Drug therapy articles within Nature Reviews Cardiology

Featured

  • Review Article |

    Increasing life expectancy in industrialized societies has resulted in a huge population of older adults with cardiovascular disease. Pharmacological treatment is the mainstay of therapy for these patients. In this extensive Review, Jerome Fleg and colleagues address the challenges associated with cardiovascular drug therapy in the elderly, as well as providing an in-depth discussion of specific disease states and drug types in this patient population.

    • Jerome L. Fleg
    • , Wilbert S. Aronow
    •  & William H. Frishman

  • Review Article |

    Both hypertension and hypotension have been associated with late-life cognitive decline and dementia. Novak and Hajjar discuss evidence supporting the relationship between blood pressure and cognition and its underlying pathophysiological mechanisms. The role that antihypertensive therapy may have in the prevention of cognitive decline is also explored.

    • Vera Novak
    •  & Ihab Hajjar

  • News & Views |

    Current medical therapies for chronic stable angina pectoris do not always render patients free of symptoms and may not be well tolerated. Xanthine oxidase inhibition with drugs such as allopurinol might be a promising new approach to treat these patients.

    • Ranil de Silva
    •  & Kim M. Fox

  • News & Views |

    Patients with diabetes mellitus and hypertension are at high cardiovascular risk and treatment guidelines recommend aggressive blood pressure (BP) control. However, a reanalysis of data from the previously published INVEST trial indicates that achieving systolic BPs <130 mmHg in patients with diabetes and coronary artery disease increases mortality, although this finding might reflect the speculative conclusions produced by post-hoc analyses.

    • Michael A. Weber

  • Review Article |

    Pulmonary hypertension is frequently associated with left-sided heart disease. Patients with this condition have a poor outcome, and few therapeutic strategies are available. In this Review, Drs. Guazzi and Arena describe the consequences and clinical features of this form of pulmonary hypertension, from reversible injury to permanent remodeling. Current and emerging therapeutic approaches are also examined.

    • Marco Guazzi
    •  & Ross Arena

  • News & Views |

    Determining the appropriate dose of warfarin that should be used in each patient is challenging, and the rate of adverse events at the beginning of therapy remains high. Testing for genetic variability related to warfarin sensitivity at the start of treatment is a promising strategy to guide dosing in clinical practice.

    • Sarina A. van der Zee
    •  & Jonathan L. Halperin

  • Review Article |

    In the second part of their Review on pulmonary embolism (PE), van Es and colleagues discuss risk stratification of patients with this condition, the short-term and long-term treatment options, and introduce some of the novel therapeutic agents under investigation for PE.

    • Josien van Es
    • , Renée A. Douma
    •  & Harry R. Büller

  • Review Article |

    Percutaneous coronary intervention can be performed successfully in most lesions; however, some specific types of lesion continue to present unique technical challenges. In this Review, stenting of bifurcations, fibrocalcific and undilatable lesions, chronic total occlusions, unprotected left main coronary artery stenoses, thrombotic lesions, and saphenous vein grafts are discussed in detail.

    • Usman Baber
    • , Annapoorna S. Kini
    •  & Samin K. Sharma

  • News & Views |

    The effectiveness of existing strategies for management of atrial fibrillation is limited, which has stimulated research into novel therapeutic approaches. A new meta-analysis of randomized controlled trials of inhibitors of the renin–angiotensin system highlights the clinical benefits of these agents and underscores their potential in the prevention and treatment of this disease.

    • Nadzeya Kuzniatsova
    • , Eduard Shantsila
    •  & Gregory Y. H. Lip

  • Review Article |

    Epigenetic modifications, such as DNA methylation and histone acetylation, are crucial for homeostasis, and enable cells to respond quickly to environmental changes. However, epigenetic alterations are also associated with the development and progression of disease. The authors of this Review outline how epigenetics may contribute to cardiovascular disease, and highlight potential therapeutic agents that modify the epigenetic state, which could be used in the prevention or treatment of cardiovascular disease.

    • José M. Ordovás
    •  & Caren E. Smith

  • Review Article |

    Antithrombotic therapy with ADP-receptor antagonists or anticoagulant agents improves outcomes in patients with acute coronary syndromes and/or undergoing percutaneous coronary intervention. However, the current standard-of-care ADP-receptor antagonist for dual antiplatelet therapy, clopidogrel, and the currently available oral anticoagulants, the coumarins, have several limitations. In this Review, the authors discuss the pharmacology and clinical potential of new antithrombotic drugs, with an emphasis on data from phase III clinical trials.

    • Jeremy S. Paikin
    • , John W. Eikelboom
    •  & Jack Hirsh

  • Review Article |

    Although effective therapies for hypertension exist, the prevalence of elevated blood pressure and resistant hypertension is increasing and novel treatment strategies are needed. In this Review, Drs. Paulis and Unger discuss new targets for antihypertensive therapy, many of which, including renalase and the (pro)renin receptor, are based on modulation of the renin–angiotensin–aldosterone system. Invasive strategies, such as renal denervation, are also explored.

