Drug therapy articles within Nature Reviews Cardiology

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  • Research Highlight |

    In a new cross-trial analysis of patients with heart failure with reduced ejection fraction, researchers predict that a comprehensive strategy combining several pharmacological approaches reduces hospitalization and mortality compared with conventional therapy.

    • Gregory B. Lim

  • Research Highlight |

    A new biomimetic drug delivery system consisting of nanoparticles that are coated with macrophage membrane and responsive to reactive oxygen species enables targeted pharmacotherapy for atherosclerosis in mice while also suppressing local inflammation by sequestering inflammatory factors.

    • Irene Fernández-Ruiz

  • Research Highlight |

    According to five new studies, therapy with angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) is not associated with an increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or with an increased risk of severe disease or in-hospital death among patients with COVID-19.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Individuals with obesity have an increased prevalence of the Bacteroides 2 enterotype, which is associated with systemic inflammation and disease. However, statin therapy is associated with a reduced prevalence of this dysbiosis in individuals with obesity.

    • Gregory B. Lim

  • Review Article |

    Congestion is the main reason for hospitalization in patients with acute decompensated heart failure and is an important target for therapy. In this Review, Boorsma and colleagues distinguish between intravascular congestion and tissue congestion, and hypothesize that specifically treating these two different forms of congestion could improve patient outcomes.

    • Eva M. Boorsma
    • , Jozine M. ter Maaten
    •  & Adriaan A. Voors

  • Review Article |

    NSAIDs are effective, widely used analgesics, but their use is associated with increased risks of thrombosis and heart failure. In this Review, the authors assess the cardiovascular safety of NSAIDs and present an approach for their use in the holistic management of pain.

    • Anne-Marie Schjerning
    • , Patricia McGettigan
    •  & Gunnar Gislason

  • Research Highlight |

    Apixaban therapy is as effective as low-molecular-weight heparin therapy for the prevention of recurrence of venous thromboembolism in patients with cancer, with no increase in major bleeding events, according to findings from the Caravaggio trial.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Findings from the VOYAGER PAD study show that adding rivaroxaban to standard aspirin therapy can reduce ischaemic risk in patients with peripheral artery disease who have undergone lower-extremity revascularization.

    • Karina Huynh

  • Research Highlight |

    An initial invasive strategy in addition to medical therapy does not reduce the risk of death or nonfatal myocardial infarction or relieve angina symptoms compared with an initial conservative strategy with medical therapy alone in patients with stable coronary artery disease, moderate or severe ischaemia and advanced chronic kidney disease.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Findings from the VICTORIA study show that vericiguat treatment can significantly reduce cardiovascular death or first hospitalization for heart failure in patients with worsening heart failure with reduced ejection fraction.

    • Karina Huynh

  • Research Highlight |

    The addition of an invasive strategy (angiography plus revascularization when feasible) to medical therapy does not reduce the risk of cardiovascular events or death but might reduce symptoms of angina among patients with stable coronary artery disease and moderate or severe ischaemia.

    • Gregory B. Lim

  • Review Article |

    Heart failure with preserved ejection fraction (HFpEF) is the predominant form of heart failure among elderly patients. In this Review, Borlaug describes the challenges of diagnosing HFpEF, summarizes the current recommendations for treatment and describes a new strategy of categorizing patients with HFpEF into phenotypically homogeneous subgroups to facilitate the individualization of treatment.

    • Barry A. Borlaug

  • Review Article |

    Familial hypercholesterolaemia is a genetic disorder that impairs the hepatic clearance of LDL, leading to premature atherosclerotic cardiovascular disease. In this Review, Watts and colleagues summarize the latest advances that can inform the development and implementation of new models of care for familial hypercholesterolaemia.

    • Gerald F. Watts
    • , Samuel S. Gidding
    •  & Kausik K. Ray

  • Review Article |

    Many patients with cardiovascular disease have a residual risk of ischaemic events despite receiving antiplatelet therapy. In this Review, Angiolillo and colleagues discuss the pharmacological rationale and clinical development of dual-pathway inhibition strategies for the prevention of atherothrombotic events in patients with cardiovascular disease.

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

  • Research Highlight |

    New analyses of the PARAGON-HF and PARADIGM-HF trials indicate that sacubitril–valsartan treatment might be beneficial in patients with heart failure with mildly reduced left ventricular ejection fraction and that the benefit might be greater in women than in men.

    • Irene Fernández-Ruiz

  • Research Highlight |

    Results of the GALILEO trial presented at the AHA Scientific Sessions 2019 indicate that a strategy with rivaroxaban 10 mg daily is associated with a higher risk of death or thromboembolic events and a higher risk of bleeding than an antiplatelet-based strategy.

    • Irene Fernández-Ruiz

  • News & Views |

    Findings from a large, international study comprising 4.9 million people with mild hypertension suggest that thiazide and thiazide-like diuretics might be more effective and safer than other first-line antihypertensive drugs. However, the study was not randomized, and the findings might be explained by a phenomenon known as ‘confounding by indication’.

    • Sverre E. Kjeldsen
    •  & Ingrid Os

  • Research Highlight |

    Statin therapy initiated during childhood in patients with familial hypercholesterolaemia (FH) slows the rate of carotid intima–media thickening and reduces the risk of cardiovascular events and death.

    • Gregory B. Lim

  • Research Highlight |

    New findings from the Hygia Chronotherapy trial suggest that taking antihypertensive medications at bedtime is associated with better blood-pressure control and a 45% reduction in the risk of cardiovascular disease compared with taking the medication in the morning upon waking up.

    • Irene Fernández-Ruiz

  • News & Views |

    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.

    • Andrew J. S. Coats

  • Research Highlight |

    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

    • Irene Fernández-Ruiz

  • Editorial |

    As Nature Reviews Cardiology marks its 15th anniversary, we are entering a new era of precision cardiology, driven by drug development, technological innovation and artificial intelligence.

  • Research Highlight |

    The PARAGON-HF trial indicates that sacubitril–valsartan does not have a significant benefit in patients with heart failure with preserved ejection fraction (HFpEF) for reducing hospitalizations for heart failure and death from cardiovascular causes. However, the trial suggests a potential benefit in patients with low left ventricular ejection fraction and in women.

    • Irene Fernández-Ruiz

  • Research Highlight |

    In the PolyIran study, a fixed-dose polypill strategy was more effective than non-pharmacological interventions in reducing the risk of cardiovascular events.

    • Karina Huynh

  • Research Highlight |

    The transcription factor FOXP1 downregulates activation of the endothelial NLRP3 inflammasome and suppresses vascular inflammation, protecting against atherosclerosis. Upregulation of FOXP1 expression is a novel anti-atherogenic effect of simvastatin.

    • Gregory B. Lim

  • Research Highlight |

    Activation of the PDGF pathway is involved in the pathogenesis of dilated cardiomyopathy caused by mutations in LMNA; this new finding suggests that inhibition of PDGFRβ is a novel therapeutic target for patients with this condition.

    • Gregory B. Lim

  • Review Article |

    Patients with known cardiovascular disease but no recent acute event are often referred to as having ‘stable’ coronary artery disease. In this Review, Fox and colleagues describe why this concept of stable disease is misleading and should instead be characterized as chronic disease with an increased risk of atherothrombotic events.

    • Keith A. A. Fox
    • , Marco Metra
    •  & Dan Atar

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