Search

The article discusses the use of antiplatelet therapy after percutaneous coronary intervention (PCI) to prevent stent thrombosis and other atherothrombotic events while minimizing bleeding complications. The default strategy of 12 months of dual antiplatelet therapy (DAPT) after PCI has been challenged due to improvements in PCI techniques, stent designs, and antiplatelet pharmacology. The article presents three papers that provide insights into strategies for de-escalation of antiplatelet intensity. The findings suggest that discontinuing aspirin from a ticagrelor-based DAPT regimen and using ticagrelor monotherapy can reduce bleeding risk without affecting the rate of adverse cardiac events. However, the decision to de-escalate antiplatelet therapy should be individualized based on factors such as stent deployment and the presence of high bleeding risk. [Extracted from the article]

The article explores the role of malic enzyme 1 (ME1) in the development of pulmonary hypertension (PH), a serious condition characterized by increased pressure in the arteries of the lungs. The study found that ME1 was more active in the blood vessels of PH patients and animal models. Inhibiting ME1 improved the function of the blood vessels and reduced PH in mice. This suggests that targeting ME1 could be a potential treatment for PH. The article also references three scientific papers that discuss the use of adenosine receptors in treating pulmonary arterial hypertension and cardiovascular health, providing valuable insights for researchers and medical professionals. [Extracted from the article]

An editorial is presented regarding the role of C-type natriuretic peptide (CNP)/guanylyl cyclase receptor B (GC-B)/cyclic guanosine 3',5' ce (cGMP) pathway in cardiovascular homeostasis and blood pressure (BP) regulation. It references the paper by K. Špiranec and colleagues to describe the function of the signaling system in mice.

The article discusses a research paper on the presence of coronary artery disease with coronary computed tomographic angiography evaluating total burden, non-calcified burden and high-risk coronary atherosclerotic plaques. It references a study by J. B. Lerman et al., published within the issue of "Circulation". It tackles the assessment of psoriasis skin disease severity, and the association between psoriasis severity and duration and noncalcified burden.

In his book, When Bad Things Happen to Good People, Harold Kushner explores explanations for human pain and suffering. He notes that while many of the afflictions of the human condition are beyond our understanding, none of us are exempt from the common experience. Despite the original publication of this thesis more than 35 years ago, Kushner's musings draw parallels to the patient experience with mechanically assisted circulation. The underlying mechanism and management of several morbid and mortal left ventricular assist device (LVAD) complications are beyond contemporary understanding but are sufficiently frequent to be considered common. The paper by Soliman in this issue of Circulation adds clarity to the question about why VAD things happen to good people by defining pre-operative risk factors that predispose patients to the development of right heart failure following implantation of a left-sided mechanical blood pump. [ABSTRACT FROM AUTHOR]

The article discusses a research paper on the effects of sodium-glucose cotransporter-2 inhibitors (SGLT-2is) on hospitalization for heart failure and death among people with type 2 diabetes mellitus. It references a study published within the issue of "Circulation". It tackles the medical records used by the researchers, the association of SGLT-2is with improved outcomes, and the claim that the researchers' conclusions infer causality.

The author comments on the paper "Heart failure with recovered ejection fraction: Clinical description, biomarkers, and outcomes" by A. Basuray and colleagues. Topics discussed include the increasing number of heart failure patients with better ejection fraction, cardiac resynchronization therapy, and beta-blocker therapy. Also discussed are other therapies including neurohormonal antagonists, digitalis, diuretics and exercise and activity.

The article comments on the paper "PDZ domain-binding motif regulates cardiomyocyte compartment-specific Nav1.5 channel expression and function" by D. Shy and colleagues. Topics discussed include characteristics of voltage-gated sodium channel complexes at the intercalated disk and lateral membrane, possible existence of voltage-gated channel complexes in the myocyte, and lessons learned after the publication of the Cardiac Arrhythmia Suppression Trial (CAST) findings.

The article comments on the paper "Efficacy and safety of rivaroxaban compared with warfarin among elderly patients with nonvalvular atrial fibrillation in the Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF)" by J.L. Halperin and colleagues. Topics discussed include a clinical trial comparing rivaroxaban and warfarin, and rates of embolic events, stroke and bleeding.

The author comments on the paper "Inhibition of glycosphingolipid synthesis ameliorates atherosclerosis and arterial stiffness in Apolipoprotein E-/- mice and rabbits fed a high fat and -cholesterol diet" by S. Chaterjee and colleagues. Topics discussed include the effects of the glycosphingolipids (GSL) synthesis inhibitor D-threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol (D-PDMP) and the influence of GSL synthesis inhibition on atherosclerosis and cholesterol metabolism.

The article comments on the paper "Contemporary trends of hospitalization for atrial fibrillation in the United States, 2000 through 2010: Implications for healthcare planning" by N. J. Patel and colleagues. Topics discussed include the emergence of atrial fibrillation (AF) as an epidemic, comorbidities of AF and increasing hospitalization rate for AF. Also highlighted is the need for public health interventions which focus on the prevention and management of risk factors.

The authors reflect on the function of cystathionine γ -lyase (SCE), focusing on the physiological significance of hydrogen sulfide (H2S) in the cardiovascular system. They comment on the article by Wang and colleagues on the role of H2S on regulation of placental vasculature dysfunction during preeclampsia and atherosclerosis. They also discuss the paper by Mani and colleagues on endogenous production of H2S in intimal proliferation and oxidative stress.

The author reflects on disease management programs in cardiology. It explores the paper by Stewart and colleagues published in the issue of the periodical "Circulation," in which the researchers summarized the results of three trials on value of nurse-led, multidisciplinary, home-based intervention in cardiovascular diseases. The author discusses the role of guidelines to the implementation of disease management programs.

Only 4 patients needed their S-ICD replaced with a transvenous ICD because of the need for antitachycardia or cardiac resynchronization therapy pacing, but none needed device replacement for bradycardia pacing. 1 Published in August 2020, the PRAETORIAN trial (Prospective, Randomized Comparison of Subcutaneoous and Transvenous Implantable Cardioverter Defibrillator Therapy) was the first trial to compare the S-ICD with the transvenous ICD in patients with ICD indications and no pacing requirements. Only 12 patients (1.1%) had their S-ICD explanted because of an infection, and no patient had bacteremia. This trial was a prospective, multinational investigation of patients with an indication for a primary prevention ICD on the basis of a reduced ejection fraction that aimed to evaluate the rate of inappropriate ICD shocks in a real-world contemporary ICD patient population receiving generation 2 or 3 S-ICD with optimal device programming and improved discrimination algorithms. [Extracted from the article]

The author reflects on the paper by Juhola and colleagues regarding the effect of blood pressure (BP) changes in children on carotid intima-media thickness (CIMT) in adulthood. He mentions that the relation between the cardiovascular disease (CVD) risk factors and metabolic diseases in children must be one of the considerations of the subject. He states that the results of the study by Juhola and colleagues were compelling, however, he expresses concerns on the effect of pharmacological BP.