|
|
- Meta-analysis of the Effect of Semaglutide on Blood Pressure in Obese
Populations-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Objective The aim was to systematically evaluate the effect of semaglutide on blood pressure in obese populations using meta-analysis methods. Methods Randomized controlled trials on the effect of semaglutide on blood pressure regulation published from the inception of the databases to October 2024 were searched for in PubMed, Embase, the Cochrane Library, and Web of Science. Stata software was used for statistical analysis of the outcome measures in all included studies. Egger’s test was applied to assess the risk of publication bias. Results A total of 22 studies involving 15,347 participants were included in this meta-analysis. The results showed that, compared to the control group, the semaglutide group significantly reduced systolic blood pressure (SBP) (mean difference [MD] − 2.90, 95% confidence interval [CI] − 3.70 to − 2.11; P
PubDate: 2025-06-10
- Efficacy of Landiolol for Treatment of Sepsis-Related Tachyarrhythmia:
Lost in Translation-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
PubDate: 2025-06-08
- Emerging Role of Weight-Loss Medications in the Management of Heart
Failure: Current Evidence and Future Perspectives-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Heart failure is a major global health concern as it contributes to high rates of mortality and morbidity, with high rates of hospitalizations. The most prevalent risk factor or comorbidity of heart failure is obesity, which not only worsens and exacerbates disease progression and the course of illness, it also reduces its prognosis. Weight management is still not well addressed, even with major advancements in heart failure pharmacotherapies. Recent advances in weight-loss medications such as glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, and other novel anti-obesity drugs have sparked interest in their potential to improve clinical outcomes for patients with heart failure, especially those who also have obesity-related cardiac dysfunction. Weight-loss medications benefit heart failure by reducing adiposity-related inflammation, myocardial stress, and remodeling. These effects are auspicious in heart failure with preserved ejection fraction, where obesity-driven mechanisms play a critical role. These medications have been demonstrated to help with weight reduction, improve heart failure symptoms, and reduce hospitalization rates. However, questions about their long-term safety, particularly in patients with severe heart failure, are still being researched. The purpose of this review is to summarize the current evidence on the safety and effectiveness of weight-loss medications in the treatment of heart failure, describe their mechanisms of action, and highlight knowledge gaps that require further research.
PubDate: 2025-05-28
- Appraisal of β-Blocker Use in Patients with Cardiovascular Disease and
Chronic Obstructive Pulmonary Disease-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: β-blockers are a fundamental component of cardiovascular disease (CVD) management, while β2-agonists are used to treat chronic obstructive pulmonary disease (COPD). Current guidelines recommend that these conditions be treated as usual, even when they coexist. However, there have been concerns over COPD exacerbation risk with β-blockers and attenuation of the beneficial effects of β2-agonists in this comorbid population, leading to β-blocker underuse. Recent evidence suggests that β-blockers, particularly cardioselective β-blockers, do not increase COPD exacerbations, demonstrate good efficacy and safety, and improve survival in patients with COPD after first-time myocardial infarction. In atrial fibrillation with COPD, both cardioselective and nonselective β-blockers may be associated with a lower COPD exacerbation risk than calcium channel blockers, as well as improving outcomes and reducing mortality risk. In this review, we summarize the β-blocker prescribing patterns in patients with CVD and COPD; describe the reasons for β-blocker underuse in patients with CVD with COPD; collate up-to-date evidence on the effects of β-blockers on symptoms and outcomes in each of these comorbid populations; and review the current treatment guidelines for coexisting COPD and CVD to support the rational prescribing of β-blockers. Finally, we provide recommendations for future research needed to demonstrate the clinical rationale of prescribing β-blockers and to encourage the generation of more robust evidence-based guidelines for β-blockers use. Future large-scale, prospective, randomized controlled trials are needed to expand the body of evidence and better understand the effects of β-blockers in CVD with comorbid COPD.
