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Current Vascular Pharmacology

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https://www.readbyqxmd.com/read/28490313/radial-vs-femoral-approach-in-acute-coronary-syndromes-a-comprehensive-meta-analysis-of-randomized-trials
#1
Matteo Nardin, Monica Verdoia, Lucia Barbieri, Alon Schaffer, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Substantial improvements have been achieved with percutaneous coronary intervention (PCI) for the treatment of acute coronary syndromes (ACS). Nevertheless, bleeding still affects outcomes. The radial approach for PCI has shown important benefits on access site complications, but is still not achieving universal consensus as first choice in acute settings. Therefore, we performed a comprehensive meta-analysis of randomized trials comparing radial vs femoral approach in PCI for ACS...
May 4, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28464775/renoprotection-by-direct-renin-inhibition-a-systematic-review-and-meta-analysis
#2
Nikolaos Louvis, James Coulson
Even mild abnormalities of the renal structure or function can increase the risk of mortality and complications in other organs. Therefore, safe and effective treatments are necessary in order to influence the progression of renal disease. We used 2 methods to assess the renoprotective effects of aliskiren: 1) a statistical analysis of clinical trials that investigated aliskiren-induced renoprotection, in terms of changes in serum creatinine concentration (sCr) or estimated glomerular filtration rate (eGFR), and, 2) clinical trials that investigated the renoprotective effects of aliskiren with respect to changes in albuminuria or proteinuria...
May 1, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28462724/non-pharmacological-modulation-of-the-autonomic-nervous-system-for-heart-failure-treatment-where-do-we-stand
#3
Costas Tsioufis, Panayiotis Iliakis, Alexandros Kasiakogias, Dimitrios Konstantinidis, Dragan Lovic, Dimitrios Petras, Michalis Doumas, Eleftherios Tsiamis, Vasilios Papademetriou, Dimitrios Tousoulis
An imbalance in the autonomic nervous system (ANS) is a central pathophysiologic mechanism in heart failure (HF) and has been a principal target of treatment in these patients. Traditional pharmacologic agents do not provide specific modulation of discrete arms of the ANS, while side effects may lead to poor tolerance. Technological advances have provided a series of invasive methods that may provide a focused effect on the ANS in selected patient groups. Renal denervation, initially targeted for patients with resistant hypertension, has given positive preliminary results in terms of heart structure and function...
April 28, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28460626/capillary-degeneration-and-right-ventricular-remodeling-due-to-hypoxic-stress-with-sugen5416
#4
Eiki Woo, Ryuji Kato, Hideki Imano, Yuji Fujiwara, Yoshio Ijiri, Yoshikatsu Okada, Takehiro Yamaguchi, Yasukatsu Izumi, Minoru Yoshiyama, Takahiro Katsumata, Tetsuya Hayashi
BACKGROUND: Sugen5416 (semaxinib) is an inhibitor of the vascular endothelial growth factor (VEGF) receptor. A rat model of pulmonary arterial hypertension (PAH), created with Sugen5416 and chronic hypoxia, is known to have similar histological findings as those of PAH patients. OBJECTIVE: To evaluate the pathophysiological mechanisms of cardiac remodeling due to hypoxic stress with Sugen5416 in vivo. METHODS: Male Sprague-Dawley rats were exposed to hypoxia (10±1% O2) for 2 weeks after a single injection of Sugen5416 (SU-hypoxia group) or the vehicle (V-hypoxia group)...
April 27, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28462715/clinical-value-of-measuring-the-renin-aldosterone-levels-optimising-the-management-of-uncontrolled-resistant-hypertension
#5
Michalis Doumas, Chrysoula Boutari, Costas Tsioufis, Kyriakos Dimitriadis, Areti Triantafyllou, Stella Douma
Resistant hypertension (HT) is a common clinical entity with debilitating cardiovascular consequences. The highly heterogeneous nature of resistant HT requires a meticulous work-up to exclude 'pseudo-resistance' and secondary forms of arterial HT. Resistant HT has recently gained wide scientific interest due to the introduction of interventional methods (renal sympathetic denervation and carotid baroreceptor stimulation) for blood pressure (BP) reduction in this patient population. Despite however the recent advances in understanding the pathophysiology and the clinical characteristics of the disease, the appropriate management of resistant HT remains elusive...
