SOSTIENICI
Pubblicazioni recenti - cardiovascular
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In-hospital outcomes in nonagenarian patients undergoing primary percutaneous coronary intervention.
Minerva Cardiol Angiol2022 Dec;():. doi: 10.23736/S2724-5683.22.06167-1.
Angelini Filippo, Franchin Luca, Bocchino Pier P, Morici Nuccia, Wa?ha Wojciech, Savonitto Stefano, Trabattoni Daniela, Cerrato Enrico, Barbieri Lucia, Fortuni Federico, DE Luca Leonardo, Greco Antonio, DE Filippo Ovidio, Montefusco Antonio, Montabone Andrea, Rubino Anna E, Gili Sebastiano, Quadri Giorgio, Somaschini Alberto, Cornara Stefano, Carugo Stefano, Capodanno Davide, Wojakowski Wojciech, Dusi Veronica, D'Ascenzo Fabrizio, DE Ferrari Gaetano M,
Abstract
BACKGROUND:
The aim of the present analysis was to evaluate the incidence and predictors of in-hospital adverse outcomes in nonagenarian patients undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI).
METHODS:
Consecutive nonagenarian patients undergoing pPCI for STEMI from 2009 to 2019 were retrospectively included in an international multicenter registry. In-hospital all-cause death was the primary outcome.
RESULTS:
A total of 308 patients were included (mean age 92.5±2.5 years, 65.6% female). Mean systolic blood pressure (SBP) at hospital admission was 130.7±33.5 mmHg, 46 (17%) patients presented with a Killip class III-IV, mean left ventricle ejection fraction (LVEF) was 40.0±11.5% and 147 (58%) patients were independent in everyday activities. In-hospital death occurred in 99 patients (32%). After multivariate adjustment, lower LVEF (OR per unit reduction 1.08, 95% CI: 1.03-1.11, P value
CONCLUSIONS:
Nonagenarian patients presenting with STEMI and undergoing pPCI have high in-hospital mortality. Independency in everyday life is a strong independent predictor of survival to hospital discharge.
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Report on the 25th meeting of the ECCR 30th Sep-2nd October 2022.
Clin Sci (Lond)2022 Dec;136(S1):1-2. doi: 10.1042/CS2022ECCR001-MR.
Fernández-Alfonso Marisol,
Abstract
The 25th meeting of the European Council for Cardiovascular Research (ECCR) was onsite in Villa Fiorita, Treviso Italy. More than 70 participants, including trainees, early career researchers and established investigators from several European countries (Austria, Bulgaria, Canada, China, Denmark, France, Germany, Italy, Lebanon, The Netherlands, Portugal, Slovakia, Slovenia, Spain, Switzerland, Turkey, UK) and the USA met face-to-face to enjoy three days of outstanding research presentations. The meeting covered several topics of cardiovascular research: from vascular, cardiac, and metabolic aspects to Covid-19, and from basic to clinical research.
© 2022 The Author(s). Published by Portland Press Limited on behalf of the European Council for Cardiovascular Research.
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Abstracts from the 25th Meeting of the European Council for Cardiovascular Research (ECCR).
Clin Sci (Lond) -
Adipocytes control haematopoiesis and inflammation through CD40 signaling.
Haematologica2022 Dec;():. doi: 10.3324/haematol.2022.281482.