PubDate: 2025-04-19
- Chronotherapy for Hypertension: A Meta-Analysis and Systematic Review of
RCTs-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Aim The aim of this study was to evaluate the efficacy of chronotherapy for patients with essential hypertension with a range of clinical characteristics. Methods We searched the PubMed, EMBASE, and Cochrane Library databases for randomized controlled trials of antihypertensive therapies in which patients were randomized to morning or evening administration. The primary outcomes of the included studies were ambulatory blood pressure (BP) parameters and patient characteristics, including age, body mass index, percentage of female participants, and drug ingestion, which were described in subgroup analyses. Results In total, 56 studies were included in the analyses. Meta-analyses and subgroup analyses revealed that specific populations of patients benefited more from bedtime dosing than from morning dosing in both 24-h or 48-h ambulatory systolic BP (SBP) and nighttime SBP, including (1) groups aged
PubDate: 2025-04-19
- The Efficacy and Safety of GLP-1 RAs in the Modification of Cardiovascular
Morbidity in Patients with Obesity Without Diabetes Mellitus: A Systematic
Review and Meta-analysis of Randomized Controlled Trials Involving 32,884
Patients-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Background Although the cardioprotective effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are well documented in patients with diabetes mellitus, their impact on cardiovascular outcomes in patients with obesity without diabetes remains under debate. Therefore, we conducted this systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the effects of GLP-1 RAs on cardiovascular outcomes in patients with obesity without diabetes. Methods We systematically searched PubMed, Web of Science, SCOPUS, and Cochrane databases through December 26, 2023. We pooled dichotomous data using risk ratios (RRs) and continuous data using mean differences with 95% confidence intervals (CIs). We evaluated the quality of each study using the Cochrane RoB2 method, and the study protocol was registered on PROSPERO ID: CRD42024498538. Results We included 19 RCTs with a total of 32,884 patients. Of these, 15 had a low overall risk of bias, two raised concerns, and two had a high risk of bias. There was no difference between GLP-1 RAs and placebo regarding cardiovascular mortality (RR 0.85; 95% CI 0.71–1.01; p = 0.07). However, compared with placebo, GLP-1 RAs significantly decreased the incidence of all-cause mortality (RR 0.82; 95% CI 0.72–0.93; p < 0.0001), non-cardiovascular mortality (RR 0.77; 95% CI 0.63–0.95; p = 0.01), and myocardial infarction (RR 0.73; 95% CI 0.62–0.86; p < 0.0001). Additionally, patients receiving GLP-1 RAs experienced significant overall weight loss (− 8.53 kg; 95% CI − 12.38 to − 4.68; p < 0.0001) and improvements in lipid profiles, including lower levels of total cholesterol (− 0.77 %; 95% CI − 1.03 to − 0.50; p < 0.0001), triglycerides (− 6.78 %; 95% CI − 8.11 to − 5.46; p < 0.0001), low-density lipoproteins (− 2.85 %; 95% CI − 3.74 to − 1.96; p < 0.0001), and very low-density lipoproteins (− 4.47 %; 95% CI − 5.56 to − 3.38; p < 0.0001). GLP-1 RAs also significantly increased the incidence of any adverse events (RR 1.11; 95% CI 1.05–1.16; p < 0.0001), with no difference regarding the incidence of serious adverse events. However, gastrointestinal adverse events were significantly more frequent in patients receiving GLP-1 RAs, with a higher risk of any gastrointestinal adverse events (RR 2.83; 95% CI 1.86–4.3; p < 0.001), nausea (RR 2.70; 95% CI 2.18–3.33; p < 0.001), diarrhea (RR 1.97; 95% CI 1.68–2.31; p < 0.001), vomiting (RR 3.85; 95% CI 3.32–4.48; p < 0.001), and constipation (RR 2.35; 95% CI 1.94–2.85; p < 0.001) than in those receiving placebo. Conclusion In obese patients without diabetes, GLP-1 RAs demonstrated substantial benefits in reducing cardiovascular risks, including all-cause mortality and myocardial infarction, and effectively promoted weight loss and improved lipid profiles and blood pressure control. However, their use is accompanied by a higher incidence of gastrointestinal adverse effects and heterogeneity in outcomes, highlighting the need for individualized treatment approaches. Registration PROSPERO identifier number: CRD42024498538.
