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Cardiovascular Drugs and Therapy

Venu Gopal Jonnalagadda, Harish Prabhanna Char, Praveen Kumar Ankana
No abstract text is available yet for this article.
March 7, 2018: Cardiovascular Drugs and Therapy
Yochai Birnbaum, Mandeep Bajaj, Hsiu-Chiung Yang, Yumei Ye
BACGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase-4 inhibitors (DPP4I) are used to treat type 2 diabetes (T2DM). DPP4 inhibitors (DPP4) attenuate Nlrp3 inflammasome activation in the kidney. SGLT2 inhibition reduces inflammation and attenuates the progression of diabetic nephropathy (DN). The effects of dapagliflozin (Dapa) on the activation of the Nlrp3 inflammasome and the combined effect of SGLT2 and DPP4 on T2DM-induced inflammasome activation and progression of DN have not been previously studied...
March 5, 2018: Cardiovascular Drugs and Therapy
Runlin Gao, Yongjian Wu, Hengliang Liu, Guohai Su, Zuyi Yuan, Aidong Zhang, Yong Wang, Zhirong Wang, Yan Wang, Huanyi Zhang, Yang Zheng, Lei Liu, Lijun Shen, Maria Leonsson-Zachrisson, Yaling Han
PURPOSE: Ticagrelor is an orally administered, reversibly binding, direct-acting P2Y12 receptor antagonist previously evaluated in several phase III trials. This phase IV, multicenter, single-arm trial assessed the safety and incidence of cardiovascular (CV) events with ticagrelor in Chinese patients experiencing an acute coronary syndrome (ACS). METHODS: Patients hospitalized with an ACS received ticagrelor (180 mg loading dose, 90 mg twice daily thereafter) plus low-dose aspirin (75-100 mg/day) for up to 12 months...
February 28, 2018: Cardiovascular Drugs and Therapy
Xiaoming Jia, Mahboob Alam, Yumei Ye, Mandeep Bajaj, Yochai Birnbaum
PURPOSE: The aim of this study is to examine the cardioprotective properties of Glucagon-like peptide-1 receptor agonist, a class of antihyperglycemic therapy, via meta-analysis of four recently published cardiovascular outcomes trials. METHODS: Meta-analysis was performed pooling data from the ELIXA, LEADER, SUSTAIN-6 and EXSCEL trials. A random effects model was used to generate risk ratio with 95% confidence interval for cardiovascular and safety outcomes. RESULTS: A total of 33,457 patients were included in the meta-analysis...
February 14, 2018: Cardiovascular Drugs and Therapy
Andrew S Tseng, Reema D Patel, Heidi E Quist, Adrijana Kekic, Jacob T Maddux, Christopher B Grilli, Fadi E Shamoun
PURPOSE: There is growing interest in the use of pharmacogenomics to optimize the safety and efficacy of anticoagulation therapy. While the pharmacogenomics of warfarin have been well-studied, the pharmacogenomics of direct oral anticoagulants (DOACs) continue to be a fledgling, but growing, field of interest. We present a pertinent clinical review of the present state of research on the pharmacogenomics of DOACs. METHODS AND RESULTS: The present article is a review of pertinent clinical and scientific research on the pharmacogenomics of DOACs between January 2008 and December 2017 using MEDLINE and the United States National Institutes of Health Clinical Trials Registry...
February 13, 2018: Cardiovascular Drugs and Therapy
Shinichiro Ueda, Michio Shimabukuro, Osamu Arasaki, Koichi Node, Takashi Nomiyama, Takeshi Morimoto
BACKGROUND: Reduction of low-density lipoprotein cholesterol (LDL-C) is important for patients with a high risk for atherosclerotic events, such as patients with diabetes and other risk factors. Anagliptin was reported to reduce LDL-C for 12 weeks in phase III trials regardless of the use of statins, but it is uncertain whether this effect is common to other dipeptidylpeptidase-4 (DPP-4) inhibitors. METHODS: A multicenter, randomized, open-label, parallel-group trial was conducted to confirm the superiority of anagliptin to sitagliptin in terms of the primary endpoint of reduction of LDL-C for 52 weeks in patients with type 2 diabetes and atherosclerotic vascular lesions, as well as the non-inferiority of anagliptin to sitagliptin in terms of change in hemoglobin A1c (HbA1c)...
