The gut microbiota and its role in the development of cardiovascular disease DOI
Carlos Escobar, Xavier Aldeguer, David Vivas

et al.

Expert Review of Cardiovascular Therapy, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 12

Published: Feb. 7, 2025

The pathophysiology of cardiovascular diseases encompasses a complex interplay genetic and environmental risk factors. Even if traditional factors are treated to target, there remains residual risk. This manuscript reviews the potential role gut microbiota in development disease, as target. A systematic search was conducted until 30 October 2024 on PubMed (MEDLINE), using MeSH terms [Gut microbiota] + [Dysbiosis] [Cardiovascular] [TMAO] [bile acids] [short-chain fatty acids]. term dysbiosis implies changes equilibrium, with modifications composition functionality series additional factors: reduced diversity uniformity microorganisms; short-chain acid-producing bacteria; increased permeability; release metabolites, such trimethylamine N-oxide, betaine, phenylalanine, tryptophan-kynurenine, phenylacetylglutamine, lipopolysaccharides; secondary bile acid excretion, leading inflammation, oxidative stress, endothelial dysfunction facilitating onset pathological conditions, including obesity, hypertension, diabetes, atherosclerosis, heart failure. Attempts restore balance through different interventions, mainly diet, have been shown positively affect individual components metabolites reduce disease. In addition, probiotics prebiotics potentially useful. Fecal transplantation is promising therapy.

Language: Английский

Obesity and cardiovascular disease: an ESC clinical consensus statement DOI Creative Commons
Konstantinos C. Koskinas, Emeline M. Van Craenenbroeck, Charalambos Antoniades

et al.

European Heart Journal, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 30, 2024

The global prevalence of obesity has more than doubled over the past four decades, currently affecting a billion individuals. Beyond its recognition as high-risk condition that is causally linked to many chronic illnesses, been declared disease per se results in impaired quality life and reduced expectancy. Notably, two-thirds obesity-related excess mortality attributable cardiovascular disease. Despite increasingly appreciated link between broad range manifestations including atherosclerotic disease, heart failure, thromboembolic arrhythmias, sudden cardiac death, underrecognized sub-optimally addressed compared with other modifiable risk factors. In view major repercussions epidemic on public health, attention focused population-based personalized approaches prevent weight gain maintain healthy body from early childhood throughout adult life, well comprehensive loss interventions for persons established obesity. This clinical consensus statement by European Society Cardiology discusses current evidence epidemiology aetiology obesity; interplay obesity, factors conditions; management patients strategies lifestyle changes, interventional procedures, anti-obesity medications particular focus their impact cardiometabolic outcomes. document aims raise awareness factor provide guidance implementing evidence-based practices prevention optimal within context primary secondary prevention.

Language: Английский

Citations

62
Colchicine in Acute Myocardial Infarction DOI
Sanjit S. Jolly, Marc-André d’Entremont, Shun Fu Lee

et al.

New England Journal of Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 17, 2024

BackgroundInflammation is associated with adverse cardiovascular events. Data from recent trials suggest that colchicine reduces the risk of events.MethodsIn this multicenter trial a 2-by-2 factorial design, we randomly assigned patients who had myocardial infarction to receive either or placebo and spironolactone placebo. The results are reported here. primary efficacy outcome was composite death causes, recurrent infarction, stroke, unplanned ischemia-driven coronary revascularization, evaluated in time-to-event analysis. C-reactive protein measured at 3 months subgroup patients, safety also assessed.ResultsA total 7062 104 centers 14 countries underwent randomization; time analysis, vital status unknown for 45 (0.6%), information most likely missing random. A primary-outcome event occurred 322 3528 (9.1%) group 327 3534 (9.3%) over median follow-up period years (hazard ratio, 0.99; 95% confidence interval [CI], 0.85 1.16; P=0.93). incidence individual components appeared be similar two groups. least-squares mean difference levels between months, adjusted according baseline values, −1.28 mg per liter (95% CI, −1.81 −0.75). Diarrhea higher percentage than (10.2% vs. 6.6%; P<0.001), but serious infections did not differ groups.ConclusionsAmong treatment colchicine, when started soon after continued years, reduce (death revascularization). (Funded by Canadian Institutes Health Research others; CLEAR ClinicalTrials.gov number, NCT03048825.)

Language: Английский

Citations

60
Obesity and cardiovascular disease: an ESC clinical consensus statement DOI Creative Commons
Konstantinos C. Koskinas, Emeline M. Van Craenenbroeck, Charalambos Antoniades

et al.

European Journal of Preventive Cardiology, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 30, 2024

The global prevalence of obesity has more than doubled over the past four decades, currently affecting a billion individuals. Beyond its recognition as high-risk condition that is causally linked to many chronic illnesses, been declared disease per se results in impaired quality life and reduced expectancy. Notably, two-thirds obesity-related excess mortality attributable cardiovascular disease. Despite increasingly appreciated link between broad range manifestations including atherosclerotic disease, heart failure, thromboembolic arrhythmias, sudden cardiac death, underrecognized sub-optimally addressed compared with other modifiable risk factors. In view major repercussions epidemic on public health, attention focused population-based personalized approaches prevent weight gain maintain healthy body from early childhood throughout adult life, well comprehensive loss interventions for persons established obesity. This clinical consensus statement by European Society Cardiology discusses current evidence epidemiology aetiology obesity; interplay obesity, factors conditions; management patients strategies lifestyle changes, interventional procedures, anti-obesity medications particular focus their impact cardiometabolic outcomes. document aims raise awareness factor provide guidance implementing evidence-based practices prevention optimal within context primary secondary prevention.

