Andrea Di Lenarda, Nicola Ferri, Massimiliano Lanzafame, E. Montuori, Luciano Pacelli
Cardiovascular disease is associated with progression to severe COVID-19 and patients with the condition are among those in whom early antiviral therapy should be warranted. The combination of nirmatrelvir/ritonavir (Paxlovid®) has been approved for clinical use by the Food and Drug Administration and European Medicines Agency. Because patients with cardiovascular disease are often on polypharmacy, physicians need to be aware of potential drug–drug interactions (DDIs) when treating COVID-19 with nirmatrelvir/ritonavir. Guidance is given for avoiding DDIs, emphasising that preventing and managing potential DDIs with nirmatrelvir/ritonavir requires thorough assessment and knowledge. The present review summarises the clinical pharmacology of nirmatrelvir/ritonavir and provides details on potential DDIs with a focus on daily practice in patients with cardiovascular disease. Particular attention is needed for drugs that are predominantly metabolised by cytochrome P450 3A4, are substrates of P-glycoprotein and have a narrow therapeutic index. Proper management of potential DDIs must balance the benefit of nirmatrelvir/ritonavir to prevent severe disease with the risk of serious adverse events.
{"title":"Cardiovascular Drug Interactions with Nirmatrelvir/Ritonavir for COVID-19: Considerations for Daily Practice","authors":"Andrea Di Lenarda, Nicola Ferri, Massimiliano Lanzafame, E. Montuori, Luciano Pacelli","doi":"10.15420/ecr.2024.04","DOIUrl":"https://doi.org/10.15420/ecr.2024.04","url":null,"abstract":"Cardiovascular disease is associated with progression to severe COVID-19 and patients with the condition are among those in whom early antiviral therapy should be warranted. The combination of nirmatrelvir/ritonavir (Paxlovid®) has been approved for clinical use by the Food and Drug Administration and European Medicines Agency. Because patients with cardiovascular disease are often on polypharmacy, physicians need to be aware of potential drug–drug interactions (DDIs) when treating COVID-19 with nirmatrelvir/ritonavir. Guidance is given for avoiding DDIs, emphasising that preventing and managing potential DDIs with nirmatrelvir/ritonavir requires thorough assessment and knowledge. The present review summarises the clinical pharmacology of nirmatrelvir/ritonavir and provides details on potential DDIs with a focus on daily practice in patients with cardiovascular disease. Particular attention is needed for drugs that are predominantly metabolised by cytochrome P450 3A4, are substrates of P-glycoprotein and have a narrow therapeutic index. Proper management of potential DDIs must balance the benefit of nirmatrelvir/ritonavir to prevent severe disease with the risk of serious adverse events.","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141922720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.15420/ecr.2024.19.po5
Fatin Fazrina Roslan, Yuexin Yu, Nurul Ain Nasim Mohd Yusof, Nor Azlina Khalil, Zhikun Guo, Jer Ping Ooi, Jun Jie Tan
{"title":"The Effects of Co-injecting Human iPSC-Derived Cardiomyocytes/Pre-epicardial Cells into Cryoinjured Rat Hearts","authors":"Fatin Fazrina Roslan, Yuexin Yu, Nurul Ain Nasim Mohd Yusof, Nor Azlina Khalil, Zhikun Guo, Jer Ping Ooi, Jun Jie Tan","doi":"10.15420/ecr.2024.19.po5","DOIUrl":"https://doi.org/10.15420/ecr.2024.19.po5","url":null,"abstract":"","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.15420/ecr.2024.19.po1
Apisara Lohachatinante, Nuttanun Kittikunkanyakit, S. Sukkha, S. Chumnumwat, Rattana Chawanasuntharapot, Junporn Kongwatcharapong
{"title":"Assessment of Direct Oral Anticoagulant Use and Clinical Outcomes among Patients with Renal Impairment at Faculty of Medicine Siriraj Hospital, Mahidol University","authors":"Apisara Lohachatinante, Nuttanun Kittikunkanyakit, S. Sukkha, S. Chumnumwat, Rattana Chawanasuntharapot, Junporn Kongwatcharapong","doi":"10.15420/ecr.2024.19.po1","DOIUrl":"https://doi.org/10.15420/ecr.2024.19.po1","url":null,"abstract":"","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.15420/ecr.2024.19.po4
Byoung Geo Choi, S. Rha, Se Yeon Choi, J. Cha, S. Hyun, W. Ahn, Soohyung Park, Cheol Ung Choi, Myung Ho Jeong
