Mineralocorticoid receptor antagonists for chronic heart failure: a meta-analysis focusing on the number needed to treat DOI Creative Commons

Chang Geng,

Yu-Cheng Mao,

Su-Fen Qi

et al.

Frontiers in Cardiovascular Medicine, Journal Year: 2023, Volume and Issue: 10

Published: Nov. 6, 2023

Aims Recent studies have shown that mineralocorticoid receptor antagonists (MRAs) can decrease mortality in patients with heart failure; however, the application of MRAs current clinical practice is limited because adverse effects such as hyperkalemia occur treatment. Therefore, this meta-analysis used number needed to treat (NNT) assess efficacy and safety chronic failure. Methods We meta-analysed randomized controlled trials (RCTs) which contrasted impacts placebo. As March 2023, all articles are published English. The primary outcome was major cardiovascular events (MACE), secondary outcomes included all-cause mortality, death, myocardial infarction (MI), stroke, events. Results incorporated seven a total 9,056 patients, 4,512 whom received 4,544 placebo, mean follow-up period 2.1 years. MACE, were reduced by MRAs, corresponding numbers for benefit (NNTB) 37, 28, 34; well no impact on MI or stroke. increased incidence gynecomastia, harm (NNTH) 18 52. Conclusions This study showed enabling one patient HF avoid MACE required treating 37 reduce death; they increase risk gynecomastia.

Language: Английский

Cardiac Fibrosis in heart failure: Focus on non-invasive diagnosis and emerging therapeutic strategies DOI Creative Commons
Susana Ravassa, Begoña López, Thomas A. Treibel

et al.

Molecular Aspects of Medicine, Journal Year: 2023, Volume and Issue: 93, P. 101194 - 101194

Published: June 27, 2023

Heart failure is a leading cause of mortality and hospitalization worldwide. Cardiac fibrosis, resulting from the excessive deposition collagen fibers, common feature across spectrum conditions converging in heart failure. Eventually, either reparative or reactive nature, long-term cardiac fibrosis contributes to development progression associated with poor clinical outcomes. Despite this, specific antifibrotic therapies are lacking, making an urgent unmet medical need. In this context, better patient phenotyping needed characterize heterogenous features advance toward its personalized management. review, we will describe different phenotypes focus on potential usefulness imaging techniques circulating biomarkers for non-invasive characterization condition tracking impact. We also recapitulate effects existing non-heart drugs discuss strategies under preclinical targeting activation fibroblasts at levels, as well additional extracardiac processes.

Language: Английский

Citations

41
New insights in the treatment of DKD: recent advances and future prospects DOI Creative Commons

Meimei Zhao,

Yongtong Cao, Liang Ma

et al.

BMC Nephrology, Journal Year: 2025, Volume and Issue: 26(1)

Published: Feb. 11, 2025

Diabetic kidney disease (DKD) represents the predominant and severe microvascular complication associated with diabetes, frequently culminating in End-Stage Kidney Disease (ESKD). The escalating prevalence of diabetes has correspondingly led to a rise DKD incidence, imposing significant challenges on both individuals society. etiology is multifaceted remains devoid definitive therapeutic interventions. This article examines pharmacological actions mechanisms different drugs used for prevention treatment that are currently clinical use or undergoing development. goal offer insights early intervention based combinations potentially slow progression.

Language: Английский

Citations

1
Hypertensive Heart Failure DOI Open Access
Filippos Triposkiadis, Pantelis Sarafidis, Αlexandros Briasoulis

et al.

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(15), P. 5090 - 5090

Published: Aug. 2, 2023

Despite overwhelming epidemiological evidence, the contribution of hypertension (HTN) to heart failure (HF) development has been undermined in current clinical practice. This is because approximately half HF patients have labeled as suffering from with preserved left ventricular (LV) ejection fraction (EF) (HFpEF), HTN, obesity, and diabetes mellitus (DM) being considered virtually equally responsible for its development. However, this suggestion obviously inaccurate, since HTN by far most frequent devastating morbidity present HFpEF. Further, obesity or DM rare absence coronary artery disease (CAD), whereas often causes per se. Finally, unlike major comorbidities HFpEF, including anemia, chronic kidney disease, pulmonary DM, atrial fibrillation, sleep apnea, depression, it unknown whether they precede result it. The purpose paper provide a contemporary overview on hypertensive HF, special emphasis inflammatory nature association autonomic nervous system (ANS) imbalance, both are pathophysiologic therapeutic interest.

