Publications by authors named "Lyubarova R"
Article Synopsis
- Calcific aortic stenosis serves as a model for understanding cardiovascular issues in older adults, influenced by multiple factors related to aging.
- Research on transcatheter aortic valve replacement has primarily involved older patients, leading to the recognition of frailty and other geriatric risks as important for better assessing patient conditions.
- The review emphasizes the need for a comprehensive approach to diagnosis and management of aortic stenosis in older adults, advocating for improved patient engagement and identifying key areas for future research.
Article Synopsis
- Global longitudinal strain (GLS) is a useful tool for detecting hidden heart problems in patients with obstructive coronary artery disease (CAD), but its relationship with ischemia in those with myocardial ischemia and no obstructive CAD (INOCA) is less understood.
- A study analyzed GLS in patients with INOCA using stress echocardiography, revealing that the majority had normal GLS values both at enrollment and after one year, but these values did not correlate with stress-induced ischemia.
- The findings suggest that in INOCA patients, normal GLS does not indicate the presence or severity of ischemia, indicating a need for alternative assessment methods for myocardial dysfunction in this group.
Article Synopsis
- Lipoprotein subfractions (LS) can help improve risk assessment for coronary artery disease (CAD) in patients who aren't considered high-risk, as shown in a study involving 157 patients undergoing coronary angiography.
- The study found that certain lipoprotein markers, such as total and small low-density lipoprotein particles (LDL-P) and apolipoprotein B, were positively associated with the presence and severity of obstructive CAD, while large high-density lipoprotein particles (HDL-P) and apolipoprotein A1 (ApoA1) showed an inverse correlation.
- Overall, specific LS measurements were effective indicators of CAD severity and acute coronary syndrome (ACS), even when adjusting for
Article Synopsis
- * Key factors contributing to this disparity include workload demands, lack of resources, organizational culture issues, and disproportionate non-work responsibilities, such as childcare.
- * The authors recommend organizational changes to address these issues, emphasizing the importance of evaluating gender differences in burnout drivers to create effective solutions.
Background: In ISCHEMIA-CKD, 777 patients with advanced chronic kidney disease and chronic coronary disease had similar all-cause mortality with either an initial invasive or conservative strategy (27.2% vs 27.8%, respectively).
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- Chronic kidney disease (CKD) increases the risk of complications after percutaneous coronary intervention (PCI), and it's unclear how genetic factors like CYP2C19 loss of function (LOF) alleles affect this risk or the safety of genotype-guided therapy.
- A study with 5,815 patients analyzed outcomes based on CKD status and found no significant interaction between treatment strategy and CKD for major cardiovascular events or bleeding risks after 12 months.
- The findings suggest that while escalating P2Y inhibitor therapy via a genotype-guided approach doesn't reduce complications in CKD patients, it also doesn't increase bleeding risks, indicating the need for larger studies to confirm these results.
Article Synopsis
- Cardiovascular disease is the leading cause of death for women, yet many drug trials fail to adequately assess how treatments affect women specifically, despite evidence of sex differences in responses to medications.
- The FDA has made efforts since 1993 to get more women involved in clinical trials, but progress in representation and reporting sex-specific data in studies remains slow.
- This review highlights the need for more sex-specific analysis in cardiovascular drug therapies and shows that while some areas like antihypertensives have better female representation, others like heart failure therapies need improvement.
Article Synopsis
- The prevalence of atrial fibrillation (AF) is rising due to an aging population, particularly those aged 75 and older, who are at higher risk for complications like stroke and bleeding.
- Older adults often face challenges with oral anticoagulation (OAC) due to concerns about syncope and falls, especially when combined with antiarrhythmic drugs.
- While rate control medications like digoxin are considered, there are concerns about increased mortality, making stroke prevention with direct OACs crucial; invasive treatments are also potential options but are under-researched in older populations.
Article Synopsis
- * Dual antiplatelet therapy (DAPT), consisting of aspirin and a P2Y inhibitor, is a key part of treatment to reduce the chances of recurrence after ACS, but experts are still debating how long this therapy should continue.