PubDate: 2025-04-17
- Trimetazidine in Cardiovascular Disease and Beyond: A Comprehensive Review
-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Trimetazidine is a metabolic modulator that acts as a competitive inhibitor of the terminal enzyme in the β-oxidation pathway to shift energy substrate from free fatty acids to the more oxygen-efficient glucose metabolism. The resulting conservation of cellular adenosine triphosphate generation in the face of ischemia/hypoxia mediates the anti-ischemic efficacy of trimetazidine. Clinically, trimetazidine has been approved as an add-on treatment in patients with symptomatic angina that is poorly controlled with first-line agents or who cannot tolerate the first-line therapy. In addition, trimetazidine has demonstrated antioxidant, cytoprotective, and anti-apoptotic activity with applications beyond angina. The aim of this review was to summarize the mechanism of action and anti-anginal efficacy of trimetazidine and to discuss the putative role of these pleiotropic effects and the evidence behind its application in cardiovascular diseases in general.
PubDate: 2025-04-03
- Geographic and Racial Variation in Oral Anticoagulant (OAC) Treatment
Among Commercially Insured Patients with Non-valvular Atrial Fibrillation
(NVAF) in the United States-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Background Oral anticoagulants (OACs) are recommended for stroke reduction in non-valvular atrial fibrillation (NVAF). OAC use has been studied in Medicare populations, but data for younger, commercially insured populations are limited. Objective This retrospective study aimed to describe the geographic variation of OAC use among commercially insured patients with NVAF at high risk of stroke (CHA2DS2-VASc score ≥ 2) in the USA. Methods Geographic variation was assessed by 3-digit zip code and race among patients identified from the Komodo Health commercial database with a diagnosis of NVAF between January 1, 2016, and August 31, 2021. Continuous health plan enrollment for ≥ 12 months before and 12 months after the NVAF diagnosis was required. Results A total of 619,111 patients with NVAF at high risk for stroke were identified, of whom approximately 50% were not treated with OACs. Of the half who received OACs, almost 85% received direct OACs (DOACs) and 15% received warfarin therapy. Overall, the highest untreated rates were observed in the South and West US regions, followed by the Midwest, then the Northeast. The highest DOAC treatment rates were in the Northeast for White patients and in the North and South for Black patients. The highest warfarin treatment rates were in the upper Midwest for White patients and the Midwest for Black patients. Conclusions This study may help guide the identification of areas to target interventions to improve treatment rates and confirm prior findings of geographic and racial variations of OAC use in NVAF.
PubDate: 2025-04-03
- Cost-Effectiveness and Price Threshold Analysis of Tafolecimab in Chinese
Patients with Elevated LDL Cholesterol Despite Statin Therapy-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Background Tafolecimab is a novel PCSK9 inhibitor developed in China. In recently published phase III clinical trials, tafolecimab demonstrated long-term safety and efficacy in Chinese patients with hypercholesterolemia despite statin therapy. However, pharmacoeconomic studies of tafolecimab have yet to be published. This study aimed to explore the maximum cost-effective price of tafolecimab compared with statins alone for Chinese patients with hypercholesterolemia at various willingness-to-pay (WTP) thresholds. Methods A Markov cohort state-transition model was employed to assess the cost-effectiveness of tafolecimab from the perspective of the Chinese healthcare system. The low-density lipoprotein cholesterol (LDL-C) lowering effect of tafolecimab was observed in the CREDIT-4 trial. The baseline and subsequent incidence and transfer probability of cardiovascular events were based on prospective observational data in China and meta-analyses from the Cholesterol Treatment Trialists Study. Cost and utility values were obtained from the China Health Statistics Yearbook, health insurance, and published articles in China. The study also performed subgroup, sensitivity, and scenario analyses. Results The annual price thresholds for tafolecimab as an adjunctive therapy to statins were Chinese yuan (CNY) 3304 and CNY 7022 at WTP thresholds of CNY 89,358 and CNY 268,074 per quality-adjusted life year (QALY), respectively. The corresponding annual price thresholds for patients with hypercholesterolemia with acute myocardial infarction were CNY 10,355 and CNY 21,793 per year. Sensitivity analyses showed that the time horizon significantly impacted price thresholds, with a several-fold difference. Conclusions From the perspective of the Chinese healthcare system, the cost-effective annual price threshold for tafolecimab for patients with hypercholesterolemia was CNY 7022, at a threshold of CNY 268,074 per QALY.