Reiche Myrthe E, Poels Kikkie, Bosmans Laura A, Vos Winnie G, Van Tiel Claudia M, Gijbels Marion J J, Aarts Suzanne A B M, Den Toom Myrthe, Beckers Linda, Weber Christian, Atzler Dorothee, Rensen Patrick C N, Kooijman Sander, Lutgens Esther,
Abstract
The co-stimulatory CD40-CD40L dyad plays an important role in chronic inflammatory diseases associated with ageing. Although CD40 is mainly expressed by immune cells, CD40 is also present on adipocytes. We aimed to delineate the role of adipocyte-CD40 in the aging haematopoietic system and evaluated the effects of adipocyte CD40 deficiency on cardiometabolic diseases. Adult adipocyte CD40-deficient mice (AdiCD40KO) mice had a decrease in bone marrow (BM) haematopoietic stem cells (Lin-Sca+cKit+, LSK) and common lymphoid progenitors, which was associated with increased BM adiposity and T-cell activation, along with elevated plasma corticosterone levels, a phenotype that became more pronounced with age. Atherosclerotic AdiCD40koApoE-/- (CD40AKO) mice also displayed changes in the LSK population, showing increased myeloid- and lymphoid multipotent progenitors, and augmented corticosterone levels. Increased T-cell activation could be observed in BM, spleen, and adipose tissue (AT), while B-cell numbers were decreased. Although atherosclerosis was reduced in CD40AKO mice, plaques contained more activated T-cells and larger necrotic cores. Analysis of peripheral AT in a diet-induced obesity model revealed that obese AdiCD40KO mice showed increased T-cell activation in AT and lymphoid organs, but exhibited decreased weight gain and improved insulin sensitivity, along with increased fat oxidation. In conclusion, adipocyte CD40 plays an important role in maintaining immune cell homeostasis in BM during ageing and chronic inflammatory diseases, particularly of the lymphoid populations. Although adipocyte CD40-deficiency reduces atherosclerosis burden and ameliorates diet-induced obesity, the accompanying T-cell activation may eventually aggravate cardiometabolic diseases.
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Incidentally discovered cold hemagglutinins within autologous blood bag and cardioplegia line in a patient with a recent history of COVID-19 undergoing coronary artery surgery.
Perfusion2022 Dec;():2676591221141323. doi: 10.1177/02676591221141323.
?im?ek Erdal, Karaca Okay G, Çetinkaya Ferit, Can Ferda, Günayd?n Serdar,
Abstract
INTRODUCTION:
Cold agglutinin disease (CAD) is a rare autoimmune disorder characterized by destruction (hemolysis) of erythrocytes. In CAD, autoantibodies that cause agglutination at temperature of optimum +3-+4 ? degree cause symptoms. It is known that CAD often occurs after viral infections. Also, it has been reported in case reports that COVID-19 disease can cause CAD.
CASE REPORT:
46-year-old male patient with a history of diabetes mellitus and hypertension presented to outpatient clinic in our department to have CABG surgery. He recovered from COVID-19 disease 1.5 months ago. Cardiopulmonary bypass was initiated and the cross-clamp was placed and antegrade Delnido cardioplegia solution was started to be given at +4 ?. It was observed that the cardioplegia line was agglutinated. On the other hand, it was seen that the autologous blood taken by the anesthesiologist was also agglutinated and formed air bubbles and became unusable. X-clamp was removed and the heart rhythm recovered. The patient was consulted to hematology during postoperative intensive care follow-ups. The cold agglutinin test performed at of +4 ? was reported as positive. In this case, we associated the CAD with covid-19 for three main reasons. First one, the patient's complaints about CAD started after COVID-19 disease. Secondly, in the national health archive, the patient's pre-COVID-19 blood tests were completely normal but it was seen that LDH increased and RBC-HCT incompatibility started after COVID-19. As the third, when we search the literature, we have seen the COVID-19 related CAD in many case reports published by hematologists.
CONCLUSION:
With the rare cold agglutinin disease, it seems that we will encounter it more often after the COVID-19 pandemic. Except for deep hypothermia, the most important problem is seen during cardioplegia administration. Therefore, non-blood cardioplegia can be lifesaving.
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HDL cholesterol, triglycerides and characteristics of coronary atherosclerosis in patients with newly diagnosed significant coronary artery disease by CTCA.
Kardiol Pol2022 Dec;():. doi: 10.33963/KP.a2022.0279.
Oleksiak Anna, K?pka Cezary, K?pka Cezary, Ruci?ska Karolina, Ruci?ska Karolina, Marcinkiewicz Kamil, Marcinkiewicz Kamil, Demkow Marcin, Demkow Marcin, Kruk Mariusz, Kruk Mariusz,
Abstract
BACKGROUND:
Current European Society of Cardiology guidelines indicate specific target low-density lipoprotein cholesterol (LDL-C) levels for different cardiovascular risk categories in terms of prevention. However, the target for high-density lipoprotein cholesterol (HDL-C) and triglycerides have not been established.
