Volume 16 Issue 12, December 2019

Results from the DAPA-HF trial demonstrate that dapagliflozin therapy is associated with lower risk of worsening heart failure or cardiovascular death than placebo, regardless of the presence or absence of diabetes.

In a socioeconomically vulnerable community in Alabama, USA, the use of a polypill containing four low-dose drugs produced greater reductions in blood pressure and LDL-cholesterol level than usual care.

The TWILIGHT trial indicates that switching to ticagrelor monotherapy after 3 months of dual antiplatelet therapy lowers the incidence of bleeding without increasing ischaemic events compared with continuation of ticagrelor plus aspirin therapy in patients who have undergone percutaneous coronary intervention and are at high risk of bleeding or ischaemic events

Near-infrared spectroscopy–intravascular ultrasonography of mildly or non-obstructive coronary arteries in patients with suspected coronary artery disease undergoing catheterization and possible percutaneous coronary intervention is safe and can detect both patients and non-culprit vulnerable plaques at high risk of secondary coronary events

The myocardial viability substudy from the STICH trial has reaffirmed the 10-year survival benefit of CABG surgery in patients with left ventricular dysfunction, but whether myocardial viability must be present for the long-term benefits of revascularization to be realized remains inconclusive.

Preclinical data and small clinical trials suggest that remote ischaemic conditioning (RIC) therapy protects patients with acute myocardial infarction undergoing percutaneous coronary intervention. In the CONDI-2/ERIC-PPCI trial, RIC proved to be safe but did not have any short-term benefits in reducing cardiac-related death and hospitalization for heart failure.

Results from a prospective study by Santema and colleagues suggest that women with heart failure and reduced ejection fraction might need lower doses of standard heart failure drugs than men. However, this conclusion was formed on the basis of data from a small proportion of the population studied and might only be relevant to participants taking β-blockers.

Neuromodulation therapy might be clinically useful in the management and prevention of lethal arrhythmias. In this Review, the authors discuss the neuroanatomical and neurophysiological basis for neuromodulation therapy, critically appraise the latest data on the clinical efficacy of this approach and highlight areas in the field of cardiac autonomic control that show the most promise for clinical translation.

In this Review, Mallat and colleagues critically evaluate the studies on the origin, fate and functions of vascular smooth muscle cells (VSMCs) in atherosclerosis, highlighting the importance of developmental origin, clonal expansion and plasticity of VSMCs cells in atherosclerosis and summarizing the roles of VSMCs and VSMC-derived cells in plaque development and progression.

Antiretroviral therapy has transformed HIV infection into a chronic disease, and cardiovascular diseases are an important health concern in this setting. This Review discusses the clinical features of cardiovascular disease in patients with HIV infection, including the mechanisms underlying HIV-associated atherosclerosis and approaches to reduce the cardiovascular risk.