    • Ludovit Paulis
    •  & Thomas Unger

  • News & Views |

    Combination therapy is used to lower blood pressure in the majority of patients with hypertension, yet there has been little evidence as to which classes of antihypertensive agents are most effective. The publication of findings from the ACCOMPLISH trial provides an opportunity to explore the merits of various combination therapies, with a focus on renal risk reduction.

    • William B. White

  • Review Article |

    Atrial fibrillation (AF) is the most common cardiac arrhythmia. Early management of this disorder using imaging, antiarrhythmia drugs and catheter ablation is necessary to prevent the progression of AF. In this Review, the authors discuss the current status of important facets of the early management of AF and emphasize the need for a greater understanding of the underlying etiology, which will lead to novel treatment approaches and amelioration of AF.

    • Ashok J. Shah
    • , Xingpeng Liu
    •  & Michel Haïssaguerre

  • Review Article |

    Statin therapy has been associated with improved outcomes in patients with heart failure. However, two large prospective, controlled trials showed neutral effects with rosuvastatin. The authors of this Review highlight data from observational studies that have showed positive outcomes, and discuss how the design of the two large trials may have contributed to the neutral effects of statin therapy on the survival of patients with heart failure.

    • W. H. Wilson Tang
    •  & Gary S. Francis

  • News & Views |

    Aldosterone antagonists decrease the mortality of patients with heart failure, but an observational study by Albert and colleagues has found that a surprisingly low number of patients receive aldosterone antagonists before discharge from hospital. This article highlights potential reasons for why there is such an underuse of efficient drugs in heart failure.

    • Jane-Lise Samuel
    •  & Claude Delcayre

  • News & Views |

    The two CHAMPION trials failed to show superiority of cangrelor (a rapid-acting, reversible intravenous platelet P2Y12 adenosine receptor antagonist) versus clopidogrel in patients with acute coronary syndromes undergoing percutaneous coronary intervention. The CHAMPION PCI trial, however, did show a significant reduction in death and stent thrombosis suggesting benefit in those without clopidogrel pretreatment.

    • David P. Faxon

  • Review Article |

    Although currently available anticoagulants, such as warfarin, can prevent stroke in patients with atrial fibrillation, the drug-related bleeding risk remains unacceptably high, and therapy could be contraindicated if the risk exceeds that for stroke. In this Review, Freek Verheugt assesses the performance of new anticoagulants that directly inhibit different stages of the coagulation cascade.

    • Freek W. A. Verheugt

  • Review Article |

    Atrial fibrillation (AF) has multifactorial intracardiac and extracardiac causes. Current development of anti-AF agents is focused on modulation of ion channel activity as well as on upstream therapies that reduce structural substrates. In this Review, Burashnikov and Antzelevitch examine new and emerging pharmacological approaches to rhythm control in patients with AF and summarize the available data on these drugs.

    • Alexander Burashnikov
    •  & Charles Antzelevitch

  • News & Views |

    Two large trials were conducted to evaluate the effects of an angiotensin-converting-enzyme inhibitor, an angiotensin-receptor blocker or a combination of both in high cardiovascular risk patients. A decrease in the prevalence of left ventricular hypertrophy (LVH) was reported, but this did not translate into a prognostic benefit. New-onset LVH was associated with an increase in cardiovascular events.

    • Alberto Zanchetti

  • News & Views |

    Despite angiographically successful primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction, microcirculatory failure is common and leads to an increased risk of morbidity and mortality. The administration of intracoronary streptokinase immediately after PCI may improve outcomes and provides a promising potential therapy for the future.

    • Paul W. Armstrong

  • Review Article |

    The incidence of prehypertension and hypertension among children and adolescents is rising as a result of the epidemic of youth overweight and obesity. Brian McCrindle addresses this important public health problem by reviewing the evaluation and management aspects of this condition that are specific to infants, children, and adolescents.

    • Brian W. McCrindle

  • News & Views |

    Amiodarone effectively maintains sinus rhythm in patients with atrial fibrillation, and although dronedarone is less effective it has a better safety profile. The choice of antiarrhythmic drug (or nonpharmacological strategy) depends on the ultimate goal of therapy, which should be considered in the context of the patient's clinical presentation and the treatment tailored to the individual.

    • Eric N. Prystowsky

  • News & Views |

    Stroke is the leading cause of morbidity and mortality in patients with atrial fibrillation. Whereas warfarin reduces the risk of stroke, its interactions with other drugs and food, individual differences in its efficacy and the need for frequent monitoring make its use inconvenient. Dabigatran etexilate might represent a step forward in the care of patients with atrial fibrillation.

    • Sarah A. Spinler

Browse broader subjects

Browse narrower subjects

Browse Drug therapy across other nature.com journals