April 26, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28462714/renal-denervation-therapy-can-it-contribute-to-better-blood-pressure-control-in-hypertension
#6
Costas Tsioufis, Kyriakos Dimitriadis, Athanasios Kordalis, Michalis Doumas, Dimitris Konstantinidis, Theodoros Kalos, Felix Mahfoud, Vasilios Papademetriou, Dimitrios Tousoulis
Although the first results from studies suggested important benefits regarding blood pressure (BP) control in resistant hypertension by the use of diverse systems of renal denervation (RDN) in the setting of resistant hypertension, the Symplicity HTN-3, randomized sham-controlled trial reduced the enthusiasm and led to a more critical approach towards this neuromodulation innovative therapy. Nowadays there is an ongoing research attempt to justify the pathophysiological background of RDN since overdrive of the sympathetic nervous system is one of the key mechanisms leading to the development and progression of the hypertensive and cardiovascular diseases...
April 26, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28413970/optimizing-the-management-of-uncontrolled-resistant-hypertension-the-importance-of-sleep-apnoea-syndrome
#7
Jacek Wolf, Krzysztof Narkiewicz
Obstructive sleep apnoea (OSA) constitutes the most prevalent form of abnormal respiratory control during sleep in adults. Evidence linked OSA to cardiovascular disease, and the role of OSA in abnormal blood pressure (BP) control has been extensively studied. Although longitudinal trials suggest a causative role of OSA in the development of hypertension, the evidence is not fully consistent. Nasal continuous positive airway pressure (nCPAP) applied during sleep is well documented and a highly efficient therapeutic aid to eliminate OSA...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28413969/optimizing-the-management-of-uncontrolled-hypertension-what-do-triple-fixed-dose-drug-combinations-add
#8
Costas Thomopoulos, Georgios Katsimagklis, Stefanos Archontakis, Georgios Skalis, Thomas Makris
Fixed-dose triple drug combinations represent one of the latest innovations of pharmacotherapy for hypertension (HT). They combine a traditional renin-angiotensin system blocker, a diuretic and a calcium channel blocker. The main benefit is the simplification of treatment regimen because 3 different agents are combined at different doses in a single pill. Improving adherence to treatment partly explains why this kind of combination may effectively reduce blood pressure (BP). BP lowering by a single-pill triple-drug combination can be approximately predicted, by using appropriate formulas described in previous meta-analysis of randomized trials...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28413968/hypertension-and-heart-failure-with-preserved-ejection-fraction-connecting-the-dots
#9
Costas Tsioufis, Georgios Georgiopoulos, Dimitrios Oikonomou, Costas Thomopoulos, Niki Katsiki, Alexandros Kasiakogias, Christina Chrysochoou, Dimitrios Konstantinidis, Theodoros Kalos, Dimitrios Tousoulis
Heart failure (HF) with preserved ejection fraction (EF) (HFpEF) accounts for approximately 50% of HF cases and its prevalence relative to HF with reduced EF is rising. Hypertension (HT) is the most common co-morbidity in HFpEF patients and it is implicated in both the pathogenesis and the prognosis of the disease. Therefore, HT is a modifiable risk factor of high yield in HFpEF. We reviewed the literature for epidemiologic data supporting the co-aggregation of the two entities as well as patho-physiologic mechanisms linking HT to HFpEF...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28413967/uncontrolled-hypertension-and-oncology-clinical-%C3%AE-ips
#10
Rigas G Kalaitzidis, Moses S Elisaf
Angiogenesis is fundamental for tumour development and progression. Thus, anti-angiogenic agents have been developed and are mainly vascular endothelial growth factor (VEGF) pathway inhibitors. However, these agents commonly exhibit cardiac and renal toxicity, proteinuria and hypertension (HT). In fact, with the use of anti-angiogenic agents a rapiddose-dependent increaseof blood pressure (BP) is observed. Thepossible mechanisms of VEGF inhibitors-induced HTinclude systemic endothelial dysfunction, renal impairment as well as vascular micro- and macroangiopathy...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28413966/the-clinical-problems-of-hypertension-treatment-in-hemodialysis-patients
#11
Charalampos N Loutradis, Costas Tsioufis, Pantelis A Sarafidis
Hypertension (HT) is present in more than 80% of patients undergoing hemodialysis (HD). Elevated blood pressure (BP) in hemodialysis patients is associated with cardiovascular events and mortality only when BP is recorded with home or ambulatory monitoring, since pre- and post-dialysis measurements are not valid estimates of BP levels during the inter-dialytic interval. Sodium and water overload is the most important of several mechanisms involved in HT development in HD. In this context, non-pharmacologic measures to ensure water and sodium balance by achieving patient dry weight and decreasing daily sodium intake, through modification of sodium level in the diet or in dialysis dialysate, are fundamental for HT control...
