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  Subjects -> PHARMACY AND PHARMACOLOGY (Total: 575 journals)
Showing 1 - 200 of 253 Journals sorted by number of followers
Nature Reviews Drug Discovery     Full-text available via subscription   (Followers: 332)
International Journal of Drug Policy     Hybrid Journal   (Followers: 254)
Journal of Clinical Oncology     Hybrid Journal   (Followers: 242)
Journal of Medicinal Chemistry     Hybrid Journal   (Followers: 157)
Journal of Pharmaceutical Sciences     Hybrid Journal   (Followers: 155)
Drugs     Full-text available via subscription   (Followers: 146)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 98)
Pharmaceutical Research     Hybrid Journal   (Followers: 94)
European Journal of Pharmaceutical Sciences     Hybrid Journal   (Followers: 86)
Drug Safety     Full-text available via subscription   (Followers: 83)
Annals of Pharmacotherapy     Hybrid Journal   (Followers: 56)
Biomaterials     Hybrid Journal   (Followers: 54)
Clinical Pharmacology & Therapeutics     Hybrid Journal   (Followers: 44)
Regulatory Toxicology and Pharmacology     Hybrid Journal   (Followers: 42)
Journal of Controlled Release     Hybrid Journal   (Followers: 38)
Annual Review of Pharmacology and Toxicology     Full-text available via subscription   (Followers: 38)
International Journal of Pharmaceutics     Hybrid Journal   (Followers: 37)
Clinical Therapeutics     Hybrid Journal   (Followers: 34)
European Journal of Pharmaceutics and Biopharmaceutics     Hybrid Journal   (Followers: 34)
Pharmacoepidemiology and Drug Safety     Hybrid Journal   (Followers: 33)
British Journal of Clinical Pharmacology     Hybrid Journal   (Followers: 32)
Journal of Pharmacy and Pharmacology     Full-text available via subscription   (Followers: 31)
Drug Development and Industrial Pharmacy     Hybrid Journal   (Followers: 29)
PharmacoEconomics     Full-text available via subscription   (Followers: 27)
Clinical Pharmacokinetics     Full-text available via subscription   (Followers: 27)
AAPS Journal     Hybrid Journal   (Followers: 26)
Critical Reviews in Toxicology     Hybrid Journal   (Followers: 25)
Journal of Clinical Psychopharmacology     Hybrid Journal   (Followers: 24)
International Journal of Pharmacy Practice     Full-text available via subscription   (Followers: 24)
Toxicology and Applied Pharmacology     Hybrid Journal   (Followers: 24)
Chemical Research in Toxicology     Hybrid Journal   (Followers: 22)
Journal of Pharmacokinetics and Pharmacodynamics     Hybrid Journal   (Followers: 22)
Journal of Pain & Palliative Care Pharmacotherapy     Hybrid Journal   (Followers: 21)
Trends in Pharmacological Sciences     Full-text available via subscription   (Followers: 20)
Journal of Applied Toxicology     Hybrid Journal   (Followers: 19)
Journal of Clinical Pharmacology     Hybrid Journal   (Followers: 19)
Pharmaceutical Development and Technology     Hybrid Journal   (Followers: 19)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 19)
Clinical Trials     Hybrid Journal   (Followers: 18)
Toxicology     Hybrid Journal   (Followers: 18)
Journal of Pharmaceutical and Biomedical Analysis     Hybrid Journal   (Followers: 18)
Clinical Toxicology     Hybrid Journal   (Followers: 18)
International Journal of Toxicology     Hybrid Journal   (Followers: 17)
Critical Reviews in Clinical Laboratory Sciences     Hybrid Journal   (Followers: 16)
Journal of Clinical Pharmacy and Therapeutics     Hybrid Journal   (Followers: 16)
Journal of Natural Products     Hybrid Journal   (Followers: 16)
Pharmaceutical Statistics     Hybrid Journal   (Followers: 15)
Toxicology Letters     Hybrid Journal   (Followers: 15)
Journal of Pharmacy Practice     Hybrid Journal   (Followers: 15)
Psychopharmacology     Hybrid Journal   (Followers: 15)
Basic & Clinical Pharmacology & Toxicology     Hybrid Journal   (Followers: 14)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 14)
European Journal of Clinical Pharmacology     Hybrid Journal   (Followers: 14)
Current Medicinal Chemistry     Hybrid Journal   (Followers: 13)
American Journal of Therapeutics     Hybrid Journal   (Followers: 13)
Drug and Chemical Toxicology     Hybrid Journal   (Followers: 13)
Journal of the American Pharmacists Association     Full-text available via subscription   (Followers: 13)
Clinical Research and Regulatory Affairs     Hybrid Journal   (Followers: 12)
Seminars in Hematology     Hybrid Journal   (Followers: 12)
Drug Discovery Today: Technologies     Full-text available via subscription   (Followers: 12)
Current Pharmaceutical Design     Hybrid Journal   (Followers: 12)
Journal of Oncology Pharmacy Practice     Hybrid Journal   (Followers: 12)
Journal of Psychopharmacology     Hybrid Journal   (Followers: 11)
Biopharmaceutics and Drug Disposition     Hybrid Journal   (Followers: 11)
Toxicology in Vitro     Hybrid Journal   (Followers: 11)
Drug Development Research     Hybrid Journal   (Followers: 11)
Drug Metabolism and Disposition     Hybrid Journal   (Followers: 11)
Seminars in Oncology Nursing     Full-text available via subscription   (Followers: 10)
Biochemical Pharmacology     Hybrid Journal   (Followers: 10)
Journal of Separation Science     Hybrid Journal   (Followers: 10)
CNS Drugs     Full-text available via subscription   (Followers: 10)
Current Pharmaceutical Biotechnology     Hybrid Journal   (Followers: 10)
Journal of Medical Marketing     Hybrid Journal   (Followers: 10)
Drugs & Aging     Full-text available via subscription   (Followers: 10)
European Neuropsychopharmacology     Hybrid Journal   (Followers: 9)
Food Additives & Contaminants Part A     Hybrid Journal   (Followers: 9)
Journal of Pharmacology and Experimental Therapeutics     Hybrid Journal   (Followers: 9)
Environmental Toxicology and Pharmacology     Hybrid Journal   (Followers: 9)
Medicinal Chemistry     Hybrid Journal   (Followers: 9)
Biometrical Journal     Hybrid Journal   (Followers: 9)
Drugs & Therapy Perspectives     Full-text available via subscription   (Followers: 9)
Prescriber     Hybrid Journal   (Followers: 9)
ChemMedChem     Hybrid Journal   (Followers: 9)
Current Opinion in Pharmacology     Hybrid Journal   (Followers: 9)
European Journal of Pharmacology     Hybrid Journal   (Followers: 8)
Inhalation Toxicology     Hybrid Journal   (Followers: 8)
Antiviral Research     Hybrid Journal   (Followers: 8)
Drug Metabolism Reviews     Hybrid Journal   (Followers: 8)
Progress in Neuro-Psychopharmacology and Biological Psychiatry     Hybrid Journal   (Followers: 8)
Human & Experimental Toxicology     Hybrid Journal   (Followers: 8)
Drug Delivery     Open Access   (Followers: 8)
BioDrugs     Full-text available via subscription   (Followers: 8)
Frontiers in Drug Design & Discovery     Hybrid Journal   (Followers: 8)
Expert Review of Pharmacoeconomics & Outcomes Research     Full-text available via subscription   (Followers: 8)
Experimental and Clinical Psychopharmacology     Full-text available via subscription   (Followers: 7)
Toxicology Mechanisms and Methods     Hybrid Journal   (Followers: 7)
Journal of Pharmacological and Toxicological Methods     Hybrid Journal   (Followers: 7)
Clinical and Experimental Pharmacology and Physiology     Hybrid Journal   (Followers: 7)
Scandinavian Journal of Clinical and Laboratory Investigation     Hybrid Journal   (Followers: 7)
Epilepsy Research     Hybrid Journal   (Followers: 7)
Clinical Drug Investigation     Full-text available via subscription   (Followers: 7)
Journal of Veterinary Pharmacology and Therapeutics     Hybrid Journal   (Followers: 6)
Toxicology and Industrial Health     Hybrid Journal   (Followers: 6)
Skin Pharmacology and Physiology     Full-text available via subscription   (Followers: 6)
Journal of Cardiovascular Pharmacology     Hybrid Journal   (Followers: 6)
AAPS PharmSciTech     Hybrid Journal   (Followers: 6)
Current Drug Discovery Technologies     Hybrid Journal   (Followers: 6)
Current Drug Delivery     Hybrid Journal   (Followers: 6)
Current Therapeutic Research     Open Access   (Followers: 6)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 6)
Neuropharmacology     Hybrid Journal   (Followers: 5)
Current Drug Metabolism     Hybrid Journal   (Followers: 5)
Fitoterapia     Hybrid Journal   (Followers: 5)
Expert Review of Molecular Diagnostics     Full-text available via subscription   (Followers: 5)
Expert Review of Anti-infective Therapy     Full-text available via subscription   (Followers: 5)
Anti-Infective Agents     Hybrid Journal   (Followers: 5)
Toxicon     Hybrid Journal   (Followers: 5)
Medicinal Research Reviews     Hybrid Journal   (Followers: 5)
Investigational New Drugs     Hybrid Journal   (Followers: 5)
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 5)
Current Cancer Therapy Reviews     Hybrid Journal   (Followers: 5)
Reviews of Physiology, Biochemistry and Pharmacology     Hybrid Journal   (Followers: 4)
Planta Medica     Hybrid Journal   (Followers: 4)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 4)
Pharmaceutical Medicine     Full-text available via subscription   (Followers: 4)
Journal of Child and Adolescent Psychopharmacology     Hybrid Journal   (Followers: 4)
CNS Drug Reviews     Open Access   (Followers: 4)
Inpharma Weekly     Full-text available via subscription   (Followers: 4)
Journal of Labelled Compounds and Radiopharmaceuticals     Hybrid Journal   (Followers: 4)
Immunopharmacology and Immunotoxicology     Hybrid Journal   (Followers: 4)
International Journal of Pharmaceutical and Healthcare Marketing     Hybrid Journal   (Followers: 4)
Inflammation Research     Hybrid Journal   (Followers: 4)
Cancer Chemotherapy and Pharmacology     Hybrid Journal   (Followers: 4)
International Journal of Neuropsychopharmacology     Open Access   (Followers: 3)
Pharmacology & Therapeutics     Hybrid Journal   (Followers: 3)
Physiology International     Full-text available via subscription   (Followers: 3)
Cardiovascular Therapeutics     Open Access   (Followers: 3)
ASSAY and Drug Development Technologies     Hybrid Journal   (Followers: 3)
Pharmacopsychiatry     Hybrid Journal   (Followers: 3)
Chemotherapy     Full-text available via subscription   (Followers: 3)
Therapeutic Drug Monitoring     Hybrid Journal   (Followers: 3)
Current Drug Therapy     Hybrid Journal   (Followers: 3)
Research in Social and Administrative Pharmacy     Hybrid Journal   (Followers: 3)
PharmacoEconomics & Outcomes News     Full-text available via subscription   (Followers: 3)
Journal of Aerosol Medicine and Pulmonary Drug Delivery     Hybrid Journal   (Followers: 3)
Journal of Ethnopharmacology     Hybrid Journal   (Followers: 3)
Drug Resistance Updates     Hybrid Journal   (Followers: 3)
Journal of Pain Management & Medicine     Open Access   (Followers: 3)
Journal of Infection and Chemotherapy     Hybrid Journal   (Followers: 3)
Journal of Cardiovascular Pharmacology and Therapeutics     Hybrid Journal   (Followers: 3)
Current Pharmacogenomics and Personalized Medicine     Hybrid Journal   (Followers: 3)
Acta Pharmacologica Sinica     Hybrid Journal   (Followers: 3)
Microbial Drug Resistance     Hybrid Journal   (Followers: 3)
Frontiers in Medicinal Chemistry     Hybrid Journal   (Followers: 3)
Human Psychopharmacology Clinical and Experimental     Hybrid Journal   (Followers: 3)
BMC Pharmacology     Open Access   (Followers: 2)
The Brown University Psychopharmacology Update     Hybrid Journal   (Followers: 2)
International Clinical Psychopharmacology     Hybrid Journal   (Followers: 2)
Canadian Journal of Physiology and Pharmacology     Hybrid Journal   (Followers: 2)
Journal of Drug Targeting     Hybrid Journal   (Followers: 2)
Inflammopharmacology     Hybrid Journal   (Followers: 2)
Journal of Inflammation     Open Access   (Followers: 2)
Fundamental & Clinical Pharmacology     Hybrid Journal   (Followers: 2)
Behavioural Pharmacology     Hybrid Journal   (Followers: 2)
Vascular Pharmacology     Hybrid Journal   (Followers: 2)
Pulmonary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 2)
Biomedicine & Pharmacotherapy     Full-text available via subscription   (Followers: 2)
Clinical Neuropharmacology     Hybrid Journal   (Followers: 2)
Drugs in R & D     Full-text available via subscription   (Followers: 2)
International Immunopharmacology     Hybrid Journal   (Followers: 2)
Pharmacology Biochemistry and Behavior     Hybrid Journal   (Followers: 2)
Letters in Drug Design & Discovery     Hybrid Journal   (Followers: 2)
Archiv der Pharmazie     Hybrid Journal   (Followers: 2)
Pharmacological Reviews     Hybrid Journal   (Followers: 2)
Molecular Pharmacology     Hybrid Journal   (Followers: 2)
Journal of Microencapsulation: Microcapsules, Liposomes, Nanoparticles, Microcells, Microspheres     Hybrid Journal   (Followers: 2)
Toxicological & Environmental Chemistry     Hybrid Journal   (Followers: 2)
Particulate Science and Technology: An International Journal     Hybrid Journal   (Followers: 1)
Pharmacological Research     Hybrid Journal   (Followers: 1)
Current Enzyme Inhibition     Hybrid Journal   (Followers: 1)
Journal of Neuroimmune Pharmacology     Hybrid Journal   (Followers: 1)
Current Pharmaceutical Analysis     Hybrid Journal   (Followers: 1)
Current Neuropharmacology     Hybrid Journal   (Followers: 1)
Pharmacogenetics and Genomics     Hybrid Journal   (Followers: 1)
Journal of Texture Studies     Hybrid Journal   (Followers: 1)
Pharmaceutical Biology     Open Access  
Journal of Liposome Research     Hybrid Journal  
Toxin Reviews     Hybrid Journal  
Kaohsiung Journal of Medical Sciences     Open Access  
Redox Report     Open Access  
Pharmacology     Full-text available via subscription  
Pharmaceutical Chemistry Journal     Hybrid Journal  
NeuroMolecular Medicine     Hybrid Journal  
Journal of Ocular Pharmacology and Therapeutics     Hybrid Journal  
Harm Reduction Journal     Open Access  
Current Nanoscience     Hybrid Journal  
Infectious Disorders - Drug Targets     Hybrid Journal  
Current Bioactive Compounds     Hybrid Journal  
Cancer Biotherapy & Radiopharmaceuticals     Hybrid Journal  
Autonomic & Autacoid Pharmacology     Hybrid Journal  

