Drug therapy articles within Nature Reviews Cardiology

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  • Research Highlight |

    In the PROMPT-HF trial, alerts embedded within electronic health records that contained guideline-directed recommendations for patients with heart failure improved the prescription of guideline-directed medical therapy.

    • Karina Huynh

  • Research Highlight |

    In patients with acute myocardial infarction, the addition of the PCSK9 inhibitor alirocumab to high-intensity statin therapy leads to a greater regression of atherosclerotic plaques in non-infarct-related arteries after 52 weeks than statin therapy alone, according to findings from the PACMAN-AMI trial.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Statins increase the rate of macrophage efferocytosis through suppression of the expression of the ‘don’t-eat-me’ molecule CD47 on atherosclerotic plaque apoptotic cells, and pro-efferocytic therapies amplify the anti-atherosclerotic effects of statin treatment in an additive manner and independently of any lipid-lowering effects of statins.

    • Irene Fernández-Ruiz

  • Review Article |

    Variants in genes encoding sarcomeric proteins can cause hypertrophic or dilated cardiomyopathy. In this Review, the authors discuss therapeutic strategies to target the cardiac sarcomere, focusing on four small molecules that have been developed that inhibit or activate the myosin motor protein to decrease or increase contractile force, respectively.

    • Sarah J. Lehman
    • , Claudia Crocini
    •  & Leslie A. Leinwand

  • Research Highlight |

    In the phase II AXIOMATIC-TKR trial, the oral, selective factor XIa inhibitor milvexian provided dose-dependent protection against venous thromboembolism in patients undergoing knee arthroplasty.

    • Gregory B. Lim

  • Research Highlight |

    Two new studies show that pharmacological blood pressure (BP) reduction is effective in older individuals and that a more intensive treatment with a lower BP threshold reduces the incidence of cardiovascular events in older patients with hypertension.

    • Irene Fernández-Ruiz

  • Research Highlight |

    In the QUARTET trial, initial treatment with a single pill containing quarter doses of four antihypertensive drugs achieved and maintained a greater blood-pressure-lowering effect than initial monotherapy with full-dose irbesartan.

    • Gregory B. Lim

  • Research Highlight |

    Data from the MASTER DAPT trial indicate that the duration of dual antiplatelet therapy can be abbreviated in patients at high risk of bleeding undergoing implantation of a drug-eluting stent, resulting in a reduction in bleeding risk without an increase in ischaemic events.

    • Gregory B. Lim

  • Review Article |

    In this Review, Angiolillo and colleagues discuss the latest evidence and updates on bleeding avoidance strategies in patients undergoing percutaneous coronary intervention, including risk stratification, timing of revascularization, pretreatment with antiplatelet agents, selection of vascular access, choice of coronary stents and antithrombotic treatment regimens.

    • Davide Capodanno
    • , Deepak L. Bhatt
    •  & Dominick J. Angiolillo

  • Research Highlight |

    PCSK9 inhibitors are a class of cholesterol-lowering drugs that regulate LDL-receptor degradation. Three new studies show successful reduction of PCSK9 levels by different approaches that all resulted in the lowering of LDL-cholesterol levels.

    • Andrew Robson

  • Research Highlight |

    Mineralocorticoid-receptor antagonism with the novel drug finerenone reduces the risk of new-onset atrial fibrillation or flutter in patients with chronic kidney disease and type 2 diabetes mellitus, according to a secondary analysis of the FIDELIO-DKD trial.

    • Gregory B. Lim

  • Research Highlight |

    A new randomized clinical trial shows that tocilizumab, a monoclonal antibody that inhibits IL-6 signalling by binding to the IL-6 receptor, increases myocardial salvage in patients with acute ST-segment elevation myocardial infarction who undergo myocardial revascularization with percutaneous coronary intervention.

    • Irene Fernández-Ruiz

  • Review Article |

    For therapeutic materials to be delivered to the heart, several barriers need to be overcome. In this Review, Ishikawa and colleagues discuss strategies for targeted delivery of therapeutic materials to the heart, including the use of adeno-associated viruses and exosomes, with a focus on agents directed at modifying gene expression.