{"title":"The Impact of Renin–Angiotensin System Inhibitor Use on Clinical Outcomes by GRACE Score in ST-elevation MI Patients Undergoing Successful Percutaneous Coronary Intervention with Drug-eluting Stents","authors":"Byoung Geo Choi, S. Rha, Se Yeon Choi, J. Cha, S. Hyun, W. Ahn, Soohyung Park, Cheol Ung Choi, Myung Ho Jeong","doi":"10.15420/ecr.2024.19.po4","DOIUrl":"https://doi.org/10.15420/ecr.2024.19.po4","url":null,"abstract":"","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Millán-Rodríguez, Carlos Palacios Castelló Palacios Castelló, M. Caballero-Valderrama, Gonzalo Barón Esquivias
Non-alcoholic fatty liver disease (NAFLD) is a spectrum of fat-associated liver conditions that increase risk of cardiovascular disease and mortality. The diagnosis and clinical management of NAFLD remain a challenge for cardiologists. Our group performed a systematic review in PubMed of the relationship between NAFLD and cardiovascular disease, identifying 35 relevant articles. NAFLD is likely to be the liver’s expression of metabolic syndrome and increases the risk of several cardiovascular diseases, including coronary artery disease, stroke, heart failure and electrical disorders, and chronic kidney disease. Echocardiography is a useful tool to check early subclinical abnormalities in heart structure and function linked to NAFLD progression, such as cardiac diastolic impairment or epicardial fat thickness. Currently, NAFLD is predominantly managed by lifestyle changes with the aim of weight loss, based on the Mediterranean diet and intense exercise training. Despite the lack of approved drugs for NAFLD, new potential treatments, mainly glucagon-like peptide-1 agonists or sodium–glucose cotransporter 2 inhibitors, could change cardiologists’ approach to this pathology.
{"title":"Clinical Management of Non-alcoholic Steatohepatitis and the Role of the Cardiologist","authors":"Carlos Millán-Rodríguez, Carlos Palacios Castelló Palacios Castelló, M. Caballero-Valderrama, Gonzalo Barón Esquivias","doi":"10.15420/ecr.2023.22","DOIUrl":"https://doi.org/10.15420/ecr.2023.22","url":null,"abstract":"Non-alcoholic fatty liver disease (NAFLD) is a spectrum of fat-associated liver conditions that increase risk of cardiovascular disease and mortality. The diagnosis and clinical management of NAFLD remain a challenge for cardiologists. Our group performed a systematic review in PubMed of the relationship between NAFLD and cardiovascular disease, identifying 35 relevant articles. NAFLD is likely to be the liver’s expression of metabolic syndrome and increases the risk of several cardiovascular diseases, including coronary artery disease, stroke, heart failure and electrical disorders, and chronic kidney disease. Echocardiography is a useful tool to check early subclinical abnormalities in heart structure and function linked to NAFLD progression, such as cardiac diastolic impairment or epicardial fat thickness. Currently, NAFLD is predominantly managed by lifestyle changes with the aim of weight loss, based on the Mediterranean diet and intense exercise training. Despite the lack of approved drugs for NAFLD, new potential treatments, mainly glucagon-like peptide-1 agonists or sodium–glucose cotransporter 2 inhibitors, could change cardiologists’ approach to this pathology.","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138944741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Torres-Ruiz, Nuria Mallofré-Vila, P. Rojas-Flores, Pablo Carrión-Montaner, E. Bosch-Peligero, Daniel Valcárcel-Paz, Ada Cardiel-Perez, J. Guindo-Soldevila, Antonio Martínez-Rubio
Left main coronary artery disease (LMCAD) is associated with high morbidity and mortality due to the large myocardial mass at risk. Although medical treatment may be an option in selected low-risk patients, revascularisation is recommended to improve survival in the majority of patients presenting with a significant left main stenosis. In the past decade, multiple randomised clinical trials and meta-analyses have compared coronary artery bypass grafting surgery (CABG) versus percutaneous coronary intervention (PCI), finding controversial results. The strategy for LMCAD revascularisation is still challenging. Coronary anatomy complexity, clinical features and patient preferences are key elements to be considered by the heart team. The current guidelines define CABG as standard therapy, but the continuous improvements in PCI techniques, the use of intracoronary imaging and functional assessment make PCI a feasible alternative in selected patients, particularly in those with comorbidities and contraindications to CABG. This review analyses the most important studies comparing CABG versus PCI in patients with LMCAD.