PubDate: 2025-04-02
- Comment on: “Door-to-Diuretic Time and Outcomes in Acute Heart Failure:
A Scoping Review”-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
PubDate: 2025-04-01
- Author’s Reply to Freund and Gorlicki: “Door-to-Diuretic Time and
Outcomes in Acute Heart Failure: A Scoping Review”-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
PubDate: 2025-04-01
- Cardiovascular Safety Profile of Semaglutide and Variations by Sex, Race,
and Kidney Function: A Systematic Review and Meta-analysis-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Background Patients with diabetes mellitus and its complications are at increased risk for cardiovascular diseases. Semaglutide is efficacious for glycemic control and reducing the risk of major adverse cardiovascular outcomes. Although trials have provided data about cardiovascular outcomes with this agent, a meta-analysis regarding its cardiovascular safety and variations in outcomes according to sex, race and estimated glomerular filtration rate was necessary. Materials and Methods We searched the PubMed, Cochrane Library, and Clinicaltrials.gov databases and included randomized controlled trials (RCTs) where semaglutide was the intervention and major adverse cardiovascular events (MACE) or expanded MACE was the outcome. We assessed the quality of the RCTs using the Cochrane Risk of Bias tool and used the statistical software RevMan 5.4. The protocol for this review was registered on PROSPERO (CRD42024580784). Results Of 5387 articles, four RCTs were included. The risk of MACE with semaglutide was significantly lower in patients with established or a risk of cardiovascular disease (risk ratio [RR] 0.81; 95% confidence interval [CI] 0.74–0.88; p < 0.00001). The risk of expanded MACE also reduced significantly with semaglutide (RR 0.80; 95% CI 0.75–0.86; p < 0.00001). MACE risk reduction was significant in males (RR 0.78; 95% CI 0.70–0.87; p < 0.00001) and in Asian (RR 0.61; 95% CI 0.44–0.83; p = 0.002) and white (RR 0.82; 95% CI 0.73–0.90; p = 0.0001) populations. Conclusion Semaglutide provides significant advantages in terms of lowering the risk of MACE and expanded MACE and could possibly be used as a crucial component of cardiovascular risk management, particularly in populations that respond well, such as men and Asian and white populations. Registration PROSPERO identifier number CRD42024580784.
PubDate: 2025-03-19
- Insights on DAPT Abbreviation and De-escalation from ULTIMATE-DAPT and
Related Trials: Are we Heading Toward an Aspirin-Free Strategy'-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: The results of the recently concluded ULTIMATE-DAPT and T-PASS trials strongly support the emerging concept of antiplatelet monotherapy in patients at high bleeding risk undergoing percutaneous coronary intervention. Monotherapy with more potent antiplatelets such as ticagrelor is both a safe and an equally effective strategy to circumvent major bleeding episodes in patients at high bleeding risk while guarding against ischemic events. Although these results were not replicated with low-dose prasugrel monotherapy in the STOP-DAPT-3 trial, the other major trials investigating ticagrelor monotherapy (GLOBAL-LEADERS and TWILIGHT-ACS) suggested the feasibility and appropriateness of abbreviating the dual antiplatelet therapy (DAPT) as early as 1–3 months of the index procedure. Moreover, the recent data from TICO, T-PASS, and now the ULTIMATE-DAPT trial, hint toward early switchover to ticagrelor monotherapy without any undue concern of increased ischemic events. However, on closer examination, we find that study cohorts in most trials had lower anatomical complexity of coronary lesions and most adopted imaging-based revascularization strategies. Among these trials, those that achieved convincing levels of safety in ischemic endpoints mainly administered ticagrelor monotherapy. Can monotherapy with these newer antiplatelets sufficiently obviate the need for year-long DAPT' Can such antiplatelet monotherapy remain effective in all coronary artery disease subsets' Can we start patients solely on a single antiplatelet from day one of the procedure' These are some of the questions we attempt to answer by revisiting the results from these trials.