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Similar Journals
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Journal of Cardiovascular Pharmacology and Therapeutics
Journal Prestige (SJR): 1.272
Citation Impact (citeScore): 3
Number of Followers: 3  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1074-2484 - ISSN (Online) 1940-4034
Published by Sage Publications Homepage  [1175 journals]
  • A Phase 3 Randomized Controlled Trial to Evaluate Efficacy and Safety of
           New-Formulation Zenon (Rosuvastatin/Ezetimibe Fixed-Dose Combination) in
           Primary Hypercholesterolemia Inadequately Controlled by Statins

    • Free pre-print version: Loading...

      Authors: Alberico L. Catapano, Michal Vrablik, Yuri Karpov, Baptiste Berthou, Megan Loy, Marie Baccara-Dinet
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Objective:In primary hypercholesterolemia many people treated with statins do not reach their plasma LDL-C goals and are at increased risk of cardiovascular disease (CVD). This study aimed to evaluate efficacy and safety of a new fixed-dose combination (FDC) formulation of rosuvastatin/ezetimibe (R/E) in this population.Methods:This was a multicenter, multinational, randomized, double-blind, double-dummy, active-controlled, parallel-arm study of FDC R/E in people with primary hypercholesterolemia at very high risk (VHR) or high risk (HR) of CVD, inadequately controlled with 20 mg or 10 mg stable daily dose of rosuvastatin or equipotent dose of another statin. The primary objective was to demonstrate superiority of FDC R/E versus rosuvastatin monotherapy uptitrated to 40 mg (R40) or 20 mg (R20) in reduction of LDL-C after 6 weeks.Results:Randomized VHR participants (n = 244) were treated with R40, R40/E10, or R20/E10; randomized HR participants (n = 208) received R10/E10 or R20. In VHR participants, superiority of R40/E10 and R20/E10 versus R40 was demonstrated on LDL-C percent change from baseline to Week 6 with least squares mean differences (LSMD) of −19.66% (95% CI: −29.48% to −9.84%; P < .001) and −12.28% (95% CI: −22.12% to −2.44%; P = .015), respectively. In HR participants, superiority of R10/E10 over R20 was not demonstrated (LSMD −5.20%; 95% CI: −15.18% to 4.78%; P = .306), despite clinically relevant LDL-C reduction with R10/E10. No unexpected safety findings were reported.Conclusions:The results from this study suggest that R/E FDCs improve LDL-C reduction and goal achievement in people with primary hypercholesterolemia inadequately controlled with statins and at VHR/HR of CVD.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-11-24T12:54:01Z
      DOI: 10.1177/10742484221138284
      Issue No: Vol. 27 (2022)
       
  • Association of Valproic Acid Use With Post-Myocardial Infarction Heart
           Failure Development: A Meta-Analysis of Two Retrospective Case–Control
           Studies