{"title":"Evidence-based Management of Left Main Coronary Artery Disease","authors":"G. Torres-Ruiz, Nuria Mallofré-Vila, P. Rojas-Flores, Pablo Carrión-Montaner, E. Bosch-Peligero, Daniel Valcárcel-Paz, Ada Cardiel-Perez, J. Guindo-Soldevila, Antonio Martínez-Rubio","doi":"10.15420/ecr.2023.36","DOIUrl":"https://doi.org/10.15420/ecr.2023.36","url":null,"abstract":"Left main coronary artery disease (LMCAD) is associated with high morbidity and mortality due to the large myocardial mass at risk. Although medical treatment may be an option in selected low-risk patients, revascularisation is recommended to improve survival in the majority of patients presenting with a significant left main stenosis. In the past decade, multiple randomised clinical trials and meta-analyses have compared coronary artery bypass grafting surgery (CABG) versus percutaneous coronary intervention (PCI), finding controversial results. The strategy for LMCAD revascularisation is still challenging. Coronary anatomy complexity, clinical features and patient preferences are key elements to be considered by the heart team. The current guidelines define CABG as standard therapy, but the continuous improvements in PCI techniques, the use of intracoronary imaging and functional assessment make PCI a feasible alternative in selected patients, particularly in those with comorbidities and contraindications to CABG. This review analyses the most important studies comparing CABG versus PCI in patients with LMCAD.","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138961117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Minh That Ton, T. H. Q. Ho, Viet Lan Nguyen, Hung Manh Pham, S. Hoang, Nhan Thanh Vo, Thai Quoc Nguyen, Linh Tran Pham, Ton Duy Mai, Thang Huy Nguyen
Part 1 of this review provided an overview of AF in Vietnam, with a particular focus on primary and secondary stroke prevention. Part 2 explores the management of AF in special, high-risk and clinically common patient populations including those with renal impairment, diabetes, the elderly, and those with coronary artery disease. Furthermore, Part 2 addresses the challenges posed by patients with AF who have a bioprosthetic valve, a group situated in a grey area of consideration. Managing AF in these patient groups presents unique clinical challenges that require careful consideration. Physicians are tasked with addressing specific clinical questions to identify the optimal anticoagulation strategy for each individual. To inform these decisions, subgroup analyses from pivotal studies are presented alongside real-world data derived from clinical practice. By synthesising available information and considering the nuanced clinical context, the aim is to provide informed perspectives that align with current medical knowledge and contribute to the enhancement of patient care in these challenging scenarios.