PubDate: 2025-03-08
- Mineralocorticoid Receptor Antagonism with Finerenone: A New Era in the
Management of Patients with Heart Failure with Mildly Reduced or Preserved
Ejection Fraction-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Finerenone is a novel nonsteroidal mineralocorticoid receptor (MR) antagonist (MRA) with unique pharmacological properties that offer potent and selective blockade of the MR with a more favorable side effect profile than spironolactone and eplerenone. In a large phase III clinical trial involving 13,026 patients with type 2 diabetes mellitus and a broad spectrum of chronic kidney disease, finerenone provoked a substantial placebo-subtracted reduction in the risk of hospitalization for heart failure (HF). These preliminary clinical trial data, along with the ongoing uncertainty about the safety and efficacy of MR antagonism in patients with HF and higher levels of ejection fraction have provided the rationale for the design of the FINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure) trial. In this multicenter, double-blind, randomized, phase III trial involving 6001 patients with HF and mildly reduced or preserved ejection fraction, finerenone was superior to placebo in improving the primary composite outcome of total (first and recurrent) worsening HF events and death from cardiovascular causes. This benefit was similar in magnitude in patients receiving and in patients not receiving background treatment with a sodium-glucose co-transporter type 2 inhibitor, suggesting a potential additive benefit with combination therapy. We explore the emerging role of the nonsteroidal MRA finerenone as a new therapeutic opportunity to improve the risk of adverse cardiovascular outcomes in patients with HF and mildly reduced or preserved ejection fraction. We discuss preliminary clinical trial data and provide a critical evaluation of the main results of the FINEARTS-HF trial.
PubDate: 2025-03-07
- Administration of Evolocumab in Patients with STEMI After Emergency PCI: A
Real-World Cohort Study-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Background and Objective Evolocumab can reduce low-density lipoprotein cholesterol (LDL-C) levels and improve cardiovascular (CV) outcomes. While its benefits are well established in broader populations, its potential impact on patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) remains underexplored, particularly in real-world settings. This study aimed to evaluate its efficacy and safety in this specific patient group on the basis of real-world clinical experience. Methods A total of 384 patients with STEMI who underwent emergency PCI at Hebei General Hospital between 1 July 2021 and 23 September 2022 were enrolled in this retrospective, single-center study. Of these, 85 patients received evolocumab (140 mg every 2 weeks) plus standard of care (SOC), while 299 received SOC alone. Patients were monitored for CV events and lipid levels during follow-up. Propensity score matching (PSM) and inverse probability treatment weighting (IPTW) were used to balance covariates. Results The experimental group had a lower cumulative incidence of the primary composite endpoint over 18 months in the unadjusted analysis (hazard ratio [HR] = 0.353; 95% confidence interval [CI] 0.180–0.693; P = 0.002), as well as after adjustment for PSM (HR = 0.341; 95% CI 0.165–0.706; P = 0.004) and IPTW (HR = 0.461; 95% CI 0.241–0.881; P = 0.019). The 18-month cumulative incidence was 10 (12%) for evolocumab + SOC and 95 (32%) for SOC. LDL-C levels in the evolocumab + SOC group showed significant reductions across different cohorts, compared with the SOC group. No significant differences in adverse events were observed between the two groups. Conclusions Evolocumab plus SOC significantly reduced postoperative CV events and LDL-C levels in patients with STEMI after emergency PCI. Graphical Abstract