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      Authors: Joseph D. English, Shuo Tian, Zhong Wang, Jasmine A. Luzum
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Background:Despite advances in treatments, myocardial infarction (MI) remains a significant cause of morbidity and mortality worldwide. Our team has previously shown that valproic acid (VPA) is cardio-protective when administered to rats post-MI. The aim of this study was to investigate the association of VPA use with post-MI heart failure (HF) development in humans.Methods:This study was a random effects meta-analysis of two retrospective case–control studies collected from electronic health record (Michigan Medicine) and claims data (OptumInsight). Cases with an active prescription for VPA at the time of their MI were matched 1:4 to controls not taking VPA at the time of their MI by multiple demographic and clinical characteristics. The primary outcome, time-to-HF development, was analyzed using the Fine-Gray competing risks model of any VPA prescription versus no VPA prescription. An exploratory analysis was conducted to evaluate the association of different VPA doses (≥1000 mg/day vs
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-11-23T12:37:11Z
      DOI: 10.1177/10742484221140303
      Issue No: Vol. 27 (2022)
       
  • Direct Ischemic Postconditioning After Carotid Endarterectomy in the
           Prevention of Postoperative Cerebral Ischemic
           Complications—Observational Case–Control Study

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      Authors: Nenad Ilijevski, Igor Atanasijević, Branko Lozuk, Predrag Gajin, Predrag Matić, Srđan Babić, Dragan Sagić, Dragana Unić-Stojanović, Slobodan Tanasković
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Introduction:Ischemic postconditioning (IPCT) represents one of the several therapeutic strategies to attenuate ischemic reperfusion injury (IR) after carotid endarterectomy (CEA). We here present the first in-human study of IPCT in carotid surgery.Methods:The study represents an observational case-control study, with the data collected in our Institution carotid database. From December 2015 to December 2020, a total of 300 patients were included in our study; IPCT group consisted of 148 patients in whom ischemic postconditioning was performed while control group consisted of 152 patients in whom IPCT was not performed. Indications for IPCT technique were: severe unilateral internal carotid artery (ICA) stenosis (>90%), severe bilateral ICA stenosis (>80%), severe ICA stenosis (>80%) with contralateral ICA occlusion and ICA subocclusion. IPCT was performed by applying 6 cycles of 30 sec reperfusion (declamping of ICA)/30 sec ischemia (clamping of ICA) after finishing the procedure and initial declamping. Two groups of patients were compared in terms of occurrence of intrahospital and early postoperative stroke, TIA (transient ischemic attack) and neurologic morbidity.Results:Cumulative incidence of intrahospital postoperative stroke or TIA was significantly higher in the control group (5.3% vs 0.7%, P = .036). According to carotid plaque characteristics, patients in the IPCT group had significantly more frequent presence of heterogenous plaque, as well as ulcerated plaque, which was associated with the absence of postoperative stroke and significantly lower cumulative rate of TIA/stroke when compared to the control group (43.9% vs 8% and 47.3% vs 1.5%). During the follow-up period of 1 month after the surgery, there were no cases of stroke, TIA and deaths due to neurological causes in both groups of patients.Conclusion:Our results showed that IPCT significantly reduced the incidence of postoperative cerebral ischemic complications after CEA in high-risk patients for IR injury when compared to the control group.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-11-15T12:25:06Z
      DOI: 10.1177/10742484221137489
      Issue No: Vol. 27 (2022)
       
  • Evaluation of Risk Factors Associated With Antihypertensive Treatment
           Success Employing Data Mining Techniques

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      Authors: Selçuk Şen, Denizhan Demirkol, Mert Kaşkal, Murat Gezer, Ayşenur Yaman Bucak, Nermin Gürel, Yasemin Selalmaz, Çiğdem Erol, Ali Yağız Üresin
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Objective:This study aimed to evaluate the effects of potential risk factors on antihypertensive treatment success.Methods:Patients with hypertension who were treated with antihypertensive medications were included in this study. Data from the last visit were analyzed retrospectively for each patient. To evaluate the predictive models for antihypertensive treatment success, data mining algorithms (logistic regression, decision tree, random forest, and artificial neural network) using 5-fold cross-validation were applied. Additionally, study parameters between patients with controlled and uncontrolled hypertension were statistically compared and multiple regression analyses were conducted for secondary endpoints.Results:The data of 592 patients were included in the analysis. The overall blood pressure control rate was 44%. The performance of random forest algorithm (accuracy = 97.46%, precision = 97.08%, F1 score = 97.04%) was slightly higher than other data mining algorithms including logistic regression (accuracy = 87.31%, precision = 86.21%, F1 score = 85.74%), decision tree (accuracy = 76.94%, precision = 70.64%, F1 score = 76.54%), and artificial neural network (accuracy = 86.47%, precision = 83.85%, F1 score = 84.86%). The top 5 important categorical variables (predictive correlation value) contributed the most to the prediction of antihypertensive treatment success were use of calcium channel blocker (−0.18), number of antihypertensive medications (0.18), female gender (0.10), alcohol use (−0.09) and attendance at regular follow up visits (0.09), respectively. The top 5 numerical variables contributed the most to the prediction of antihypertensive treatment success were blood urea nitrogen (−0.12), glucose (−0.12), hemoglobin A1c (−0.12), uric acid (−0.09) and creatinine (−0.07), respectively. According to the decision tree model; age, gender, regular attendance at follow-up visits, and diabetes status were identified as the most critical patterns for stratifying the patients.Conclusion:Data mining algorithms have the potential to produce predictive models for screening the antihypertensive treatment success. Further research on larger populations and longitudinal datasets are required to improve the models.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-11-03T04:54:11Z
      DOI: 10.1177/10742484221136758
      Issue No: Vol. 27 (2022)
       
  • CSL112 (Apolipoprotein A-I [Human]) Strongly Enhances Plasma Apoa-I and
           Cholesterol Efflux Capacity in Post-Acute Myocardial Infarction Patients:
           A PK/PD Substudy of the AEGIS-I Trial

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      Authors: C. Michael Gibson, Syed Hassan A. Kazmi, Serge Korjian, Gerald Chi, Adam T. Phillips, Sahar Memar Montazerin, Danielle Duffy, Bo Zheng, Mark Heise, Charles Liss, Lawrence I. Deckelbaum, Samuel D. Wright, Andreas Gille
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Introduction:Cholesterol efflux capacity (CEC) is impaired following acute myocardial infarction (AMI). CSL112 is an intravenous preparation of human plasma-derived apoA-I formulated with phosphatidylcholine (PC). CSL112 is intended to improve CEC and thereby prevent early recurrent cardiovascular events following AMI. AEGIS-I (ApoA-I Event Reducing in Ischemic Syndromes I) was a multicenter, randomized, double-blind, placebo-controlled, dose-ranging phase 2b study, designed to evaluate the hepatic and renal safety of CSL112. Here, we report an analysis of a pharmacokinetic (PK) and pharmacodynamic (PD) substudy of AEGIS-I.Methods:AMI patients were stratified by renal function and randomized 3:3:2 to 4, weekly, 2-hour infusions of low- and high-dose (2 g and 6 g) CSL112, or placebo. PK/PD assessments included plasma concentrations of apoA-I and PC, and measures of total and ABCA1-dependent CEC, as well as lipids/lipoproteins including high density lipoprotein cholesterol (HDL-C), non-HDL-C, low density lipoprotein cholesterol (LDL-C), ApoB, and triglycerides. Inflammatory and cardio-metabolic biomarkers were also evaluated.Results:The substudy included 63 subjects from AEGIS-I. CSL112 infusions resulted in rapid, dose-dependent increases in baseline corrected apoA-I and PC, which peaked at the end of the infusion (Tmax ≈ 2 hours). Similarly, there was a dose-dependent elevation in both total CEC and ABCA1-mediated CEC. Mild renal impairment did not affect the PK or PD of CSL112. CSL112 administration was also associated with an increase in plasma levels of HDL-C but not non-HDL-C, LDL-C, apoB, or triglycerides. No dose-effects on inflammatory or cardio-metabolic biomarkers were observed.Conclusion:Among patients with AMI, impaired CEC was rapidly elevated by CSL112 infusions in a dose-dependent fashion, along with an increase in apoA-I plasma concentrations. Findings from the current sub-study of the AEGIS-I support a potential atheroprotective benefit of CSL112 for AMI patients.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-10-25T12:59:28Z
      DOI: 10.1177/10742484221121507
      Issue No: Vol. 27 (2022)
       
  • Randomized Clinical and Biochemical Study Comparing the Effect of
           L-arginine and Sildenafil in Beta Thalassemia Major Children With High
           Tricuspid Regurgitant Jet Velocity