    • Susmita Sahoo
    • , Taro Kariya
    •  & Kiyotake Ishikawa

  • Research Highlight |

    A new study shows that hydralazine, a drug used for the treatment of resistant hypertension and heart failure, can inhibit mitochondrial fission, thereby reducing cardiomyocyte death and myocardial infarct size after ischaemia–reperfusion injury in mice.

    • Andrew Robson

  • Research Highlight |

    Antihypertensive therapy, particularly with the use of an angiotensin-converting enzyme inhibitor, improves outcomes in patients with hypertension and SARS-CoV-2 infection, who are susceptible to hyperinflammation and severe outcomes with COVID-19.

    • Gregory B. Lim

  • News & Views |

    Statin nocebo effects have been demonstrated in numerous randomized, double-blind, placebo-controlled and active-controlled trials. Emerging evidence suggests that brain pathways might mediate statin nocebo hyperalgesia. Evidence-based pain-management approaches can be used to manage nocebo symptoms that occur during statin therapy.

    • Jennifer G. Robinson

  • Research Highlight |

    In the AFFIRM-AHF trial, the use of intravenous ferric carboxymaltose in patients with acute heart failure and iron deficiency was associated with a reduction in hospitalization for heart failure and cardiovascular death.

    • Andrew Robson

  • Research Highlight |

    In patients with recurrent pericarditis, treatment with rilonacept, an engineered fusion protein that acts as an IL-1 trap, leads to a rapid resolution of recurrent pericarditis episodes and reduces the risk of pericarditis recurrence.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Findings from two clinical trials indicate that cryoablation as first-line treatment is superior to drug therapy for the prevention of atrial arrhythmia recurrence in patients with paroxysmal atrial fibrillation.

    • Irene Fernández-Ruiz

  • Research Highlight |

    In the TIPS-3 trial, a single polypill comprising blood-pressure-lowering and cholesterol-lowering drugs, together with a daily dose of aspirin, reduced cardiovascular events in people at risk of cardiovascular disease.

    • Andrew Robson

  • Research Highlight |

    Sotagliflozin reduces the risk of adverse cardiovascular events in patients with type 2 diabetes mellitus and chronic kidney disease or worsening heart failure according to the SCORED and SOLOIST-WHF trials.

    • Andrew Robson

  • Research Highlight |

    A study in an in vitro model of RBM20-deficient dilated cardiomyopathy suggests that pharmacological upregulation of RBM20 with all-trans retinoic acid is a potential therapeutic strategy in patients with a heterozygous RBM20 mutation.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Mavacamten, a first-in-class cardiac myosin inhibitor, reduces symptoms and improves health status in patients with obstructive hypertrophic cardiomyopathy, according to findings from the EXPLORER-HCM trial.

    • Gregory B. Lim

  • Research Highlight |

    Anti-inflammatory therapy with low-dose colchicine reduces the risk of cardiovascular events by 31% compared with placebo in patients with chronic coronary artery disease, according to findings from the LoDoCo2 trial presented at the ESC Congress 2020.

    • Irene Fernández-Ruiz

  • Research Highlight |

    A strategy of early rhythm control for patients with recently diagnosed atrial fibrillation reduces the risk of cardiovascular events compared with usual care, according to findings from the EAST-AFNET 4 trial.

    • Gregory B. Lim

  • Research Highlight |

    Empagliflozin, an SGLT2 inhibitor, reduces the risk of cardiovascular death or hospitalization for heart failure in patients with heart failure with reduced ejection fraction with or without diabetes mellitus, according to findings from the EMPEROR-Reduced trial.

    • Gregory B. Lim

  • Research Highlight |

    Findings from the ATPCI trial show that trimetazidine is safe but not protective against angina and cardiac events in the long term after percutaneous coronary intervention.

    • Andrew Robson

  • News & Views |

    The overuse of opioids for acute pain management has led to an epidemic of persistent opioid use. A new study by Brown and colleagues evaluates opioids prescribed at discharge from hospital after coronary artery bypass graft surgery and heart valve procedures.

    • Elizabeth B. Habermann

  • Research Highlight |

    In a prespecified secondary analysis of the ACCELERATE trial, Puri and colleagues report a stepwise relationship between lipoprotein(a) levels and risk of major adverse cardiac events in patients with high-sensitivity C-reactive protein levels ≥2 mg/l.

    • Karina Huynh

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