin therapy after ICH might be still beneficial. Anticoagulation in atrial fibrillation after ICH specifically with novel oral anticoagulants may be associated with better long-term outcomes. Left atrial appendage occlusion may be an alternative for stroke prevention in ICH survivors with...
Source: Current Cardiology Reports - October 1, 2021 Category: Cardiology Source Type: research

The Global Impact of Rheumatic Heart Disease
AbstractPurpose of ReviewRheumatic heart disease (RHD) is a neglected disease of poverty, which presents challenges for patients, communities, and health systems. These effects are magnified in low resource countries, which bear the highest disease burden. When considering the impact of RHD, it is imperative that we widen our lens in order to better understand how RHD impacts the over 40 million people currently living with this preventable condition and their communities. We aimed to perform an updated literature review on the global impact of RHD, examining a broad range of aspects from disease burden to impact on health...
Source: Current Cardiology Reports - October 1, 2021 Category: Cardiology Source Type: research

Stroke Prevention with Extracranial Carotid Artery Disease
This article reviews contemporary treatments for carotid artery stenosis, the underlying evidence, and areas of uncertainties.Recent FindingsSpecific recommendations are available to guide the standard of care of carotid artery stenosis. Nonetheless, significant uncertainties are noted in patient selection for surgical treatment of asymptomatic carotid stenosis and in optimal treatment targets for pharmacological therapies. Advanced imaging has been used to predict future risk of ipsilateral stroke and clarify mechanisms of actions of pharmacological therapies, primarily in observational studies.SummaryPharmacological and ...
Source: Current Cardiology Reports - October 1, 2021 Category: Cardiology Source Type: research

A Clinical Update on Antiplatelet Therapy in Secondary Prevention of Ischemic Stroke
AbstractPurpose of ReviewAntiplatelet therapy remains the standard of care in secondary stroke prevention for non-cardioembolic ischemic stroke and transient ischemic attack. We aim to examine the use of antiplatelet agents in secondary prevention through highlighting relevant clinical trials and meta-analyses as well as providing commentary regarding our practice.Recent FindingsIn the POINT and CHANCE trials, dual antiplatelet therapy reduced recurrent stroke compared to aspirin monotherapy. Sub-analyses of these trials suggest that genetic polymorphisms could play a role in diminishing the effectiveness of clopidogrel. S...
Source: Current Cardiology Reports - August 19, 2021 Category: Cardiology Source Type: research

Cardiovascular Toxicity of Androgen Deprivation Therapy
AbstractPurpose of ReviewAndrogen deprivation therapy (ADT) is the standard of care for the treatment of advanced prostate cancer (PC). ADT, particularly with GnRH agonists, leads to increased risk of cardiovascular disease, including myocardial infarction, hypertension, and stroke. This review discusses the options of ADT, the mechanism of ADT-associated cardiovascular side effects, and potential benefit by using GnRH antagonists.Recent FindingsGnRH antagonists have relatively less cardiovascular adverse effects compared to GnRH agonists. We highlight on a recently published phase III clinical trial on the oral GnRH antag...
Source: Current Cardiology Reports - July 3, 2021 Category: Cardiology Source Type: research

Prognostic Significance of Echocardiographic Measures of Cardiac Remodeling in the Community
AbstractPurpose of ReviewEchocardiography is a noninvasive tool of choice for evaluating cardiac structure and function in numerous cardiac conditions ranging from congenital heart disease, myocardial diseases, coronary artery disease (CAD), valvulopathies, arrhythmias, and pericardial disorders. We review the prognostic significance of echocardiographic indices of cardiac remodeling in the general population.Recent FindingsRecent meta-analyses have confirmed the prognostic significance of echocardiographic measurements (left ventricular mass/hypertrophy, systolic and diastolic dysfunction, left atrial dimensions and funct...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Therapeutic Outcomes with Surgical and Medical Management of Primary Aldosteronism
AbstractPurpose of ReviewPrimary aldosteronism (PA) is the most common cause of secondary hypertension and is significantly under-diagnosed. Delays in diagnosis and treatment can lead to cardiovascular morbidity and mortality. The goal of this study is to review the management of PA, with a focus on medical and surgical treatment outcomes.Recent FindingsPA causes cardiovascular dysfunction in excess of degree of hypertension. Adrenalectomy demonstrates a therapeutic advantage over mineralocorticoid antagonist (MRA) therapy, after controlling for degree of hypertension and subtype of PA. Higher rates of atrial fibrillation,...
Source: Current Cardiology Reports - June 3, 2021 Category: Cardiology Source Type: research