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      Authors: Eman El-Khateeb, Sahar Mohamed El-Haggar, Osama El-Razaky, Mohamed Ramadan El-Shanshory, Tarek Mohamed Mostafa
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Background:Pulmonary hypertension (PHT) is common in β-thalassemia patients due to hemolysis, iron overload and diminished nitric oxide (NO) levels. Biochemical markers can help to understand the pathophysiology and to introduce new therapies for this condition.Aim:This study aimed to evaluate the effectiveness of L-arginine and sildenafil in thalassemia children with PHT at both clinical and biochemical levels.Methods and Results:In a randomized controlled study, 60 β-thalassemia major children with PHT were divided into 3 equal groups; Control group (Conventional thalassemia and PHT management), L-arginine group (Conventional + Oral L-arginine 0.1 mg.kg−1 daily), and sildenafil group (Conventional + Oral sildenafil 0.25 mg.kg−1 two times a day) for 60 days. Tricuspid Regurgitant Jet Velocity (TRJV) with Doppler echocardiography along with serum levels of NO, asymmetric dimethylarginine (ADMA), interleukin 1-beta (IL-1β), E-selectin, and visfatin were followed-up at baseline, 30, and 60 days after treatment. Both drugs reduced the TRJV significantly. NO was significantly higher in both L-arginine and sildenafil groups after 60 days compared to baseline, while visfatin levels were lower. Only L-arginine reduced ADMA levels compared to baseline, while sildenafil did not. E-selectin and IL-1β levels did not change remarkably by both drugs. NO and TRJV showed significant negative correlations in both treatment groups.Conclusion:L-arginine and sildenafil could clinically ameliorate chronic PHT whereas, L-arginine showed superiority to sildenafil on some biochemical markers.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-10-25T01:00:48Z
      DOI: 10.1177/10742484221132671
      Issue No: Vol. 27 (2022)
       
  • Impact of COVID-19 on the Prescribing Pattern of Oral Anticoagulants for
           Atrial Fibrillation After Cardiac Surgery

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      Authors: Dannick Brochu, Amélie St-Arnaud, Louis-Étienne Marchand, Pierre Voisine, Julie Méthot
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Background:Because of logistic challenges associated with the COVID-19 pandemic, direct oral anticoagulants (DOAC) were favored over warfarin in patients presenting postoperative atrial fibrillation (AF) after cardiac surgery in our institution. Considering the limited evidence supporting the use of DOAC in this context, we sought to evaluate the safety and efficacy of this practice change.Methods:A retrospective study was performed with patients from the Quebec City metropolitan area who were hospitalized at the Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval following cardiac surgery and who required oral anticoagulant (OAC) for postoperative AF. The primary objective was to compare the pre- and peri-COVID-19 period for OAC prescribing patterns and the incidence of thrombotic and bleeding events at 3 months post-surgery. The secondary objective was to compare DOAC to warfarin in terms of thrombotic events and bleeding events.Results:A total of 233 patients were included, 142 from the pre-COVID-19 and 91 from the peri-COVID-19 period, respectively. Both groups had equivalent proportions of preoperative AF (48%) and new-onset postoperative AF (52%). The proportion of patients treated with a DOAC increased from 13% pre-COVID-19 to 82% peri-COVID-19. This change in practice was not associated with a significant difference in the incidence of thrombotic or bleeding events 3 months postoperatively. However, compared to DOAC, warfarin was associated with a higher incidence of major bleeding. Only 1 thrombotic event was reported with warfarin, and none were reported with DOAC.Conclusion:This study suggests that DOAC are an effective and safe alternative to warfarin to treat postoperative AF after cardiac surgery and that this practice can be safely maintained.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-10-03T06:50:14Z
      DOI: 10.1177/10742484221128124
      Issue No: Vol. 27 (2022)
       
  • Understanding the Mechanism of Drug Transfer and Retention of Drug-Coated
           Balloons

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      Authors: Estefanny Villar-Matamoros, Lauren Stokes, Alyssa Lloret, Meagan Todd, Bryan W. Tillman, Saami K. Yazdani
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Objective:The purpose of this study was to determine the impact of varying inflation parameters on paclitaxel delivery and retention using a commercially available DCB.Background:Drug-coated balloons (DCB) have become the standard treatment for peripheral artery disease. Clinical data suggest that varying DCB delivery parameters directly impact patient outcome. Differences in delivery parameters can potentially alter the retention of the drug coating on DCBs.Methods:Harvested porcine carotid arteries were utilized in an ex vivo pulsatile flow bioreactor system. The DCBs were then deployed at a DCB-to-artery ratio of 1:1 or 1.25:1, an inflation time of 30 seconds or 1 minute and transit time of 30 seconds or 3 minutes. The amount of drug retention in arterial tissue was evaluated by pharmacokinetic analysis at 1 hour and 1 day post DCB deployment.Results:Arterial paclitaxel levels were found to be less at an inflation ratio of 1:1 with 3-minute transit time as compared to 30 seconds of transit time at 1 hour (12.3 ± 1.6 ng/mg vs. 391 ± 139 ng/mg, P = .036). At 1-day, DCBs deployed at a ratio of 1:1 resulted in less drug retention as compared to 1.25:1 (61.3 ± 23.1 ng/mg vs. 404 ± 195 ng/mg, P = .013).Conclusion:Arterial paclitaxel retention is reduced with extended transit times and sub-optimal expansion of the balloon. Optimization of delivery parameters can serve as an effective strategy to enhance clinical DCB outcomes.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-08-16T12:43:32Z
      DOI: 10.1177/10742484221119559
      Issue No: Vol. 27 (2022)
       
  • Morphine Use in ST-Elevation Myocardial Infarction With Downstream P2Y12
           Receptor Blockers—Insight From Observational Study

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      Authors: Ariel Roguin, Ofer Kobo, Simcha Ron Meisel, Emad Maraga, Aaron Frimerman, Naama Amsalem, Rinat Malka, Yaniv Levi, Rami Abu Fanne
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Background and Aims:Morphine use for patients presenting with NSTE-ACS is associated with excess mortality. However, the role of morphine in STE-ACS is ill characterized. We have recently confirmed direct prothrombotic effect of morphine using murine models. We sought to explore whether morphine use in STE-ACS patients, used to be scheduled for downstream P2Y12 blockers, is negatively associated with procedural and clinical outcomes.Methods:A single-center, observational retrospective analysis enrolling 130 non-randomized stable patients sustaining STE-ACS as their first manifestation of coronary disease, who presented between December 2010 and June 2013. All were managed by early invasive approach. Of study patients, 55 were treated by morphine, and 75 were not. All were administered downstream P2Y12 blockers according to an already abandoned local policy. Outcomes evaluated included TIMI grade flow, thrombus burden, ST-segment resolution, myocardial function by echocardiography, and cardiovascular death.Results:Morphine administration was associated with a significantly higher incidence of impaired final TIMI grade flow (TIMI < 3, 40% vs 4%, P < .05), lower incidence of ST-segment resolution>70% (40.7% vs 76.5%, P < .05), and a higher incidence of moderate or severe systolic dysfunction (48.1% vs 29.1%, P < .05) compared with morphine naive patients. Interestingly, the overall mortality rate was higher in the morphine-treated group (18% vs 5.3%, P < .05).Conclusions and Relevance:Morphine administration combined with the downstream P2Y12 blockers practice signify a group with a higher occurrence of impaired myocardial reperfusion and cardiovascular death despite established on-time primary angioplasty.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-07-21T12:41:57Z
      DOI: 10.1177/10742484221107793
      Issue No: Vol. 27 (2022)
       
  • Duration of Heart Failure With Reduced Ejection Fraction Associated With
           Electrocardiographic Outcomes Before and After Sacubitril/Valsartan

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      Authors: Po-Lin Lin, Ying-Hsiang Lee, Lawrence Yu-Min Liu, Cheng-Ting Tsai, Ten-Fang Yang, Wei-Ru Chiou, Mu-Yang Hsieh, Hung-Yu Chang, Chun-Che Huang
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Aim:Changes in QRS duration in patients with heart failure with reduced ejection fraction (HFrEF) after sacubitril/valsartan therapy is not fully understood. This study aimed to assess the association of duration of HFrEF diagnosis with electrocardiographic and echocardiographic outcomes between before and after sacubitril/valsartan.Methods:We included HFrEF patients who received naïve sacubitril/valsartan therapy for ≥3 months, between January 2016 and March 2018. All patients were divided into 2 groups based on their duration of HFrEF. Generalized linear models were analyzed the cardiac outcomes after sacubitril/valsartan therapy by HFrEF duration.Results:Among these, 42 patients were HFrEF duration of
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-06-17T01:02:13Z
      DOI: 10.1177/10742484221107799
      Issue No: Vol. 27 (2022)
       
  • Renin-Angiotensin-Aldosterone System Inhibitors, Statins, and
           Beta-Blockers in Diabetic Patients With Critical Limb Ischemia and Foot
           Lesions