PubDate: 2025-02-24
- Safety and Efficacy of DOAC Versus VKA in Adult Congenital Heart Disease:
A Systematic Review and Meta-Analysis-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Background Patients with adult congenital heart disease (CHD) have various indications for anticoagulation (e.g., presence of Fontan circuit, atrial fibrillation due to surgical scar). Guidelines recommend vitamin K antagonists (VKA) for thromboprophylaxis in adult CHD, as trial data comparing safety/efficacy of direct oral anticoagulants (DOAC) to VKA are not available in this population. Methods PubMed/MEDLINE, Embase, Web of Science, and Google Scholar were searched for trials comparing DOAC with VKA in patients with ACHD. Outcomes of interest were efficacy endpoints (thromboembolic complications) and safety endpoints (bleeding complications). Results were meta-analyzed and sensitivity analyses were performed. Results A total of 4 retrospective studies comprising 6004 patients (2566 DOAC, 3438 VKA) were analyzed. Compared with VKA, DOAC did not cause a statistically significant difference in incidence of thromboembolism (risk ratio, RR, 0.76; 95% confidence intervals, CI, 0.28, 2.07); composite bleeding (RR 1.02, 95% CI 0.71, 1.47); major bleeding (RR 1.05, 95% CI 0.92, 1.21); minor bleeding (RR 1.12, 95% CI 0.51, 2.44); or intracranial bleeding (RR 0.86, 95% CI 0.50, 1.46). Numerically, the DOAC arm had fewer thromboembolisms/intracranial bleeds but more major/composite bleeds. However, upon removal of the largest study, the DOAC arm had fewer major/composite bleeds. Conclusions DOAC did not confer a significant increase in either thromboembolic or bleeding risk as compared with VKA. Sensitivity analysis showed notable heterogeneity among studies. Large-scale trials comparing DOAC with VKA in patients with adult CHD are needed.
PubDate: 2025-02-18
- Cardiovascular Effects of Semaglutide in Patients with Heart Failure with
Preserved Ejection Fraction: A Systematic Review and Meta-Analysis-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Background Semaglutide has emerged as an effective medication for treating type 2 diabetes mellitus (DM). However, the cardiovascular effects and safety of this agent in patients with heart failure with preserved ejection fraction (HFpEF) are unclear. Objective This systematic review and meta-analysis aimed to assess the clinical and laboratory effects of semaglutide compared to placebo in patients with HFpEF. Methods We systematically searched EMBASE, PubMed, and Cochrane databases for randomized controlled trials (RCTs) and non-randomized cohorts, from inception to July 2024, comparing semaglutide versus placebo in patients with HFpEF. Statistical analyses were performed using R Studio 4.3.2. Mean difference (MD) and odds ratio (OR) with 95% confidence intervals (CIs) were pooled across trials. Results This meta-analysis included three studies, two RCTs and one non-randomized cohort, reporting data on 1463 patients. The follow-up time of the studies was 52 weeks. Compared to placebo, the use of semaglutide was associated with a significant increase in the 6-min walk distance (MD 16.20; 95% CI 10.19–22.21; p < 0.01; I2 = 0%). Additionally, reductions were observed in systolic blood pressure (MD −2.22; 95% CI −3.60 to −0.83; p < 0.01; I2 = 0%), C-reactive protein level (MD 0.59; 95% CI 0.49–0.70; p < 0.01; I2 = 51%), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels (MD 0.81; 95% CI 0.74–0.89; p < 0.01; I2 = 0%). Conclusion These findings suggest that the use of semaglutide is associated with clinical and laboratory benefits in patients with HFpEF.