Role of Telemedicine in Prehospital Stroke Care
AbstractPurpose of ReviewTo summarize evidence for the feasibility and the efficacy of mobile stroke units (MSUs) and telemedicine in the field to reduce time delays in offering acute stroke interventions.Recent FindingsA mobile stroke unit is a modified ambulance and includes sophisticated equipment, either trained personnel on board, or connection with skilled physicians via telemedicine. Stroke assessment and treatment agreeability between the on board and remote neurologist is high in MSUs. MSUs are the promising option to reduce stroke symptom onset to treatment time; telemedicine platform has a satisfactory audiovisu...
Source: Current Cardiology Reports - May 10, 2021 Category: Cardiology Source Type: research

Olive Oil Intake and Cardiovascular Disease Prevention: “Seek and You Shall Find”
AbstractPurpose of ReviewThe present narrative review focuses on the up-to-date clinical data on the correlations between olive oil consumption and cardiovascular (CV) diseases (i.e., CHD, stroke, and peripheral artery disease).Recent FindingsOlive oil contains monounsaturated fats, several antioxidant phenols, and other micronutrients that mediate CV-protective effects via improvements in oxidative stress, endothelial dysfunction, inflammation, thrombosis, blood pressure, and lipid and carbohydrate metabolism. High consumption of olive oil, and in particular the extra-virgin, which is rich in phenolic antioxidants, has be...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Impact of Early Blood Pressure Lowering in Patients Presenting with Acute Ischemic Stroke
AbstractPurpose of ReviewIn this review article we will discuss the acute hypertensive response in the context of acute ischemic stroke and present the latest evidence-based concepts of the significance and management of the hemodynamic response in acute ischemic stroke.Recent FindingsAcute hypertensive response is considered a common hemodynamic physiologic response in the early setting of an acute ischemic stroke. The significance of the acute hypertensive response is not entirely well understood. However, in certain types of acute ischemic strokes, the systemic elevation of the blood pressure helps to maintain the colla...
Source: Current Cardiology Reports - May 7, 2021 Category: Cardiology Source Type: research

Stroke Rates Following Surgical Versus Percutaneous Revascularization for Ischemic Heart Disease
AbstractPurpose of ReviewCoronary revascularization is a commonly performed major procedure in the hospitals. Stroke is one of the dreaded complications after coronary revascularization procedures. The focus of this review is to understand the stroke risk in percutaneous cutaneous intervention (PCI) and coronary artery bypass grafting (CABG) procedures.Recent FindingsAvailable data show that PCI offers less procedural stroke risk compared to CABG although the survival benefits of CABG are better in certain scenarios. Innovative advancements in techniques, pre-procedural optimum medical therapy (OMT), intraoperative neuro-m...
Source: Current Cardiology Reports - March 15, 2021 Category: Cardiology Source Type: research

Direct Oral Anticoagulant Use in Special Populations: Elderly, Obesity, and Renal Failure
AbstractPurpose of ReviewThe purpose of this review is to examine the safety and effectiveness of direct oral anticoagulants and provide recommendations for the treatment of venous thromboembolism and atrial fibrillation in obese patients, elderly patients, and patients with chronic kidney disease.Recent FindingsMultiple retrospective cohort studies have shown no difference in bleeding, stroke, or venous thromboembolism outcomes between DOACs and warfarin in patients who are obese, elderly, or those with chronic kidney disease or on dialysis. Some studies have shown that DOACs have a lower bleeding risk than warfarin in th...
Source: Current Cardiology Reports - March 2, 2021 Category: Cardiology Source Type: research

Update on the Inflammatory Hypothesis of Coronary Artery Disease
AbstractPurpose of ReviewThe pathogenesis and progression of coronary artery disease (CAD) is now known to be largely driven by inflammation on top of the well-accepted role for the disequilibrium between cholesterol deposition and removal from the arterial wall. Recent clinical trials have supported the inflammatory hypothesis of CAD and will be discussed in this review.Recent FindingsThe clinical trial Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS) found that treatment with canakinumab, an anti-interleukin-1 β agent, resulted in a reduction in non-fatal myocardial infarction, non-fatal stroke, or death...
Source: Current Cardiology Reports - January 6, 2021 Category: Cardiology Source Type: research

Risks and Benefits of Removal of the Left Atrial Appendage
AbstractPurpose of ReviewIn patients with atrial fibrillation who are unable to take novel oral anticoagulants for stroke prophylaxis due to bleeding risk or other contraindications, left atrial appendage (LAA) occlusion and exclusion devices have shown benefit. In this review, we highlight the risks and benefits associated with LAA removal.Recent FindingsLAA, once considered a vestigial organ, has been shown to have physiological, anatomical, and arrhythmogenic properties. Device-related complications such as pericardial effusion, device embolization, device-related thrombus, while uncommon, are still present. With increa...
Source: Current Cardiology Reports - September 9, 2020 Category: Cardiology Source Type: research

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