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      Authors: Paolo Cimaglia, Davide Bernucci, Laura Sofia Cardelli, Anna Carone, Giuseppe Scavone, Marco Manfrini, Stefano Censi, Simone Calvi, Roberto Ferrari, Gianluca Campo, Luca Dalla Paola
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Medical therapy for secondary prevention is known to be under-used in patients with peripheral artery disease (PAD). Few data are available on the subgroup with critical limb ischemia (CLI). Prescription of cardiovascular preventive therapies was recorded at discharge in a large, prospective cohort of patients admitted for treatment of CLI and foot lesions, stratified for coronary artery disease (CAD) diagnosis. All patients were followed up for at least 1 year. The primary endpoint was major adverse cardiovascular events (MACE). 618 patients were observed for a median follow-up of 981 days. Renin-angiotensin-aldosterone system (RAAS) inhibitors, statins, beta-blockers, and antithrombotic drugs were prescribed in 52%, 80%, 51%, and 99% of patients, respectively. However, only 43% of patients received optimal medical therapy (OMT), defined as the combination of RAAS inhibitor plus statin plus at least one antithrombotic drug. It was observed that the prescription of OMT was not affected by the presence of a CAD diagnosis. On the other hand, it was noticed that the renal function affected the prescription of OMT. OMT was independently associated with MACE (HR 0.688, 95%CI 0.475-0.995, P = .047) and, after propensity matching, also with all-cause mortality (HR 0.626, 95%CI 0.409-0.958, P = .031). Beta-blockers prescription was not associated with any outcome. In conclusion, patients with critical limb ischemia are under-treated with cardiovascular preventive therapies, irrespective of a CAD diagnosis. This has consequences on their prognosis.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-05-20T09:27:30Z
      DOI: 10.1177/10742484221101980
      Issue No: Vol. 27 (2022)
       
  • A Comprehensive Review of PCSK9 Inhibitors

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      Authors: Caroline Coppinger, Mohammad Reza Movahed, Veronica Azemawah, Lee Peyton, James Gregory, Mehrnoosh Hashemzadeh
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Cardiovascular disease (CVD) is the leading cause of death in the United States and worldwide. A major risk factor for this condition is increased serum low-density lipoprotein cholesterol (LDL-C) levels for which statins have been successful in reducing serum LDL-C to healthy concentrations. However, patients who are statin intolerant or those who do not achieve their treatment goals while on high-intensity statin therapy, such as those with familial hypercholesterolemia, remain at risk. With the discovery of PCSK9 inhibitors, the ability to provide more aggressive treatment for patients with homozygous and heterozygous familial hypercholesterolemia has increased. Ezetimibe reduces LDL-C by 15%-20% when combined with statin., Protein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been found to achieve profound reductions in LDL-C (54%-74%) when added to statins. They have shown dramatic effects at lowering major adverse cardiovascular events (MACE) in high-risk patients with LDL-C levels ≥70 mg/dL and can be used in populations that are statin intolerant or not at goal levels with maximally tolerated statin therapy. PCSK9 inhibitors also produce minimal side effects. Myopathy, a common side effect for patients on statins, has been rare in patients on PCSK9 inhibitors. Randomized trials have shown that reduction in LDL-C has translated to clinical benefits even in patients who have not achieved their LDL-C target.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-05-20T09:25:52Z
      DOI: 10.1177/10742484221100107
      Issue No: Vol. 27 (2022)
       
  • Continuation Versus Interruption of Renin-Angiotensin System Inhibitors in
           Acute Decompensated Heart Failure: A Brief Report

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      Authors: Christian A. Bernhardi, Stephen Fendt, Brent N. Reed, Gautam Ramani, Stormi E. Gale
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Evidence suggests that interruption of beta-blockers during acute decompensated heart failure (ADHF) in the absence of contraindications leads to poorer long-term outcomes. This study assesses whether similar effects occur when interrupting renin-angiotensin system inhibitor (RASi) therapy in ADHF. Data were retrospectively analyzed from patients admitted from 2015 to 2020 with ADHF and left ventricular ejection fraction (LVEF) ≤ 40% taking RASi therapy prior to admission. Patients were excluded if they required acute inotropic therapy or mechanical circulatory support, had worsening renal function (WRF), hyperkalemia, or symptomatic hypotension on admission. The primary endpoint was readmission for heart failure, which was analyzed using Cox regression analysis. One-hundred patients were included, with 22 patients in the interruption group and 78 patients in the continuation group. Baseline characteristics for each group were similar except for older age (67.4 vs 58.9 years; P = .014) and lower systolic blood pressure (120.5 vs 132.3 mm Hg; P = .037) in the interruption group. Interrupting RASi therapy was associated with a nonsignificant increase in the primary outcome (13.6% vs 5.1%; P = .177). Patients continuing RASi therapy were discharged on higher doses (10.1 vs 17.9 mg lisinopril equivalents; P = .044). Additionally, patients with interrupted RASi therapy were more likely to be re-admitted for WRF at 30-, 60-, and 90-day increments and at any-time after discharge (P < .05 for all). Adverse effects were similar except for more frequent hypotension in the interruption group at 72 hours (40.9% vs 14.1%; P = .013) and at any time (50% vs 19.2%; P = .004). In patients admitted for acute decompensated heart failure, RASi continuation in the absence of contraindications appears safe and was associated with more optimal guideline-directed medical therapy at discharge.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-05-11T10:24:12Z
      DOI: 10.1177/10742484221100127
      Issue No: Vol. 27 (2022)
       
  • Bioassays of Humoral Cardioprotective Factors Released by Remote Ischemic
           Conditioning in Patients Undergoing Coronary Artery Bypass Surgery

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      Authors: Helmut Raphael Lieder, Pia Tüller, Felix Braczko, Afsaneh Zandi, Markus Kamler, Matthias Thielmann, Gerd Heusch, Petra Kleinbongard
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Remote ischemic conditioning (RIC) induces the release of circulating cardioprotective factors and attenuates myocardial ischemia/reperfusion injury. Evidence for such humoral cardioprotective factor(s) is derived from transfer with plasma (derivatives) from one individual undergoing RIC to another individual’s heart, even across species. With transfer into an isolated perfused heart, only a single plasma (derivative) sample can be studied with infarct size as endpoint, and therefore the comparison of samples before and after RIC or between RIC and placebo is hampered by the inter-individual variation of infarct sizes in isolated perfused hearts. We therefore developed a preparation of cardiomyocytes from a single mouse heart, where aliquots of the same heart can undergo hypoxia/reoxygenation (H/R) with exposure to buffer, RIC, or placebo samples without or with pharmacological blockade. To validate this approach, we used plasma dialysates taken before and after RIC from patients undergoing coronary bypass grafting who had experienced protection by RIC (troponin release ↓ by 28% vs placebo). The cardiomyocyte bioassay had little variation after H/R with buffer (mean ± standard deviation; 7% ± 2% viable cells) and demonstrated preserved viability after RIC (15% ± 5% vs 6% ± 3% before). For comparison, infarct size in isolated mouse hearts after global ischemia and reperfusion was 22% ± 14% of left ventricular mass after versus 42% ± 14% before RIC. Stattic, an inhibitor of signal transducer and activator of transcription (STAT)3 protein, abrogated protection in the cardiomyocytes. We have thus established a cardiomyocyte bioassay to analyze RIC’s protection which minimizes inter-individual variation and the use of animals.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-05-05T10:06:36Z
      DOI: 10.1177/10742484221097273
      Issue No: Vol. 27 (2022)
       
  • Platelet-to-Lymphocyte Ratio as Marker of Platelet Activation in Patients
           on Potent P2Y12 Inhibitors

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      Authors: Patricia P. Wadowski, Joseph Pultar, Constantin Weikert, Beate Eichelberger, Maximilian Tscharre, Renate Koppensteiner, Simon Panzer, Thomas Gremmel
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      A high platelet-to-lymphocyte ratio (PLR) has recently been associated with ischemic outcomes in cardiovascular disease. Increased platelet reactivity and leukocyte-platelet aggregate formation are directly involved in the progress of atherosclerosis and have been linked to ischemic events following percutaneous coronary intervention (PCI). In order to understand the relation of PLR with platelet reactivity, we assessed PLR as well as agonist-inducible platelet aggregation and neutrophil-platelet aggregate (NPA) formation in 182 acute coronary syndrome (ACS) patients on dual antiplatelet therapy with aspirin and prasugrel (n = 96) or ticagrelor (n = 86) 3 days after PCI. PLR was calculated from the blood count. Platelet aggregation was measured by multiple electrode aggregometry and NPA formation was determined by flow cytometry, both in response to ADP and SFLLRN. A PLR ≥91 was considered as high PLR based on previous data showing an association of this threshold with adverse ischemic outcomes. In the overall cohort and in prasugrel-treated patients, high PLR was associated with higher SFLLRN-inducible platelet aggregation (67 AU [50-85 AU] vs 59.5 AU [44.3-71.3 AU], P = .01, and 73 AU [50-85 AU] vs 61.5 AU [46-69 AU], P = .02, respectively). Further, prasugrel-treated patients with high PLR exhibited higher ADP- (15% [11%-23%] vs 10.9% [7.6%-15.9%], P = .007) and SFLLRN-inducible NPA formation (64.3% [55.4%-73.8%] vs 53.8% [44.1%-70.1%], P = .01) as compared to patients with low PLR. These differences were not seen in ticagrelor-treated patients. In conclusion, high PLR is associated with increased on-treatment platelet reactivity in prasugrel-treated patients, but not in patients on ticagrelor.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-04-28T06:12:15Z
      DOI: 10.1177/10742484221096524
      Issue No: Vol. 27 (2022)
       