{"title":"Selection of Non-vitamin K Antagonist Oral Anticoagulant for Stroke Prevention in Atrial Fibrillation Based on Patient Profile: Perspectives from Vietnamese Experts. Part 2","authors":"Minh That Ton, T. H. Q. Ho, Viet Lan Nguyen, Hung Manh Pham, S. Hoang, Nhan Thanh Vo, Thai Quoc Nguyen, Linh Tran Pham, Ton Duy Mai, Thang Huy Nguyen","doi":"10.15420/ecr.2023.25","DOIUrl":"https://doi.org/10.15420/ecr.2023.25","url":null,"abstract":"Part 1 of this review provided an overview of AF in Vietnam, with a particular focus on primary and secondary stroke prevention. Part 2 explores the management of AF in special, high-risk and clinically common patient populations including those with renal impairment, diabetes, the elderly, and those with coronary artery disease. Furthermore, Part 2 addresses the challenges posed by patients with AF who have a bioprosthetic valve, a group situated in a grey area of consideration. Managing AF in these patient groups presents unique clinical challenges that require careful consideration. Physicians are tasked with addressing specific clinical questions to identify the optimal anticoagulation strategy for each individual. To inform these decisions, subgroup analyses from pivotal studies are presented alongside real-world data derived from clinical practice. By synthesising available information and considering the nuanced clinical context, the aim is to provide informed perspectives that align with current medical knowledge and contribute to the enhancement of patient care in these challenging scenarios.","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138997611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. H. Q. Ho, Minh That Ton, Viet Lan Nguyen, Hung Manh Pham, S. Hoang, Nhan Thanh Vo, Thai Quoc Nguyen, Linh Tran Pham, Ton Duy Mai, Thang Huy Nguyen
In Asia, especially Vietnam, AF is a common arrhythmia and is linked to a higher risk of stroke and systemic embolism. Anticoagulation therapy for stroke prevention in AF patients can result in bleeding complications. To effectively manage AF, adopting appropriate anticoagulation and addressing modifiable risk factors are crucial. Vietnamese clinicians are particularly interested in non-vitamin K antagonist oral anticoagulants (NOACs), a recent development in AF treatment. However, the lack of head-to-head trials comparing NOACs makes selecting a specific NOAC challenging. This review aims to provide a comprehensive overview of the available clinical evidence on NOACs for stroke prevention in AF to assist clinicians in making informed decisions and improving treatment outcomes in patients with AF. The first part of this review will present the current landscape of AF in Vietnam, focusing on AF prevalence and highlighting gaps in clinical practice. Furthermore, this part extensively discusses the anticoagulation strategy for both primary and secondary stroke prevention in AF.
在亚洲，尤其是越南，房颤是一种常见的心律失常，与中风和全身性栓塞的高风险有关。心房颤动患者为预防中风而进行的抗凝治疗可能会导致出血并发症。要有效控制心房颤动，采取适当的抗凝治疗和应对可改变的风险因素至关重要。越南临床医生对非维生素 K 拮抗剂口服抗凝药（NOACs）尤其感兴趣，这是心房颤动治疗的最新进展。然而，由于缺乏对 NOACs 进行头对头比较的试验，因此选择特定的 NOACs 具有挑战性。本综述旨在全面概述 NOACs 用于房颤卒中预防的现有临床证据，以帮助临床医生做出明智的决定并改善房颤患者的治疗效果。综述的第一部分将介绍越南心房颤动的现状，重点关注心房颤动的患病率，并强调临床实践中存在的差距。此外，这一部分还将广泛讨论心房颤动中风一级和二级预防的抗凝策略。
{"title":"Selection of Non-vitamin K Antagonist Oral Anticoagulant for Stroke Prevention in Atrial Fibrillation Based on Patient Profile: Perspectives from Vietnamese Experts. Part 1","authors":"T. H. Q. Ho, Minh That Ton, Viet Lan Nguyen, Hung Manh Pham, S. Hoang, Nhan Thanh Vo, Thai Quoc Nguyen, Linh Tran Pham, Ton Duy Mai, Thang Huy Nguyen","doi":"10.15420/ecr.2023.24","DOIUrl":"https://doi.org/10.15420/ecr.2023.24","url":null,"abstract":"In Asia, especially Vietnam, AF is a common arrhythmia and is linked to a higher risk of stroke and systemic embolism. Anticoagulation therapy for stroke prevention in AF patients can result in bleeding complications. To effectively manage AF, adopting appropriate anticoagulation and addressing modifiable risk factors are crucial. Vietnamese clinicians are particularly interested in non-vitamin K antagonist oral anticoagulants (NOACs), a recent development in AF treatment. However, the lack of head-to-head trials comparing NOACs makes selecting a specific NOAC challenging. This review aims to provide a comprehensive overview of the available clinical evidence on NOACs for stroke prevention in AF to assist clinicians in making informed decisions and improving treatment outcomes in patients with AF. The first part of this review will present the current landscape of AF in Vietnam, focusing on AF prevalence and highlighting gaps in clinical practice. Furthermore, this part extensively discusses the anticoagulation strategy for both primary and secondary stroke prevention in AF.","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139000601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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