AIM:
The study aim to investigate the associations betweenHDL-C,triglycerides andcoronary plaquescharacteristics.
METHODS:
This is a prospective single-center study with enrolled consecutive patients with newly diagnosed significant (?1stenosis ?50%) CAD on CTCA. Patients had lipids andCTCA analysis, including high-risk plaque (HRP) features: low-attenuation plaque (LAP), napkin-ring sign (NRS), positive remodeling (PR) and spotty calcium (SC), type of plaque (calcified, noncalcified, mixed), and their composition (calcified, fibrous, fibro-fatty, necrotic core).
RESULTS:
The study included 300 patients (191 men, 66 [8] years). 66% of them took lipid-lowering therapy. HRPwere found in 208 patients. There was no association between LDL-C, plaque composition and HRP presence. There was a negative correlation between HDL-Cand fibro-fatty and necrotic core plaque components (P = 0.0002, P = 0.0009). There was a positive correlation between triglycerides and necrotic core (P = 0.038). There were differences in HDL-C and triglycerides in patients with and without NRS (47 vs. 53 mg/dl, P = 0.0002 and 128 vs. 109 mg/dl, P = 0.02). In logistic regression, HDL-C (odds ratio [OR], 0.95;95% confidence interval [CI], 0.93-?0.98; P
CONCLUSION:
Lower HDL-C and higher triglycerides were associated with NRS presence and more necrotic core plaque component in coronary plaques in patients with newly diagnosed CAD.
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BioMatrix Versus Orsiro Stents for Coronary Artery Disease: A Multicenter, Randomized, Open-Label Study.
Circ Cardiovasc Interv2022 Dec;():e012307. doi: 10.1161/CIRCINTERVENTIONS.122.012307.
Yoon Chang-Hwan, Kwun Ju-Seung, Choi Young Jin, Park Jin Joo, Kang Si-Hyuck, Kim Sun-Hwa, Suh Jung-Won, Youn Tae-Jin, Kim Myeong-Kon, Cha Kwang Soo, Lee Seung-Hwan, Hong Bum-Kee, Rha Seung-Woon, Kang Woong Chol, Lee Jae-Hwan, Kim Sang-Hyun, Chae In-Ho,
Abstract
BACKGROUND:
Comparative studies of ultrathin-strut biodegradable polymer sirolimus-eluting stent (BP-SES) have reported promising results and validated its excellent outcomes in terms of safety and efficacy. However, there are limited studies comparing BP drug-eluting stents with struts of different thicknesses. We compared the long-term clinical outcomes of patients treated with an ultrathin-strut BP-SES or a thick-strut biodegradable polymer biolimus-eluting stent (BP-BES).
METHODS:
The BIODEGRADE trial (Biomatrix and Orsiro Drug-Eluting Stents in Angiographic Result in Patients With Coronary Artery Disease) is a multicenter prospective randomized study comparing coronary revascularization in patients with ultrathin-strut BP-SES and thick-strut BP-BES with the primary end point of target lesion failure at 18 months posttreatment. We performed the prespecified analysis of 3-year clinical outcomes.
RESULTS:
In total, 2341 patients were randomized to receive treatment with ultrathin-strut BP-SES (N=1175) or thick-strut BP-BES (N=1166). The 3-year incidence rate of target lesion failure was 3.2% for BP-SES and 5.1% for BP-BES (=0.023). The difference was primarily due to differences in ischemia-driven target lesion revascularization (BP-SES, 1.5%; BP-BES, 2.8%; =0.035) between groups. A landmark analysis of the late follow-up period showed significant differences in target lesion failure, with outcomes being better in BP-SES. Cardiac death and target lesion revascularization were significantly lower in the BP-SES group.