  • Association of Cardiovascular Disease and Military Veteran Status With
           Impairments in Physical and Psychological Functioning: Retrospective
           Cross-Sectional Analysis of US National Survey Data

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      Authors: Nicole K. Early, Kelsey Buckley, Nana Entsuah, Kathleen A. Fairman
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Introduction:The Veterans Health Administration (VHA) provides multidisciplinary team-based care with peer-to-peer support for diabetes and obesity, but not for most heart diseases.Objective:To inform disease-care models, assess physical and psychological functioning in veterans with, or at high risk of, heart disease.Methods:Retrospective, cross-sectional cohort analysis of data from the National Survey on Drug Use and Health, 2015-2019, based on standard measures of functioning: self-rated health, serious psychological distress, and high-risk substance use. Cohorts were veterans with respondent-reported heart disease, or at high risk of cardiovascular disease based on age/comorbidity combinations (HD/risk); nonveterans with HD/risk; and veterans without HD/risk. Ordinal logistic regression models adjusted for demographics, social determinants of health, and chronic conditions. A priori alpha was set to 0.01 because of large sample size (N = 28,314).Results:Among those with HD/risk, veterans (n = 3,483) and nonveterans (n = 16,438) had similar physical impairments, but distress trended higher among veterans (adjusted odds ratio = 1.36, 99% confidence interval [CI] = 0.99-1.86). Among those with comorbid HD/risk and behavioral health problems, regression-adjusted treatment rates were similar for veterans and nonveterans with psychological symptoms (55.9% vs. 55.2%, respectively, P = 0.531) or high-risk substance use (18.7% vs. 19.4%, P = .547); veterans were more likely to receive outpatient mental health treatment (36.1% [CI = 34.4%-37.8%] vs. 28.9% [CI = 28.2%-29.6%]).Conclusion:An upward trend in distress among veterans compared with nonveterans with HD/risk was not explained by differences in behavioral health treatment utilization. Further research should test multidisciplinary team-based care for veterans with HD/risk, similar to that used for other chronic diseases.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-04-04T04:54:13Z
      DOI: 10.1177/10742484221091015
      Issue No: Vol. 27 (2022)
       
  • A Long-Term Study Evaluating the Effects of Nicorandil Treatment on
           Duchenne Muscular Dystrophy-Associated Cardiomyopathy in mdx Mice

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      Authors: Melanie Gartz, Margaret Haberman, Mariah J. Prom, Margaret J. Beatka, Jennifer L. Strande, Michael W. Lawlor
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Background:Duchenne muscular dystrophy (DMD) is a neuromuscular disease caused by dystrophin gene mutations affecting striated muscle. Due to advances in skeletal muscle treatment, cardiomyopathy has emerged as a leading cause of death. Previously, nicorandil, a drug with antioxidant and nitrate-like properties, ameliorated cardiac damage and improved cardiac function in young, injured mdx mice. Nicorandil mitigated damage by stimulating antioxidant activity and limiting pro-oxidant expression. Here, we examined whether nicorandil was similarly cardioprotective in aged mdx mice.Methods and Results:Nicorandil (6 mg/kg) was given over 15 months. Echocardiography of mdx mice showed some functional defects at 12 months compared to wild-type (WT) mice, but not at 15 months. Disease manifestation was evident in mdx mice via treadmill assays and survival, but not open field and grip strength assays. Cardiac levels of SOD2 and NOX4 were decreased in mdx vs. WT. Nicorandil increased survival in mdx but did not alter cardiac function, fibrosis, diaphragm function or muscle fatigue.Conclusions:In contrast to our prior work in young, injured mdx mice, nicorandil did not exert cardioprotective effects in 15 month aged mdx mice. Discordant findings may be explained by the lack of cardiac disease manifestation in aged mdx mice compared to WT, whereas significant cardiac dysfunction was previously seen with the sub-acute injury in young mice. Therefore, we are not able to conclude any cardioprotective effects with long-term nicorandil treatment in aging mdx mice.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-03-30T05:40:56Z
      DOI: 10.1177/10742484221088655
      Issue No: Vol. 27 (2022)
       
  • Corrigendum to “Direct Oral Anticoagulants in the Treatment of Left
           Ventricular Thrombus: A Retrospective, Multicenter Study and Meta-Analysis
           of Existing Data”

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      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.

      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-03-22T11:58:54Z
      DOI: 10.1177/10742484221091047
      Issue No: Vol. 27 (2022)
       
  • Nitric Oxide Is the Cause of Nitroglycerin Tolerance: Providing an Old Dog
           New Tricks for Acute Heart Failure

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      Authors: Wayne Kaesemeyer, Tatsiana Suvorava
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Our paper highlights the past 50 years of research focusing solely on tolerance involving nitroglycerin (glyceryl trinitrate, GTN). It also identifies and discusses inconsistencies in previous mechanistic explanations that have failed to provide a way to administer GTN continuously, free of limitations from tolerance and without the requirement of a nitrate-free interval. We illustrate, for the first time in 135 years, a mechanism whereby nitric oxide, the mediator of vasodilation by GTN, may also be the cause of tolerance. Based on targeting superoxide from mitochondrial complex I, uncoupled by glutathione depletion in response to nitric oxide from GTN, a novel unit dose GTN formulation in glutathione for use as a continuous i.v. infusion has been proposed. We hypothesize that this will reduce or eliminate tolerance seen currently with i.v. GTN. Finally, to evaluate the new formulation we suggest future studies of this new formulation for the treatment of acute decompensated heart failure.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-03-12T08:40:33Z
      DOI: 10.1177/10742484221086091
      Issue No: Vol. 27 (2022)
       
  • Estimated Aggregate Treatment Benefit With Addition of Multiple Novel
           Medications for Secondary Prevention of Atherosclerotic Cardiovascular
           Disease

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      Authors: Robert W. Ariss, Rajesh Gupta
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Purpose:Interest in improving residual cardiovascular (CV) risk by targeting multiple causative pathways has been growing. Several medications including icosapent ethyl, rivaroxaban, and ezetimibe have been shown to individually improve outcomes in the secondary prevention of atherosclerotic cardiovascular disease (ASCVD) beyond conventional therapy consisting of aspirin and statins. While each drug has been shown to individually improve outcomes, the expected treatment benefit of the combined use of these drugs for enhanced secondary prevention of ASCVD is not known.Methods:In this cross-trial analysis, we estimated the aggregate treatment effect of comprehensive medical therapy consisting of icosapent ethyl, rivaroxaban, and ezetimibe added to background aspirin and statin therapy through established methods of indirect comparisons of the results of three key clinical trials (REDUCE-IT [n = 8,179], COMPASS [n = 27,395], and IMPROVE-IT [n = 18,144]). The primary endpoint was a composite of cardiovascular death, non-fatal myocardial infarction (MI), or non-fatal stroke. Secondary endpoints included each individual component of the primary endpoint.Results:The hazard ratio (HR) of the imputed aggregate treatment effects for enhanced secondary prevention of ASCVD with comprehensive disease modifying therapy compared to aspirin and statin alone for the primary endpoint was 0.51 (95% confidence interval [CI] 0.42-0.61). The HR for CV death was 0.62 (95% CI 0.46-0.85), non-fatal MI was 0.52 (95% CI 0.40-0.69), and non-fatal stroke was 0.35 (95% CI 0.23-0.54). The results were similar in sensitivity analyses.Conclusion:The estimated aggregate treatment effect of enhanced secondary prevention of ASCVD through comprehensive medical therapy is substantial. This exploratory analysis supports further study of comprehensive therapy to reduce residual CV risk for the secondary prevention of ASCVD.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-03-08T07:01:37Z
      DOI: 10.1177/10742484221084772
      Issue No: Vol. 27 (2022)
       
  • Early Detection of Atrial Fibrillation in Community
           Pharmacies—CRIFAFARMA Study

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      Authors: María González Valdivieso, Domingo Orozco-Beltrán, Adriana López-Pineda, Vicente Francisco Gil-Guillén, José A. Quesada, Concepción Carratalá-Munuera, Rauf Nouni-García
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Background:Atrial fibrillation (AF) is the most common arrhythmia to appear in clinical practice. People with AF have 5 times the risk of stroke compared to the general population.Objective:This study aimed to determine the prevalence of AF in people over the age of 50 without known AF, who presented to a community pharmacy to check their cardiovascular risk factors, to identify risk factors associated with AF, and to assess the risk of stroke in people who screened positive for AF.Methods:A multicenter observational descriptive study of a screening program took place from May to December 2016. A blood pressure monitor (Microlife Watch BP Home) was used to screen for AF, and the CHA2DS2-VASc questionnaire was used to assess stroke risk.Results:The study included 452 adults over the age of 50. The CRIFAFARMA study detected a prevalence of AF of 9.1%. Risk factors for AF were: age of 75 years or older (P = .024), lack of physical activity (P = .043), diabetes (P < .001), dyslipidemia (P = .003), and history of cardiovascular disease (P = .003). Diabetes (OR 2.79, P = .005) and dyslipidemia (OR 2.16, P = .031) had a combined explanatory capacity in the multivariable logistic regression model adjusted for age. 85% were at high risk of stroke according to the CHA2DS2-VASc scale.Conclusions:AF was detected in more than 9% of the included population. Factors associated with AF were advanced age, lack of physical activity, diabetes, dyslipidemia, and history of cardiovascular disease, with diabetes and dyslipidemia standing out as the factors with independent explanatory capacity.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-02-24T04:10:19Z
      DOI: 10.1177/10742484221078973
      Issue No: Vol. 27 (2022)
       