Language: Английский

Citations

11
Progress in the treatment of vascular complications in type 2 diabetes by finerenone in combination with RAS inhibitors/SGLT-2i DOI
Ruoqi Liu, Zhi Qu, Yun‐Zhi Feng

et al.

Journal of Diabetes and its Complications, Journal Year: 2025, Volume and Issue: 39(4), P. 108981 - 108981

Published: Feb. 25, 2025

Language: Английский

Citations

0
Distinct Roles of Common Genetic Variants and Their Contributions to Diabetes: MODY and Uncontrolled T2DM DOI Creative Commons
Shadi Bazzazzadehgan,

Zia Shariat‐Madar,

Fakhri Mahdi

et al.

Biomolecules, Journal Year: 2025, Volume and Issue: 15(3), P. 414 - 414

Published: March 14, 2025

Type 2 diabetes mellitus (T2DM) encompasses a range of clinical manifestations, with uncontrolled leading to progressive or irreversible damage various organs. Numerous genes associated monogenic diabetes, exhibiting classical patterns inheritance (autosomal dominant recessive), have been identified. Additionally, involved in complex which interact environmental factors trigger the disease, also discovered. These genetic findings raised hopes that testing could enhance diagnostics, disease surveillance, treatment selection, and family counseling. However, accurate interpretation data remains significant challenge, as variants may not always be definitively classified either benign pathogenic. Research date, however, indicates periodic reevaluation has led more consistent findings, biases being steadily eliminated. This improved across diverse ethnicities. Clinical studies suggest risk information motivate patients adopt behaviors promote prevention management T2DM. Given features certain types overlap T2DM, considering role healthcare providers caring for prediabetic should consider part diagnostic process. review summarizes current knowledge most common explores novel therapeutic targets, discusses recent advancements pharmaceutical

Language: Английский

Citations

0
Finerenona no Tratamento da Nefropatia Diabética: Perspectivas Atuais e Evidências Clínicas DOI Creative Commons
R. Schmidt, Luís Alberto Batista Peres,

Alfredo Casagrande Laude

et al.

Cuadernos de Educación y Desarrollo, Journal Year: 2025, Volume and Issue: 17(3), P. e7760 - e7760

Published: March 18, 2025

A nefropatia diabética é a principal causa de doença renal crônica terminal e está associada à alta morbimortalidade cardiovascular em pacientes com diabetes tipo 2. hiperatividade dos receptores mineralocorticoides (MR) contribui para progressão da doença, promovendo inflamação fibrose. finerenona, um antagonista não esteroidal do MR, surge como alternativa promissora devido sua seletividade menor incidência efeitos adversos. Este estudo revisou ensaios clínicos randomizados, estudos observacionais metanálises publicados entre 2019 2024, priorizando desfechos renais cardiovasculares. Estudos FIDELIO-DKD FIGARO-DKD demonstraram que finerenona reduz albuminúria, retarda perda função diminui eventos cardiovasculares, benefícios adicionais quando inibidores SGLT2. No entanto, eficácia pode ser idosos mulheres limitada estágios avançados. uma opção eficaz segura, mas pesquisas são necessárias avaliar longo prazo.

Citations

0
Clinical efficacy and safety of sodium-glucose cotransporter protein-2 (SGLT-2) inhibitor, glucagon-like peptide-1 (GLP-1) receptor agonist, and Finerenone in type 2 diabetes mellitus with non-dialysis chronic kidney disease: a network meta-analysis of randomized clinical trials DOI Creative Commons
Jingyi Guo,

Maoying Wei,

Wen‐Hua Zhang

et al.