PubDate: 2025-02-05
- Flurpiridaz F 18: First Approval
-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Flurpiridaz F 18 (FLYRCADO™) is an intravenous (IV) radioactive diagnostic drug being developed by GE Healthcare and Lantheus Medical Imaging for use in positron emission tomography (PET) myocardial perfusion imaging (MPI) to detect coronary artery disease (CAD). In September 2024, flurpiridaz F 18 was approved in the USA for PET MPI under rest or stress (pharmacologic or exercise) in adult patients with known or suspected CAD to evaluate for myocardial ischemia and infarction. This article summarizes the milestones in the development of flurpiridaz F 18 leading to this first approval for use in PET MPI in adult patients to evaluate for myocardial ischemia and infarction.
PubDate: 2025-01-25
- Bempedoic Acid: A Review in Cardiovascular Risk Reduction in
Statin-Intolerant Patients-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Oral bempedoic acid (NEXLETOL® in the USA; Nilemdo® in the EU) and the fixed dose combination (FDC) of bempedoic acid/ezetimibe (NEXLIZET® in the USA; Nustendi® in the EU) are approved to reduce cardiovascular (CV) risk in statin-intolerant patients who are at high risk for, or have, CV disease. A first-in-class therapy, bempedoic acid inhibits the adenosine triphosphate-citrate lyase enzyme in the cholesterol biosynthesis pathway. In the multinational phase III CLEAR Outcomes trial in statin-intolerant patients, once-daily bempedoic acid 180 mg significantly reduced the risk of the primary endpoint (a four-component major adverse CV event composite of CV death, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization) compared with placebo. Bempedoic acid was generally well tolerated and, unlike statins, was associated with a low incidence of musculoskeletal adverse events (AEs). In conclusion, bempedoic acid as a monotherapy or adjunctive to other lipid-lowering therapies expands the treatment options available for the pharmacological reduction of CV risk in statin-intolerant patients, supporting achievement of low-density lipoprotein cholesterol (LDL-C) targets required for CV risk reduction.
PubDate: 2025-01-23
- Exercise Training Enhances Brachial Artery Endothelial Function, Possibly
via Improved HDL-C, not LDL-C and TG, in Patients with Coronary Artery
Disease: A Systematic Review and Meta-analysis-
Free pre-print version: Loading...
Rate this result:
What is this?
Please help us test our new pre-print finding feature by giving the pre-print link a rating.
A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Abstract: Background It remains controversial whether exercise training (EX) improves vascular endothelial function (VEF) independent of lipoprotein changes even though these are therapeutic goals for coronary artery disease (CAD). Objective The purpose of this study was to systematically review the effects of EX on VEF and blood lipid variables in patients with CAD. Methods This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched five electronic databases (CINAHL, Embase, PubMed, SportDiscus, and Web of Science) until March 2024 for studies that met the following criteria: (i) patients with CAD aged ≥ 18 years; (ii) structured EX for ≥ 1 week in randomized or nonrandomized controlled studies; and (iii) measured brachial artery flow-mediated dilation (FMD) with or without blood lipid variables. We calculated effect sizes (ESs) and 95% confidence intervals (CIs) using a random-effects model and conducted subgroup analyses to identify the effect of training factors (duration, intensity, and weekly volume) on outcomes. Results In total, 11 studies with 19 trials (629 patients, 60 ± 9 years) met the inclusion criteria. We conducted a separate meta-analysis for each of the four outcome measures: FMD (13 ESs), high-density lipoprotein-cholesterol (HDL-C; eight ESs), low-density lipoprotein cholesterol (LDL-C; eight ESs), and triglycerides (TGs; eight ESs). EX significantly increased FMD (mean ES 0.57; 95% CI 0.44–0.70; P < 0.001) and HDL-C levels (mean ES 0.25; 95% CI 0.12–0.39; P < 0.001) but had no effect on LDL-C and TG. Subgroup analyses for FMD found no significant variation in effect by training factor (duration, intensity, and weekly volume). Conclusion EX improves VEF with increased HDL-C, but we found no changes in LDL-C and TG in patients with CAD, suggesting that HDL-C is preferentially associated with exercise-induced VEF improvement.
PubDate: 2025-01-19
|
Hybrid journal (It can contain Open Access articles)