  • The Association of Alanine Aminotransferase Levels With Myocardial
           Perfusion Imaging and Cardiovascular Morbidity

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      Authors: David Yardeni, Ronen Toledano, Victor Novack, Aryeh Shalev, Arik Wolak, Yaron Rotman, Ohad Etzion
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Introduction:Studies suggest that non-alcoholic fatty liver disease (NAFLD) is associated with an independent risk of cardiovascular disease (CVD). We utilized a large cohort of patients undergoing myocardial perfusion imaging (MPI) with single photon emission computed tomography (SPECT) to determine the association between alanine aminotransferase (ALT) as a surrogate marker for presumed NAFLD, and the presence of myocardial ischemia and mortality.Methods:We retrospectively assessed SPECT-MPI results and medical records of individuals evaluated between 1997 and 2008. We excluded patients with known non-NAFLD liver diseases, ALT values 340 U/L and absent liver tests. Elevated ALT cases were classified as presumed NAFLD. The primary endpoint was abnormal SPECT-MPI. Secondary endpoints included cardiac death, acute myocardial infarction and all-cause mortality.Results:Of 26,034 patients who underwent SPECT-MPI, 11,324 met inclusion criteria. 1635 (14.4%) patients had elevated ALT. SPECT-MPI results did not differ significantly between subjects with elevated ALT and controls. Elevated ALT was associated with increased risk for the composite endpoint of cardiac death or acute myocardial infarction at 5-year follow-up (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.01-1.67) and in all-cause mortality (HR 1.27, CI 1.02-1.58) but only in patients with normal SPECT-MPI.Conclusions:The long-term mortality of patients with abnormal SPECT-MPI is not modulated by ALT, likely reflecting an already high risk and established CVD. However, patients with normal SPECT-MPI are at increased risk for a future cardiac event if they have an elevated ALT level, suggesting an important role for NAFLD in earlier stages of CVD.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-01-25T05:04:38Z
      DOI: 10.1177/10742484221074585
      Issue No: Vol. 27 (2022)
       
  • Thanks to Reviewers

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      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.

      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-01-21T06:43:30Z
      DOI: 10.1177/10742484221075869
      Issue No: Vol. 27 (2022)
       
  • QT Prolongation in Critically Ill Patients With SARS-CoV-2 Infection

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      Authors: Wasim S. El Nekidy, Khalid Almuti, Hazem ElRefaei, Bassam Atallah, Lana M. Mohammad, Wael AlMahmeed, Mohamed Badr, Khaled Abdallah, Fadi Hamed, Jihad Mallat
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Background:Several reports linked the use of repurposed drugs such as hydroxychloroquine (HCQ), azithromycin, lopinavir/ritonavir, and favipiravir with QT interval prolongation in patients with SARS-CoV2 infection. Little is known about the risk factors for QT interval prolongation in this population. We sought to describe the prevalence and identify the main risk factors associated with clinically significant corrected QT (QTc) prolongation in this population.Methods:We conducted a retrospective analysis of critically ill patients who were admitted to our intensive care unit (ICU), had at least one electrocardiogram performed during their ICU stay, and tested positive for SARs-CoV-2. Clinically significant QTc interval prolongation was defined as QTc>500 milliseconds (ms).Results:Out of the 111 critically ill patients with SARS-CoV-2 infection, QTc was significantly prolonged in 47 cases (42.3%). Patients with a clinically significant QTc prolongation had significantly higher proportions of history of cardiac diseases/surgery (22 [46.8%] vs. 10 [15.6%], P < .001), hypokalemia (10 [21.3] vs. 5 [7.8%], P = .04), and male gender (95% vs. 82.8%, P = .036) than patients with QTc ≤500 ms, respectively. A total of 46 patients (41.4%) received HCQ, 28 (25.2%) received lopinavir/ritonavir, and 5 (4.5%) received azithromycin. Multivariate logistic regression analysis showed that a history of cardiac disease was the only independent factor associated with clinically significant QTc prolongation (P = .004 for the likelihood-ratio test).Conclusion:The prevalence of clinically significant QTc prolongation in critically ill patients with SARS-CoV-2 infection was high and independent of drugs used. Larger prospective observational studies are warranted to elucidate independent risk factors associated with clinically significant QTc prolongation in this study population.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-01-10T03:31:36Z
      DOI: 10.1177/10742484211069479
      Issue No: Vol. 27 (2022)
       
  • Associations of Atrial Fibrillation Patterns With Mortality and
           Cardiovascular Events: Implications of the MISOAC-AF Trial

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      Authors: Amalia Baroutidou, Anastasios Kartas, Athanasios Samaras, Andreas S. Papazoglou, Eleni Vrana, Dimitrios V. Moysidis, Evangelos Akrivos, Anastasios Papanastasiou, Ioannis Vouloagkas, Michail Botis, Evangelos Liampas, Artemios G. Karagiannidis, Efstratios Karagiannidis, Georgios Efthimiadis, Haralambos Karvounis, Apostolos Tzikas, George Giannakoulas
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Aim:This retrospective cohort study aimed to evaluate the prognostic implications of the distinct atrial fibrillation (AF) temporal patterns: first diagnosed, paroxysmal, and persistent or permanent AF.Methods:In this post hoc analysis of the MISOAC-AF trial (NCT02941978), a total of 1052 patients with AF (median age 76 years), discharged from the cardiology ward between 2015 and 2018, were analyzed. Kaplan-Meier and Cox-regression analyses were performed to compare the primary outcome of all-cause mortality, the secondary outcomes of stroke, major bleeding and the composite outcome of cardiovascular (CV) mortality or hospitalization among AF patterns.Results:Of patients, 121 (11.2%) had first diagnosed, 356 (33%) paroxysmal, and 575 (53.2%) persistent or permanent AF. During a median follow-up of 31 months (interquartile range 10 to 52 months), 37.3% of patients died. Compared with paroxysmal AF, patients with persistent or permanent AF had higher mortality rates (adjusted hazard ratio (aHR), 1.37; 95% confidence interval [CI], 1.08-1.74, P = .009), but similar CV mortality or hospitalization rates (aHR, 1.09; 95% CI, 0.91-1.31, P = .35). Compared with first diagnosed AF, patients with persistent or permanent AF had similar mortality (aHR, 1.26; 95% CI, 0.87-1.82, P = .24), but higher CV mortality or hospitalization rates (aHR, 1.35; 95% CI, 1.01-1.8, P = .04). Stroke and major bleeding events did not differ across AF patterns (all P> .05).Conclusions:In conclusion, in recently hospitalized patients with comorbid AF, the presence of persistent or permanent AF was associated with a higher incidence of mortality and morbidity compared with paroxysmal and first diagnosed AF.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-01-10T03:30:56Z
      DOI: 10.1177/10742484211069422
      Issue No: Vol. 27 (2022)
       
  • A Review of Pulmonary Arterial Hypertension Treatment in Extracorporeal
           Membrane Oxygenation: A Case Series of Adult Patients

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      Authors: Heather Torbic, Benjamin Hohlfelder, Sudhir Krishnan, Adriano R. Tonelli
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Background:Little data is published describing the use of medications prescribed for pulmonary arterial hypertension (PAH) in patients receiving extracorporeal membrane oxygenation (ECMO). Even though many patients with PAH may require ECMO as a bridge to transplant or recovery, little is reported regarding the use of PAH medications in this setting.Methods:This retrospective case series summarizes the clinical experience of 8 patients with PAH receiving ECMO and reviews medication management in the setting of ECMO.Results:Eight PAH patients, 5 of whom were female, ranging in age from 21 to 61 years old, were initiated on ECMO. Veno-arterial (VA) ECMO was used in 4 patients, veno-venous (VV) ECMO and hybrid ECMO configurations in 2 patients respectively. Common indications for ECMO included cardiogenic shock, bridge to transplant, and cardiac arrest. All patients were on intravenous (IV) prostacyclin therapy at baseline. Refractory hypotension was noted in 7 patients of whom 5 patients required downtitration or discontinuation of baseline PAH therapies. Three patients had continuous inhaled epoprostenol added during their time on ECMO. In patients who were decannulated from ECMO, PAH therapies were typically resumed or titrated back to baseline dosages. One patient required no adjustment in PAH therapy while on ECMO. Two patients were not able to be decannulated from ECMO.Conclusion:The treatment of critically ill PAH patients is challenging given a variety of factors that could affect PAH drug concentrations. In particular, PAH patients on prostacyclin analogues placed on VA ECMO appear to have pronounced systemic vasodilation requiring vasopressors which is alleviated by temporarily reducing the intravenous prostacyclin dose. Patients should be closely monitored for potential need for rapid titrations in prostacyclin therapy to maintain hemodynamic stability.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-01-10T02:50:30Z
      DOI: 10.1177/10742484211069005
      Issue No: Vol. 27 (2022)
       