CONCLUSIONS:
In a large, randomized trial, the long-term clinical outcome of target lesion failure at 3 years was significantly better among patients treated with the ultrathin-strut BP-SES. The results indicate the superiority of the ultrathin-strut BP-SES compared with the thick-strut BP-BES.
REGISTRATION:
URL: https://clinicaltrials.gov; Unique identifier: NCT02299011.
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Personalized Contrast Dosing: Not Quite Ready For Primetime, But We're Getting Closer.
Circ Cardiovasc Qual Outcomes2022 Dec;():e009569. doi: 10.1161/CIRCOUTCOMES.122.009569.
Sukul Devraj, Gurm Hitinder S,
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Prognostic Value of Left Ventricular Global Longitudinal Strain in Patients With Congenital Heart Disease.
Circ Cardiovasc Imaging2022 Dec;():e014865. doi: 10.1161/CIRCIMAGING.122.014865.
Egbe Alexander C, Miranda William R, Anderson Jason H, Pellikka Patricia A, Connolly Heidi M,
Abstract
BACKGROUND:
Left ventricular global longitudinal strain (LVGLS) has been shown to improve risk stratification in patients with LV systolic dysfunction and subsequent recovery of LV ejection fraction (LVEF) in the acquired heart disease population. The purpose of this study was to assess the relationship between LVGLS and cardiovascular events (heart failure hospitalization, sustained ventricular tachycardia/appropriate shock, heart transplant, or cardiovascular death) and deterioration in LVEF (absolute decrease in LVEF ?10% to LVEF
METHODS:
Retrospective cohort study of congenital heart disease patients with previous diagnosis of LV systolic dysfunction (LVEF 18%) versus abnormal LVGLS (absolute LVGLS ?18%) groups.
RESULTS:
Of 193 patients with recovered LVEF, 86 (45%) had normalization of LVGLS at index echocardiogram. A higher absolute LVGLS and use of renin angiotensin aldosterone system antagonist was associated with a lower risk of cardiovascular events and subsequent deterioration in LVEF, while hypertension was associated with higher risk of cardiovascular events and deterioration in LVEF.
CONCLUSIONS:
These results suggest that patients with congenital heart disease with recovered LVEF remained at risk for adverse outcomes, and LVGLS can be used to identify patients at risk for adverse outcomes. Medical therapy for heart failure and treatment of hypertension may reduce the risk of adverse outcome, but these findings require empirical validation, hence the need for a clinical trial.
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Increased Serum Systemic Immune-Inflammation Index is Independently Associated With Severity of Carotid Artery Stenosis.
Angiology2022 Dec;():33197221144934. doi: 10.1177/00033197221144934.
Kelesoglu Saban, Yilmaz Yucel, Elcik Deniz, Bireciklioglu Fehmi, Ozdemir Fatma, Balc? Fatih, Tuncay Aydin, Kalay Nihat,
Abstract
Stroke is a significant contributor to morbidity and mortality. The present study investigated how the systemic immune inflammation index (SII) could be used to predict the likelihood of developing carotid artery stenosis (CAS), which can be seen using carotid artery angiography (CAAG). This study comprised 418 individuals who underwent CAAG for CAS. SII was calculated by multiplying the platelet count by the neutrophil/lymphocyte ratio (NLR). The patients were divided into two groups: non-critical and critical CAS (stenosis below %70 and above ?70%, respectively). Compared with the non-critical CAS, the critical CAS group had greater high sensitivity C-reactive protein levels (4.5 [3.1-5.7] vs 3.9 [2-5] [mg/L],
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Mechanical regulation of the early stages of angiogenesis.
J R Soc Interface2022 Dec;19(197):20220360. doi: 10.1098/rsif.2022.0360.