February 12, 2018: Cardiovascular Drugs and Therapy
Kuixiang Chen, Mubarak Rekep, Wei Wei, Qian Wu, Qin Xue, Sujuan Li, Jiahui Tian, Quan Yi, Genshui Zhang, Guiping Zhang, Qing Xiao, Jiandong Luo, Yinghua Liu
PURPOSE: Quercetin, a flavonoid, has been reported to ameliorate cardiovascular diseases, such as cardiac hypertrophy. However, the mechanism is not completely understood. In this study, a mechanism related to proteasome-glycogen synthesis kinase 3 (GSK-3) was elucidated in rats and primary neonatal cardiomyocytes. METHODS: Rats were subjected to sham or constriction of abdominal aorta surgery groups and treated with or without quercetin for 8 weeks. Angiotensin II (Ang II)-induced primary cardiomyocytes were cultured with quercetin treatment or not for 48 h...
February 12, 2018: Cardiovascular Drugs and Therapy
Diogo de Almeida Fernandes, Natália António, Marta Madeira, Pedro Sousa, Miguel Ventura, João Cristóvão, José Nascimento, Luís Elvas, Lino Gonçalves, Guilherme Mariano Pego
PURPOSE: Brugada syndrome is a hereditary disease linked with an increased risk of sudden death that may require an implantable cardioverter-defibrillator (ICD) in order to halt the arrhythmic events. The aim of this study was to identify possible triggers for appropriate ICD therapies in patients with Brugada syndrome, focusing on their past and current therapeutic profiles. METHODS: Thirty patients with high-risk Brugada syndrome, with ICD implanted at the Coimbra Hospital and University Center, were enrolled...
January 25, 2018: Cardiovascular Drugs and Therapy
Juan Tamargo, Ricardo Caballero, Eva Delpón
Hyperkalemia (serum potassium > 5.5 mEq/L) is a common clinical problem in patients with chronic kidney disease, hypertension, diabetes, and heart failure. It can result from increased K+ intake, impaired distribution between intracellular and extracellular spaces, and most frequently, decreased renal excretion. Patients at the highest risk of hyperkalemia are treated with renin-angiotensin-aldosterone system inhibitors (RAASIs) as they improve cardiovascular and renal outcomes and are strongly recommended in clinical guidelines...
January 25, 2018: Cardiovascular Drugs and Therapy
Evangelos Kaltsas, George Chalikias, Dimitrios Tziakas
Acute kidney injury (AKI) is one of the most common complications during hospitalization in various clinical settings. The goal of this review was to assess the incidence of AKI in acute myocardial infarction patients (AMI), how this incidence is affected by the diverse definitions, and if there is variability in the reported rates over recent years. Additionally, we sought to appraise the impact of AKI on short- and long-term prognosis of these patients. Finally, we report on the current preventive measures as they are suggested in the current guidelines of various societies, we comment on the evidence that support them, and we review the literature for other proposed therapeutic strategies, which either failed to prove their efficacy or they are not adequately confirmed yet...
January 19, 2018: Cardiovascular Drugs and Therapy
Ken Lee Chin, Rory Wolfe, Christopher M Reid, Andrew Tonkin, Ingrid Hopper, Angela Brennan, Nick Andrianopoulos, Stephen J Duffy, David Clark, Andrew Ajani, Danny Liew
PURPOSE: The effectiveness of statins in improving clinical outcomes among patients with heart failure (HF) undergoing percutaneous coronary intervention (PCI) is unclear. We examined the association between use of statins and clinical outcomes in patients with HF included in the Melbourne Interventional Group registry. METHODS: Patients were followed from 30 days to 1 year post-PCI for a primary composite outcome of all-cause mortality and hospitalisation for cardiovascular (CV) causes...
January 18, 2018: Cardiovascular Drugs and Therapy
Ken Lee Chin, Marina Skiba, Christopher M Reid, Andrew Tonkin, Ingrid Hopper, Justin A Mariani, Danny Liew
PURPOSE: Previous studies on the 'treatment gap' in patients with heart failure (HF) have focused either on prescribing or patients' adherence to prescribed treatment. This study sought to determine whether or not recent initiatives to close the gap have also minimised any mismatches between physicians' expectation of their patients' medications, medications in the patients' possession and their actual medication use. METHODS: A cross-sectional observational survey was conducted from December 2015 to June 2016 in The Alfred Hospital HF clinic in Melbourne, Australia...
January 9, 2018: Cardiovascular Drugs and Therapy
Teresa N Harrison, Jin-Wen Y Hsu, Robert S Rosenson, Emily B Levitan, Paul Muntner, T Craig Cheetham, Rong Wei, Ronald D Scott, Kristi Reynolds
PURPOSE: A substantial percentage of patients report intolerance or side effects of statin treatment leading to treatment changes or discontinuation. The purpose of this study was to examine statin therapy changes and subsequent effects on low-density lipoprotein cholesterol (LDL-C) among patients with statin intolerance (SI). METHODS: We identified 45,037 adults from Kaiser Permanente Southern California with SI documented between 2006 and 2012. Changes in statin therapy in the year before and after the SI index date were examined...