  • Vorapaxar for Prevention of Major Adverse Cardiovascular and Limb Events
           in Peripheral Artery Disease

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      Authors: Justin T. Morrison, Nicholas Govsyeyev, Connie N. Hess, Marc P. Bonaca
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Peripheral artery disease (PAD) is a severe manifestation of atherosclerosis. Patients with PAD are at heightened risk for atherothrombotic complications, including myocardial infarction and stroke (MACE); however, there is also an equal or greater risk of major adverse limb events (MALE), such as acute limb ischemia (ALI) and major amputation. Therefore, there is a need for effective medical therapies to reduce the risk of both MACE and MALE. Recent trials have demonstrated the role of thrombin inhibition in reducing the risk of MACE and MALE in PAD patients. One such medical therapy, vorapaxar, is a potent inhibitor of protease activated receptor-1 which mediates the cellular effects of thrombin. Vorapaxar, used in addition to aspirin, has demonstrated robust reductions in MACE and MALE in PAD patients. In this article, we provide a contemporary review of the current state of PAD and the role of antithrombotic medications in the treatment of PAD, as well as the current clinical data on vorapaxar and strategies to integrate vorapaxar into contemporary medical management of peripheral artery disease.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-01-10T02:49:11Z
      DOI: 10.1177/10742484211056115
      Issue No: Vol. 27 (2022)
       
  • The Efficacy and Safety of Sacubitril/Valsartan in Heart Failure Patients:
           A Review

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      Authors: Rui Zhang, Xiaotong Sun, Ya Li, Wenzheng He, Hongguang Zhu, Baoshan Liu, Aiyuan Zhang
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor, has been approved for the treatment of HF. At present, there have been few systematic and detailed reviews discussing the efficacy and safety of sacubitril/valsartan in HF. In this review, we first introduced the pharmacological mechanisms of sacubitril/valsartan, including the reduction in the degradation of natriuretic peptides in the natriuretic peptide system and inhibition of the renin-angiotensin system. Then, we summarized the efficacy of sacubitril/valsartan in HF patients with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF) including the reduction in risks of mortality and hospitalization, reversal of cardiac remodeling, regulation of biomarkers of HF, improvement of the quality of life, antiarrhythmia, improving renal dysfunction and regulation of metabolism. Finally, we discussed the safety and tolerability of sacubitril/valsartan in the treatment of HFrEF or HFpEF. Compared with ACEIs/ARBs or placebo, sacubitril/valsartan showed good safety and tolerability, although the risk of hypotension might be high. In conclusion, the overwhelming majority of studies show that sacubitril/valsartan is effective and safe in the treatment of HFrEF patients but that it has little benefit in HFpEF patients. Sacubitril/valsartan will probably be a promising anti-HF drug in the near future.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-01-07T10:30:39Z
      DOI: 10.1177/10742484211058681
      Issue No: Vol. 27 (2022)
       
  • IV Sodium Ferric Gluconate Complex in Patients Hospitalized Due to Acute
           Decompensated Heart Failure and Iron Deficiency

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      Authors: Itay Borreda, Robert Zukermann, Danny Epstein, Erez Marcusohn
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Background:Patients suffering from heart failure (HF) and iron deficiency (ID) have worse outcomes. Treatment with intra-venous (IV) ferric carboxymaltose has been shown to reduce HF rehospitalizations and to improve functional capacity and symptoms in patients with HF and reduced ejection fraction (HFrEF). However, IV ferric carboxymaltose is significantly more expensive than IV sodium ferric gluconate complex (SFGC) limiting its availability to most HF patients around the globe.Methods:A retrospective analysis comparing patients admitted to internal medicine or cardiology departments between January 2013 to December 2018 due to acute decompensated HF (ADHF) and treated with or without IV SFGC on top of standard medical therapy.Results:During the study period, a total of 1863 patients were hospitalized due to ADHF with either HFrEF or HF with preserved ejection fraction (HFpEF). Among them, 840 patients had laboratory evidence of iron deficiency (absolute or functional) and met the inclusion criteria. One hundred twenty-two of them (14.5%) were treated with IV SFGC during the index hospitalization. Patients treated with IV iron were more likely to have history of ischemic heart disease, atrial fibrillation, and chronic kidney disease. The rate of readmissions due to ADHF was similar between the groups at 30 days, 3 months, and 1 year.Conclusion:High risk patient hospitalized to ADHF and treated with IV SFGC showed comparable ADHF readmission rates, compared to those who did not receive iron supplementation.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-01-07T10:29:23Z
      DOI: 10.1177/10742484211055639
      Issue No: Vol. 27 (2022)
       
  • Impact of Homoarginine on Myocardial Function and Remodeling in a Rat
           Model of Chronic Renal Failure

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      Authors: Vitali Koch, Christophe Weber, Johannes H. Riffel, Kristina Buchner, Sebastian J. Buss, Selina Hein, Derliz Mereles, Marco Hagenmueller, Christian Erbel, Winfried März, Christian Booz, Moritz H. Albrecht, Thomas J. Vogl, Norbert Frey, Stefan E. Hardt, Marco Ochs
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Purpose:Low plasma concentrations of the amino acid homoarginine (HA) have been shown to correlate with adverse cardiovascular outcome, particularly in patients with chronic kidney disease. The present study sought to investigate the effect of HA treatment on cardiac remodeling in rats undergoing artificially induced renal insufficiency by 5/6 nephrectomy (5/6 Nx).Methods:A total of 33 male Wistar rats were randomly divided into sham and 5/6 Nx groups, receiving either placebo treatment or 400 mg·kg−1·day−1 HA over a 4-week period.Results:5/6 Nx per se resulted in adverse myocardial remodeling with aggravated cardiac function and associated cardiac overload as the most obvious alteration (−23% ejection fraction, P < 0.0001), as well as increased myocardial fibrosis (+80%, P = 0.0005) compared to placebo treated sham animals. HA treatment of 5/6 Nx rats has led to an improvement of ejection fraction (+24%, P = 0.0003) and fractional shortening (+21%, P = 0.0126), as well as a decrease of collagen deposition (−32%, P = 0.0041), left ventricular weight (−14%, P = 0.0468), and myocyte cross-sectional area (−12%, P < 0.0001). These changes were accompanied by a downregulation of atrial natriuretic factor (−65% P < 0.0001) and collagen type V alpha 1 chain (−44%, P = 0.0006). Sham animals revealed no significant changes in cardiac function, myocardial fibrosis, or any of the aforementioned molecular changes after drug treatment.Conclusion:Dietary HA supplementation appears to have the potential of preventing cardiac remodeling and improving heart function in the setting of chronic kidney disease. Our findings shed new light on HA as a possible new therapeutic agent for patients at high cardiovascular risk.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-01-07T10:28:01Z
      DOI: 10.1177/10742484211054620
      Issue No: Vol. 27 (2022)
       
  • Gender Related Differences in Gastrointestinal Bleeding With Oral
           Anticoagulation in Atrial Fibrillation

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      Authors: Eliana Ferroni, Gentian Denas, Nicola Gennaro, Ugo Fedeli, Vittorio Pengo
      Abstract: Journal of Cardiovascular Pharmacology and Therapeutics, Volume 27, Issue , January-December 2022.
      Background:DOACs are characterized by a higher incidence of gastrointestinal bleeding and this may be different among males and females. Female patients were underrepresented in the DOAC pivotal trials. We aimed to assess real-world differences in gastrointestinal bleeding with oral anticoagulants (DOACs and VKAs) among males and females with atrial fibrillation.Methods:We performed a population-based retrospective analysis on linked administrative claims. Atrial fibrillation patients of 65 years and above were considered. Bleeding risk factors were assessed through HASBED and previous history of gastrointestinal disease. A time-to-event analysis compared gastrointestinal bleeding between males and females.Results:The overall cohort consisted of 15338 (55% female) DOAC and 44542 (50% female) VKA users. Most of the patients showed HASBED ≥2. Incidence rate of GI bleeding was higher in females as compared to males among DOAC users (0.90% vs 0.59%), and significant gender difference in GI bleeding was found, after adjustment, in the Cox regression analysis (HR 1.48, 95%CI 1.02-2.16). In the VKA group, no significant difference among genders was found in the time-to-event analysis.Conclusions:Our data suggest that female patients treated with DOACs have a higher risk of GI bleeding versus male patients; this difference is not observed in VKA patients.
      Citation: Journal of Cardiovascular Pharmacology and Therapeutics
      PubDate: 2022-01-07T10:23:30Z
      DOI: 10.1177/10742484211054609
      Issue No: Vol. 27 (2022)
       
 
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