Frontiers in Pharmacology, Journal Year: 2025, Volume and Issue: 16

Published: March 27, 2025

Objective To investigate the safety and clinical efficacy of sodium-glucose cotransporter protein-2 (SGLT-2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists Finerenone in treating patients with type 2 diabetes mellitus (T2DM) combined non-dialysis chronic kidney disease (CKD). Methods Cochrane Library, PubMed, EMBASE, Web Science, CNKI, CQVIP database, WanFang from their inception up to November 2023 were searched compare SGLT-2 GLP-1 RA treatment T2DM CKD. assess methodological quality risk bias included studies, we utilized Risk Bias Assessment tool (RoB 2.0). The confidence evidence was examined using Confidence Network Meta-Analysis (CINeMA). Traditional meta-analysis variables conducted Stata 17.0 software a random-effects model. We assessed publication funnel plots explored potential sources heterogeneity through subgroup analysis. Results A total 39 studies (99,599 patients) included. Compared Placebo (PBO), inhibitors demonstrated superior reducing glycosylated hemoglobin (HbA1c) (MD = −0.33; 95%CI: −0.52 −0.15), systolic blood pressure (SBP) −5.52 −1.50; 95%CI −8.80 −0.23), body weight −3.81 −1.29; −6.34 −0.84) diastolic (DBP) −1.86; −3.18, −40.54). Liraglutide Low-Density Lipoprotein Cholesterol (LDL-C) surpassed that other agents −1.58 −1.41; −2.05 −0.81). significantly reduced SBP −1.65; −2.48, −0.81) compared PBO. According SUCRA based relative ranking treatments, Empagliflozin most effective HbA1c DBP. Semaglutide least harmful estimated glomerular filtration rate. LDL-C. Bexagliflozin, Canagliflozin weight. had lowest incidence urinary tract infection, Hypoglycemia Luseogliflozin group. Ertugliflozin likely cause acute injury. probability any adverse event. Conclusion these drugs has been confirmed, except for some special drugs. preferential glucose-lowering weight-loss function, lowering LDL-C glucose, Finereone Systematic Review Registration: PROSPERO, CRD42024571544.

Language: Английский

Citations

0
The Critical Role of GLP-1 Signaling Pathways in the Pathology of Parkinson's Disease and Diabetes DOI
Jinhao Chen, Xiang Dong,

Yi-Chen Lin

et al.

Pathology - Research and Practice, Journal Year: 2025, Volume and Issue: unknown, P. 155985 - 155985

Published: April 1, 2025

Language: Английский

Citations

0
The interplay between heart failure and chronic kidney disease DOI Creative Commons
Anuradha Lala, Adeera Levin, Kamlesh Khunti

et al.

Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown

Published: April 21, 2025

Abstract Chronic kidney disease (CKD) and heart failure (HF) are two globally prevalent, independent, long‐term conditions, which often coexist in an individual display a bidirectional yet interconnected relationship. The presence of CKD leads to the development HF vice versa, propagates worsening each disease, reflecting intertwined cycle. Both share common risk factors, such as increasing age, diabetes, high blood pressure, obesity smoking. Data show that approximately half all people with also have CKD, impacts patient burden quality life due significantly greater hospitalization death, compared those either or HF. To maximize treatment effectiveness individuals both healthcare professionals should recognize these diseases systemic representing organ‐specific manifestations similar underlying processes. It is essential understand role renin–angiotensin system inhibitors, sodium–glucose cotransporter 2 nonsteroidal mineralocorticoid receptor antagonist finerenone, glucagon‐like peptide‐1 agonists managing conditions. Lifestyle modifications be recommended. This review discusses factors contributing interplay between key providing appropriate for co‐existing diseases.

Language: Английский

Citations

0
Research Progress on Anti-fibrotic Effects and Mechanisms of Tetrandrine DOI
Peng Ma,

Yu-ju Cai,

Hui Dong

et al.

Chinese Journal of Integrative Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: May 23, 2025

Language: Английский

Citations

0