Barrasa-Ramos Sara, Dessalles Claire A, Hautefeuille Mathieu, Barakat Abdul I,
Abstract
Favouring or thwarting the development of a vascular network is essential in fields as diverse as oncology, cardiovascular disease or tissue engineering. As a result, understanding and controlling angiogenesis has become a major scientific challenge. Mechanical factors play a fundamental role in angiogenesis and can potentially be exploited for optimizing the architecture of the resulting vascular network. Largely focusing on systems but also supported by some evidence, the aim of this Highlight Review is dual. First, we describe the current knowledge with particular focus on the effects of fluid and solid mechanical stimuli on the early stages of the angiogenic process, most notably the destabilization of existing vessels and the initiation and elongation of new vessels. Second, we explore inherent difficulties in the field and propose future perspectives on the use of and physics-based modelling to overcome these difficulties.
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Quantitative high-resolution 7T MRI to assess longitudinal changes in articular cartilage after anterior cruciate ligament injury in a rabbit model of post-traumatic osteoarthritis.
Osteoarthr Cartil Open2022 Jun;4(2):100259. doi: 100259.
Terracciano Rossana, Carcamo-Bahena Yareli, Royal Amber Lee R, Demarchi Danilo, Labis John Scott, Harris Joshua D, Weiner Bradley K, Gupta Nakul, Filgueira Carly S,
Abstract
OBJECTIVE:
To demonstrate an ultra-high field (UHF) 7 ?T delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) protocol for quantitative post-traumatic osteoarthritis (PTOA) detection and monitoring in a rabbit anterior cruciate ligament transection (ACLT) model.
DESIGN:
ACL transections were performed unilaterally in 5 rabbits (33-weeks-old, 3.5 ?± ?0.5 ?kg) to induce PTOA. MRI exams were performed at 7 ?T prior to and 2, 4, 7 and 10-weeks after ACLT using a modified dGEMRIC protocol. Voxel-based T1 and T2 maps were created over manually drawn femoral cartilage ROIs from the center of the tibial plateau to the posterior meniscus. Femoral, tibial, and patellar epiphyses were harvested 10-weeks post-surgery and processed for ?CT imaging and histology.
RESULTS:
Quantitative analysis revealed a 35% and 39% decrease in dGEMRIC index in the medial ACLT knee compartment 7- and 10-weeks post-surgery, respectively ( ?= ?0.009 and ?= ?0.006) when compared to baseline. There was no significant change in the lateral ACLT compartment or in either compartment of the control knees. Visual inspection of histology confirmed PTOA in the ACLT knees. Osteophytes were found only in ACLT knees (osteophyte volume in femur: 94.53 ?± ?44.08 ?mm, tibia: 29.35 ?± ?13.79 ?mm, and patella: 3.84 ?± ?0.92 ?mm) and were significantly larger in the medial compartments of the femur than lateral ( ?= ?0.0312).
CONCLUSION:
The dGEMRIC technique quantitatively applied at 7 ?T UHF-MRI demonstrates site-specific cartilage degeneration in a large animal PTOA model. This should encourage further investigation, with potential applications in drug and therapeutic animal trials as well as human studies.
© 2022 The Authors.
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Does osteoarthritis modify the association between NSAID use and risk of comorbidities and adverse events?
Osteoarthr Cartil Open2022 Jun;4(2):100253. doi: 100253.
Dell'Isola Andrea, Turkiewicz Aleksandra, Zhang Weiya, Kiadaliri Ali, Bierma-Zeinstra Sita, Runhaar Jos, Prieto-Alhambra Daniel, Englund Martin,
Abstract
OBJECTIVES:
To investigate the role of osteoarthritis (OA) in the incidence of musculoskeletal, metabolic, cardiovascular, digestive, neuro-psychological, kidney and other comorbidities/adverse events after (i) incident non-steroidal anti-inflammatory drug (NSAID) initiation and (ii) NSAID discontinuation.
METHODS:
We used register data for the population of Skåne, Sweden. For (i), we analysed the association between starting NSAIDs and the risk of incident outcome events in the 6 years following NSAID dispensation among people with prevalent OA vs no OA. For (ii) we studied the effect of discontinuing NSAIDs among people with and without OA up to 120 days. We used flexible parametric models to estimate adjusted differences in cumulative incidence with NSAIDs as time-varying exposure in the presence of non-proportional hazards.