February 2018: Cardiovascular Drugs and Therapy
Min-Shan Tsai, Chao-Hsiun Tang, Chia-Ying Lin, Po-Ya Chuang, Nai-Chuan Chen, Chien-Hua Huang, Wei-Tien Chang, Tzung-Dau Wang, Ping-Hsun Yu, Wen-Jone Chen
BACKGROUND: In patients already receiving combination of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) and calcium channel blocker (CCB), whether the choice of additional diuretic or beta-blocker affects the cardiovascular and cerebrovascular outcomes remains unclear. METHODS: A total of 13,551 patients who were concurrently receiving three anti-hypertensive agents of different classes through outpatient clinics during 2004-2006 were identified from the National Health Insurance Research Database of Taiwan...
December 2017: Cardiovascular Drugs and Therapy
Yumei Ye, Sven Nylander, Yochai Birnbaum
PURPOSE: We explored the effects of rosuvastatin, aspirin, ticagrelor, and clopidogrel, alone or in combinations on the progression of atherosclerosis and inflammasome activation in diabetic mice. Statins and ticagrelor increase the production of 15-epi-lipoxin A4 via cyclooxygenase-2. Aspirin alone increases 15-epi-lipoxin A4 , but when combined with statins, cyclooxygenase-2 is completely blocked. METHODS: ApoE-/- /db+ /db+ double-knockout mice received rosuvastatin (5 mg/kg/day), aspirin (25 mg/kg/day), ticagrelor (300 mg/kg/day), clopidogrel (75 mg/kg/day), or their combination for 14 weeks...
December 2017: Cardiovascular Drugs and Therapy
Emily B Levitan, Melissa K Van Dyke, Matthew Shane Loop, Ronan O'Beirne, Monika M Safford
PURPOSE: For patients with heart failure with reduced ejection fraction (HFrEF), guidelines recommend use of beta-blockers with gradual up-titration. However, many patients with HFrEF do not use beta-blockers and up-titration is rare. Our purpose was to identify and rank barriers to beta-blocker use and up-titration from the perspective of primary care physicians. METHODS: We conducted 4 moderated, structured group discussions among 19 primary care physicians using the nominal group technique; 16 participants also completed a survey...
December 2017: Cardiovascular Drugs and Therapy
Denis V Abramochkin, Vladislav S Kuzmin, Leonid V Rosenshtraukh
PURPOSE: A new class III antiarrhythmic drug niferidil (RG-2) has been introduced as a highly effective therapy for cases of persistent atrial fibrillation, but ionic mechanisms of its action are poorly understood. In the present study, the effects of niferidil on action potential (AP) waveform and potassium currents responsible for AP repolarization were investigated in guinea pig atrial myocardium. METHODS: APs were recorded with sharp glass microelectrodes in multicellular atrial preparations...
December 2017: Cardiovascular Drugs and Therapy
Roy O Mathew, Joshua Schulman-Marcus, Elizabeth L Nichols, Jonathan D Newman, Sripal Bangalore, Michael Farkouh, Mandeep S Sidhu
Chelation therapy, typically used to remove heavy metal toxins, has also been controversially used as a treatment for coronary artery disease. The first Trial to Assess Chelation Therapy (TACT) aimed to provide evidence on chelation therapy's potential for benefit or harm. Although TACT had some significant results, the trial does not provide enough evidence to recommend routine chelation therapy and has limitations. The second TACT was recently funded reigniting a discussion about the value of chelation therapy, its efficacy, and allocation of research resources...
December 2017: Cardiovascular Drugs and Therapy
Vincent Roule, Katrien Blanchart, Xavier Humbert, Damien Legallois, Adrien Lemaitre, Paul Milliez, Farzin Beygui, Joachim Alexandre
BACKGROUND: Patients over 75 account for more than one third of those presenting with myocardial infarction and more than 50% of intrahospital mortality. There are no specific guidelines for the management of acute coronary syndromes (ACS) in the elderly. SETTING: Although antithrombotic therapy seems to be effective and safe in such patients, it requires specific precautions and treatment adjustments because of the higher bleeding risk due to comorbidities such as renal function impairment and malnutrition...
December 2017: Cardiovascular Drugs and Therapy
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