April 14, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28412912/the-socioeconomic-effects-of-uncontrolled-hypertension
#12
Kostas Athanasakis
Hypertension (HT), albeit a modifiable risk factor of cardiovascular morbidity and mortality, remains one of the main contributors to the total disease burden internationally and, thus, inevitably one of the basic cost drivers in healthcare systems. Taking the above into account, this brief narrative review aims at presenting the main findings of the international health economics literature on HTwith regards to four key areas: a) the costs attributable to HT, b) the effects of HTon patient well-being, c) the cost-effectiveness of pharmaceutical interventions against high blood pressure, and, d) the costs and benefits of preventive measures against HT...
April 13, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28412911/pharmacological-therapy-of-abdominal-aortic-aneurysm-an-update
#13
Yi-Dong Wang, Zhen-Jie Liu, Jun Ren, Mei-Xiang Xiang
Abdominal aortic aneurysm (AAA), a progressive segmental abdominal aortic dilation, is associated with high mortality. AAA is characterized by inflammation, smooth muscle cell (SMC) depletion and extracellular matrix (ECM) degradation. Surgical intervention and endovascular therapy are recommended to prevent rupture of large AAAs. Unfortunately, there is no reliable pharmacological agent available to limit AAA expansion. In the past decades, extensive investigations and a body of ongoing clinical trials aimed at defining potent treatments to inhibit and even regress AAA growth...
April 13, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28393705/antithrombotic-therapy-for-transcatheter-valvular-interventions-a-revisit
#14
Shaban Mohammed, Ayman El-Menyar, Haifa Al-Janubi, Adel Shabana, Zaid Alanazi
The optimal antithrombotic therapies for transcatheter aortic valve implantation (TAVI) and MitraClip implantation have not been well established. We conducted a narrative review from currently available studies between January 2002 and May 2016 to highlight the advantages and disadvantages of antithrombotic therapy use in cardiac catheter-based therapeutic techniques. Recently, these techniques have dramatically altered the approach towards valvular heart diseases management. The introduction into clinical practice, of TAVI for severe aortic stenosis and MitraClip for mitral regurgitation, has revolutionized interventional cardiology...
April 6, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28393707/relationship-of-high-sensitivity-c-reactive-protein-concentrations-and-systolic-heart-failure
#15
Sheng Kang, Lie-Ying Fan, Ming Chen, Jue Li, Zhong-Min Liu
Objective Excessive activated proinflammatory cytokines may promote extracellular matrix alterations which induce adverse left ventricular remodeling in systolic heart failure (SHF). We sought to identify whether high-sensitivity C-reactive protein (hsCRP) levels were independently associated with SHF. Methods In our retrospective case-control study, 2236 subjects were included, and 260 patients had SHF. Blood sample collection, clinical laboratory tests, electrocardiogram and echocardiography examinations were performed...