RESULTS:
For (i) we included between 243,832 and 409,749 persons. In the whole cohort, over the 6 years of follow-up, NSAID initiation was associated with a 3% (metabolic) to 16% (musculoskeletal) higher cumulative incidence of outcomes compared to non-users. The difference between those initiating NSAIDs vs non-users was similar in those with and without OA for most outcomes, but in those with OA the increase was lower for neuro-psychological (95%CI: 3.7%-4.6% vs 7.1%-7.9%) and musculoskeletal comorbidities (12%-14.5% vs 16.2%-17.2%).In (ii), we found no interaction between OA and NSAID discontinuation. NSAID discontinuation was associated with decreased risks for most of the outcomes, from -1.3% for musculoskeletal to -0.4% for cardiovascular comorbidities.
CONCLUSIONS:
OA appears to have little influence on the increased risk of comorbidities observed after NSAID initiation or decrease after discontinuation.
© 2022 The Authors.
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Cost-Effectiveness of the CNIC-Polypill Strategy Compared With Separate Monocomponents in Secondary Prevention of Cardiovascular and Cerebrovascular Disease in Portugal: The MERCURY Study.
J Health Econ Outcomes Res2022 ;9(2):134-146. doi: 10.36469/001c.39768.
Aguiar Carlos, Araujo Francisco, Rubio-Mercade Gabriel, Carcedo David, Paz Silvia, Castellano Jose María, Fuster Valentín,
Abstract
Cardiovascular (CV) diseases remain a leading and costly cause of death globally. Patients with previous CV events are at high risk of recurrence. Secondary prevention therapies improve CV risk factor control and reduce disease costs. To assess the cost-effectiveness of a CV polypill strategy (CNIC-Polypill) compared with the loose combination of monocomponents to improve the control of CV risk factors in patients with previous coronary heart disease or stroke. A Markov model cost-utility analysis was developed using 4 health states, SMART risk equation, and 3-month cycles for year 1 and annual cycles thereafter, over a lifetime horizon from the perspective of the National Health System in Portugal (base case). The NEPTUNO study, Portuguese registries, mortality tables, official reports, and the literature were consulted to define effectiveness, epidemiological costs, and utility data. Outcomes were costs (estimated in 2020 euros) per life-year (LY) and quality-adjusted LY (QALY) gained. A 4% discount rate was applied. Alternative scenarios and one-way and probabilistic sensitivity analyses tested the consistency and robustness of results. The CNIC-Polypill strategy in secondary prevention provides more LY and QALY, at a higher cost, than monocomponents. The incremental cost-utility ratio is ?1557/QALY gained. Assuming a willingness-to-pay threshold of ?30?000/QALY gained, there is a 79.7% and a 44.4% probability of the CNIC-Polypill being cost-effective and cost-saving, respectively, compared with the loose combination of monocomponents. Results remain consistent in the alternative scenarios and robust in the sensitivity analyses. The model reflects increments in the number of years patients would live and in quality of life with the CNIC-Polypill. The clinical effectiveness of the CNIC-Polypill strategy initially demonstrated in the NEPTUNO study has been recently corroborated in the SECURE trial. The incremental cost of the CNIC-Polypill strategy emerges slightly above the comparator, but willingness-to-pay estimates and sensitivity analyses indicate that the CNIC-Polypill strategy is consistently cost-effective compared with monocomponents and remains within acceptable affordability margins. The CNIC-Polypill is a cost-effective secondary prevention strategy. In patients with histories of coronary heart disease or stroke, the CNIC-Polypill more effectively controls CV risk factors compared with monocomponents.
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Overlapping Myocarditis and Postural Orthostatic Tachycardia Syndrome After COVID-19 Messenger RNA Vaccination: A Case Report.
Cureus2022 Nov;14(11):e31006. doi: e31006.