Language: Английский

Citations

22
Quantitative flow ratio versus fractional flow reserve for coronary revascularisation guidance (FAVOR III Europe): a multicentre, randomised, non-inferiority trial DOI
Birgitte Krogsgaard Andersen, Martin Sejr‐Hansen, Luc Maillard

et al.

The Lancet, Journal Year: 2024, Volume and Issue: 404(10465), P. 1835 - 1846

Published: Oct. 31, 2024

Language: Английский

Citations

22
Integrated Management of Cardiovascular–Renal–Hepatic–Metabolic Syndrome: Expanding Roles of SGLT2is, GLP-1RAs, and GIP/GLP-1-RAs DOI Creative Commons
Nikolaos Theodorakis, Maria Nikolaou

Biomedicines, Journal Year: 2025, Volume and Issue: 13(1), P. 135 - 135

Published: Jan. 8, 2025

Cardiovascular-Kidney-Metabolic syndrome, introduced by the American Heart Association in 2023, represents a complex and interconnected spectrum of diseases driven shared pathophysiological mechanisms. However, this framework notably excludes liver-an organ fundamental to metabolic regulation. Building on concept, Cardiovascular-Renal-Hepatic-Metabolic (CRHM) syndrome incorporates liver's pivotal role disease spectrum, particularly through its involvement via dysfunction-associated steatotic liver (MASLD). Despite increasing prevalence CRHM unified management strategies remain insufficiently explored. This review addresses following critical question: How can novel anti-diabetic agents, including sodium-glucose cotransporter-2 inhibitors (SGLT2is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), dual gastric inhibitory polypeptide (GIP)/GLP-1RA, offer an integrated approach managing beyond boundaries traditional specialties? By synthesizing evidence from landmark clinical trials, we highlight paradigm-shifting potential these therapies. SGLT2is, such as dapagliflozin empagliflozin, have emerged cornerstone guideline-directed treatments for heart failure (HF) chronic kidney (CKD), providing benefits that extend glycemic control are independent diabetes status. GLP-1RAs, e.g., semaglutide, transformed obesity enabling weight reductions exceeding 15% improving outcomes atherosclerotic cardiovascular (ASCVD), diabetic CKD, HF, MASLD. Additionally, tirzepatide, GIP/GLP-1RA, enables unprecedented loss (>20%), reduces risk over 90%, improves HF with preserved ejection fraction (HFpEF), MASLD, obstructive sleep apnea. moving organ-specific approach, propose integrates agents into holistic syndrome. paradigm shift moves away fragmented, organ-centric toward more fostering collaboration across specialties marking progress precision cardiometabolic medicine.

Language: Английский

Citations

11
Anticoagulation and Antiplatelet Therapy for Atrial Fibrillation and Stable Coronary Disease: Meta-analysis of Randomized Trials DOI
Sina Rashedi, Mohammad Keykhaei,

Alyssa Sato

et al.

Journal of the American College of Cardiology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 1, 2025

Language: Английский

Citations

5
Efficacy and safety of clopidogrel versus aspirin monotherapy in patients at high risk of subsequent cardiovascular event after percutaneous coronary intervention (SMART-CHOICE 3): a randomised, open-label, multicentre trial DOI
Ki Hong Choi, Yong Hwan Park, Jong‐Young Lee

et al.

The Lancet, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

Citations

5
Coronary CT angiography-guided management of patients with stable chest pain: 10-year outcomes from the SCOT-HEART randomised controlled trial in Scotland DOI Creative Commons
Michelle C. Williams, Ryan Wereski, Christopher Tuck

et al.

The Lancet, Journal Year: 2025, Volume and Issue: 405(10475), P. 329 - 337

Published: Jan. 1, 2025

Language: Английский

Citations

4
Orbital atherectomy versus balloon angioplasty before drug-eluting stent implantation in severely calcified lesions eligible for both treatment strategies (ECLIPSE): a multicentre, open-label, randomised trial DOI
Ajay J. Kirtane, Philippe Généreux,

Bruce Lewis

et al.

The Lancet, Journal Year: 2025, Volume and Issue: unknown

Published: March 1, 2025

Language: Английский

Citations

4
Coronary revascularisation deferral based on quantitative flow ratio or fractional flow reserve: a post hoc analysis of the FAVOR III Europe trial DOI
Birgitte Krogsgaard Andersen,

Niels Ramsing Holm,

Lone J.H. Mogensen

et al.

EuroIntervention, Journal Year: 2025, Volume and Issue: 21(3), P. e161 - e170

Published: Jan. 29, 2025

Safe deferral of revascularisation is a key aspect physiology-guided percutaneous coronary intervention (PCI). While recent evidence gathered in the FAVOR III Europe trial showed that quantitative flow ratio (QFR) guidance did not meet non-inferiority to fractional reserve (FFR) guidance, it remains unknown if QFR might have specific value deferral. We aimed evaluate safety based on as compared with FFR. Patients randomised whom PCI was deferred at least one artery, or FFR>0.80, were included present substudy. The primary outcome 1-year rate major adverse cardiac events (MACE), results reported for two subsets patients: (1) any study lesion and (2) complete A total 523 patients (55.2%) group 599 (65.3%) FFR had Of these, 433 (82.8%) 511 (85.3%) patients, respectively, In "complete deferral" patient group, occurrence MACE significantly higher QFR-deferred FFR-deferred (24 [5.6%] vs 14 [2.8%], adjusted hazard [HR] 2.07, 95% confidence interval [CI]: 1.07-4.03; p=0.03). subgroup "any deferral", 5.6% 3.6% (QFR FFR), HR 1.55, CI: 0.88-2.73; p=0.13. QFR-based artery resulted incidence FFR-based

Language: Английский

Citations

3