April 4, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28393706/ultrasound-assisted-catheter-directed-thrombolysis-in-high-risk-and-intermediate-high-risk-pulmonary-embolism-a-meta-analysis
#16
Cihangir Kaymaz, Özgür Yaşar Akbal, Ibrahim Halil Tanboğa, Aykun Hakgör, Fatih Yilmaz, Selçuk Öztürk, Nertila Poçi, Sevim Türkday, Nihal Özdemir, Stavros Konstantinides
Catheter-directed Ultrasound-Assisted Thrombolysis (USAT) is a novel technology providing a high efficacy with a reduced bleeding risk in patients with pulmonary embolism (PE). We performed a meta-analysis based on presented or published PE series in which USAT was utilized. We searched the MEDLINE, EMBASE and the Cochrane Library for trials published up to December 2015. The primary outcomes were mean pulmonary artery pressure (PAMP), right to left ventricle diameter ratio (RV/LV ratio) and computed tomography (CT) obstruction score...
April 4, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28356033/a-glycation-angle-to-look-into-the-diabetic-vasculopathy-cause-and-cure
#17
Saheem Ahmad, Zeba Siddiqui, Shahnawaz Rehman, Mohd Yasir Khan, Hamda Khan, Sheeba Khanum, Sultan Alouffi, Mohd Saeed
The process of advanced glycation, which is accelerated in diabetes as a result of chronic hyperglycemia and increased oxidative stress, has been suggested to play a vital role in the diabetic complications. Extensive intracellular and extracellular generation and accumulation of advanced glycation end products (AGEs) have been linked to increased risk for microvascular and macrovascular injuries in diabetes. AGEs result from the nonenzymatic reaction of reducing sugars with proteins, lipids, and nucleic acids, potentially altering their function...
March 27, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28294047/klotho-fgf23-cardiovascular-disease-and-vascular-calcification-black-or-white
#18
Giuseppe Cianciolo, Andrea Galassi, Irene Capelli, Roberto Schillaci, Gaetano La Manna, Mario Cozzolino
Patients affected by Chronic Kidney Disease and Mineral Bone Disorder (CKD-MBD) have a high risk of cardiovascular (CV) mortality that is poorly explained by traditional risk factors. The newest medical treatments for CKD-MBD have been associated with encouraging, but still inconsistent, improvement in CV disease complications and patient survival. A better understanding of the biomarkers and mechanisms of left ventricular hypertrophy (LVH), atherosclerosis, and vascular calcification (VC) may help with diagnosis and treatment of the organ damage that occurs secondary to CKD-MBD, thus improving survival...
March 9, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28260516/wounds-difficult-to-heal-an-effective-treatment-strategy
#19
Raffaele Capoano, Rita Businaro, Maria Chiara Tesori, Claudia Donello, Federica Lombardo, Vincenza Rita Lo Vasco, Lorena Capriotti, Mariangela Corsi, Tania Di Raimo, Martina Leopizzi, Bruno Salvati, Serafino Ricci
OBJECTIVE: Treatment of wounds difficult to heal concerns 50% of the elderly population in Italy and is therefore an extreme relevance social burden. The present study shows how the treatment with autologous leuco-platelets reduces the healing time of wounds improving the functional recovery. PATIENTS AND METHODS: One hundred patients with ulcers of the legs were divided in two groups: 1) 50 patients treated with conventional therapies; 2) 50 patients treated with autologous leuco-platelet concentrate (LPC) and HYAFF as a scaffold...
March 1, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28245773/low-density-lipoprotein-cholesterol-ldl-c-how-low
#20
Thomas F Whayne
Low-density lipoprotein cholesterol (LDL-C) is a well-established major cardiovascular (CV) risk factor supported by clinical evidence showing decreased atherosclerotic disease events when LDL-C is therapeutically lowered. A reasonable approach is to tailor each patient's LDL-C target level depending on the initial LDL-C level and the perceived risk. Multiple clinical entities such as the newborn, hypobetalipoproteinemia, proprotein convertase subtilisin/kexin type 9 (PCSK9) missense mutations, and an unexpected excess response to a statin or other medications, are associated with very low LDL-C levels in otherwise healthy individuals...
February 26, 2017: Current Vascular Pharmacology
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