Sanada Yuichi, Azuma Junji, Hirano Yasuhiro, Hasegawa Yasuhiro, Yamamoto Takehisa,
Abstract
The worldwide spread of the coronavirus disease 2019 (COVID-19) pandemic and the significant morbidity and mortality rate associated with it led to the rapid development of several COVID-19 vaccines. While serious side effects related to the vaccines are rare, various adverse events have been reported to occur after COVID-19 messenger RNA (mRNA) vaccination, including myocarditis, Guillain-Barré syndrome, and thrombosis. Postural orthostatic tachycardia syndrome (POTS) is a chronic cardiovascular dysautonomia among young and middle-aged individuals. Although the pathophysiology of POTS is thought to be heterogeneous, vaccine-induced immune-mediated autonomic dysfunction is hypothesized to be one cause of the syndrome. In this report, we present a case of myocarditis and POTS occurring in a 13-year-old male following COVID-19 mRNA vaccination. He presented with persistent severe fatigue and headache. The patient's symptoms improved after intravenous immunoglobulin for myocarditis, non-pharmacologic interventions, and multiple medications for POTS.
Copyright © 2022, Sanada et al.
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Comparing Simvastatin Monotherapy V/S Simvastatin-Ezetimibe Combination Therapy for the Treatment of Hyperlipidemia: A Meta-Analysis and Review.
Cureus2022 Nov;14(11):e31007. doi: e31007.
Chauhan Dhruva, Memon Farzana, Patwardhan Vaibhav, Kotwani Priya, Shah Parth, Samala Venkata Vikramaditya,
Abstract
Longstanding hyperlipidemia can increase the risk of cardiovascular disease. Statins are currently the mainstay of treatment in hyperlipidemia. Combination therapy of statin with ezetimibe is only indicated for severe hypercholesterolemia and very high-risk atherosclerotic cardiovascular disease (ASCVD) population. There is a paucity of studies comparing statin monotherapy vs combination therapy with ezetimibe. This study aims to perform a meta-analysis of the existing literature and compare the effectiveness of statin monotherapy with statin-ezetimibe combination therapy in the management of hyperlipidemia. A systematic electronic search of the scientific literature was performed in PubMed, EMBASE, and Scopus. Only randomized controlled trials comparing simvastatin monotherapy vs simvastatin-ezetimibe combination therapy between the years 2000 and 2021 and published in English language were included. Fifteen studies were included in the final analysis. The main outcomes that were compared were a reduction in low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Our study showed that combination therapy led to a higher reduction of LDL-C (Mean difference: -20.22(-26.38, -14.07); P
Copyright © 2022, Chauhan et al.
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COVID-19, cardiac involvement and cardiac rehabilitation: Insights from a rehabilitation perspective - State of the Art.
Turk J Phys Med Rehabil2022 Sep;68(3):317-335. doi: 10.5606/tftrd.2022.11435.
Sonel Tur Birkan, Köseo?lu Belma Füsun, Kutay Ordu Gökkaya Nilüfer, Kurtai? Aytür Ye?im, Özyemi?ci Ta?k?ran Özden, Demirba? Kabayel Derya, Kesikta? Nur, T?k?z Canan, Özdemir Hande, Alemdaro?lu Ebru, Bilir Kaya Ba?ak, Genç Aysun, Tomruk Sütbeyaz Serap,
Abstract
Since the beginning of the pandemic, many novel coronavirus disease 2019 (COVID-19) patients have experienced multisystem involvement or become critically ill and treated in intensive care units, and even died. Among these systemic effects, cardiac involvement may have very important consequences for the patient's prognosis and later life. Patients with COVID-19 may develop cardiac complications such as heart failure, myocarditis, pericarditis, vasculitis, acute coronary syndrome, and cardiac arrhythmias or trigger an accompanying cardiac disease. The ratio of COVID-19 cardiac involvement ranges between 7 and 28% in hospitalized patients with worse outcomes, longer stay in the intensive care unit, and a higher risk of death. Furthermore, deconditioning due to immobility and muscle involvement can be seen in post-COVID-19 patients and significant physical, cognitive and psychosocial impairments may be observed in some cases. Considering that the definition of health is "a state of complete physical, mental and social well-being", individuals with heart involvement due to COVID-19 should be rehabilitated by evaluating all these aspects of the disease effect. In the light of the rehabilitation perspective and given the increasing number of patients with cardiac manifestations of COVID-19, in this review, we discuss the rehabilitation principles in this group of patients.
Copyright © 2022, Turkish Society of Physical Medicine and Rehabilitation.
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Peroxynitrite induced cytotoxicity and detection in cardiovascular, neurodegenerative and inflammatory disorders.
Int J Health Sci (Qassim) -
Cardiotoxicity in cancer patients treated with chemotherapy: A systematic review.
Int J Health Sci (Qassim)2022 ;16(6):39-46.
Lima Maria Adriely Cunha, Brito Henrique Rodrigues de Almeida, Mitidieri Gabriel Guimarães, de Souza Eduardo Paulo, Sobral Ana Caroline Gois, Melo Hemmely Hevelyn Maria Araujo, Vasconcelos Guilherme Barreto, de Almeida Berila Beatriz Dias, Figueiredo Thainá de Araújo Diniz, Filho Marcello Augusto Anchieta Santos, Santos Douglas Silva Rosendo, de Carvalho Renan Fontes, Oliveira Halley Ferraro,
Abstract
OBJECTIVE:
The objective of the study was to assess the incidence of chemotherapy cardiotoxicity.
METHODS:
This is a systematic review carried out through the PubMed, VHL and Scientific Electronic Library Online databases, using the descriptors "Cardiotoxicity" and "Chemotherapy" associated with the Boolean operator "AND." Initially, 15,090 articles were found between 2015 and 2021. After applying the defined inclusion and exclusion criteria, 80 studies remained, of which 27 underwent complete reading, after which all were included in the study.
RESULTS:
In total, 32,009 cancer patients were analyzed, of which 27,270 (85.2%) were female. Breast cancer was the most frequent neoplasm, with 11,145 (34.8%) cases. Regarding the type of chemotherapy, anthracycline was the most prevalent, analyzed in 18 (66.7%) studies, followed by trastuzumab, in 9 (33.3%) studies. Of the studies evaluated, five did not present any case of cardiotoxicity, a total of 2255 (8.3%) cases were recorded, in addition other outcomes mentioned in patients after chemotherapy were arrhythmia ( = 522), acute coronary syndrome ( = 185), diastolic dysfunction ( = 184), cardiomyopathy ( = 161), and arterial hypertension ( = 89).
CONCLUSION:
Post-chemotherapeutic cardiotoxicity was mentioned in most studies, being present in a relevant percentage of the sample. Furthermore, these patients may develop other cardiovascular events.
Copyright: © International Journal of Health Sciences.
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Cells, growth factors and biomaterials used in tissue engineering for hair follicles regeneration.
Regen Ther2022 Dec;21():596-610. doi: 10.1016/j.reth.2022.11.003.
Xu Kailei, Yu Enxing, Wu Miaoben, Wei Peng, Yin Jun,
Abstract
Alopecia is a common and distressing medical condition that has affected a majority of people worldwide, which leads to great effects on the quality of life and self-esteem. Numerous treatments had been used to cure alopecia, including hair growth stimulants, herbal products, and hair transplantation. However, these treatments have their side effects, such as hypertrichosis, edema, and even cardiovascular adverse effects, which lead to the urgent requirement to explore a new hair-follicle (HF) regeneration approach. Tissue engineering could be the potential way for HF regeneration by simulating the epithelial-mesenchymal interaction and cell-extracellular matrix interactions. This review summarized the potential cells that are used in tissue engineering, commonly used tissue engineering techniques, and most importantly, the biomaterials that have been applied for three-dimensional cell culture or co-transplantation in HF regeneration. The literature shows that advances in this field toward functional HF development have progressively increased. Although the clinical application of biomaterial co-transplantation for HF regeneration still faces various challenges, numerous studies have proved that this is a promising direction that could be achieved in the future.
© 2022 The Japanese Society for Regenerative Medicine. Production and hosting by Elsevier B.V.
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