- * While extending DAPT beyond 12 months may decrease ACS recurrence, there are also risks like bleeding; therefore, careful assessment of a patient's individual health risks is important to determine the ideal duration of therapy.
Article Synopsis
- There are physiological differences in how men and women metabolize lipids, but both genders respond well to similar pharmacologic treatments for dyslipidemia according to current guidelines.
- Despite having similar treatment guidelines, women tend to experience worse control of dyslipidemia due to factors like underestimating their cardiovascular risk and lower adherence to prescribed therapies.
- Heart disease is the leading cause of death among women, often detected later than in men, leading to misconceptions about their risk, which can diminish the aggressiveness of treatment needed for effective management.
Article Synopsis
- The study investigates the relationship between the immunosuppressant sirolimus and the occurrence of pericardial effusion in patients who received kidney transplants.
- This retrospective analysis included 585 renal transplant patients, finding that 14% developed new pericardial effusion, notably distinguishing between early (≤4 years) and late (>4 years) onset of effusion.
- Results indicated that sirolimus use was more prevalent in late-onset effusion cases, with an adjusted odds ratio of 3.58, suggesting an increased risk for this complication among patients treated with sirolimus.
Introduction: Cardiovascular comorbidities may predispose to adverse outcomes in hospitalized patients with coronavirus disease 2019 (COVID-19). However, across the USA, the burden of cardiovascular comorbidities varies significantly. Whether clinical outcomes of hospitalized patients with COVID-19 differ between regions has not yet been studied systematically.
View Article and Find Full Text PDFSex Differences Remain Under-Reported in Cardiovascular Publications.
J Womens Health (Larchmt)
September 2021
Article Synopsis
- Recent interest in studying sex differences in cardiovascular disease has been growing, but it’s unclear if this has led to more relevant publications.
- A bibliometric analysis of cardiovascular journal articles from 2006 to 2015 found that only 12.99% were sex-specific, showing limited focus on this area.
- Although there was a notable increase in sex-specific publications in general articles, other categories like reviews and clinical trials showed no significant growth.
Article Synopsis
- Older adults are more susceptible to cardiovascular disease, but management strategies used for younger patients may not be effective or applicable for them.
- Aging affects biology, physiology, and body composition, which complicates the interpretation of cardiovascular tests designed for younger populations.
- A workshop hosted by leading organizations focused on understanding and improving diagnostic testing for older adults with cardiovascular disease, aiming to highlight challenges and research opportunities in this field.
Article Synopsis
- Atherosclerotic cardiovascular disease (ASCVD) is a major health problem for people with chronic kidney disease (CKD) and can lead to serious issues or even death.
- CKD makes patients more likely to need stronger treatments to lower bad cholesterol levels, but there is debate about how effective these treatments are, especially for those on dialysis.
- Some studies suggest that using statins can help reduce heart events for CKD patients not on dialysis, but new cholesterol-lowering drugs haven't been widely tested in these patients yet.
Article Synopsis
- - Recent guidelines by the American College of Cardiology and European Society of Cardiology help identify high-risk syncope patients, recommending inpatient evaluation for those with high-risk features.
- - A study compared patient admissions for syncope in October 2016 and October 2018, observing changes in adherence to the new syncope protocol implemented in 2017.
- - Results showed an increase in the proportion of high-risk patients admitted after the protocol introduction, suggesting that it can enhance adherence to guidelines and optimize patient care while reducing healthcare costs.
Pericardial effusion and cardiac tamponade following renal transplantation have been recognized as a potentially serious complications associated with the use of sirolimus for immunosuppression. Our study aims to analyze the development of sirolimus-associated pericardial effusion. Patients who underwent renal transplantation at our institution between 2001 and 2014 were reviewed and the correlation between sirolimus exposure and pericardial effusion was determined.
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- Lipoprotein-associated phospholipase A (LpPLA) is linked to higher risk of cardiovascular (CV) events and vulnerable plaque formation.
- A study assessed the impact of extended-release niacin (ERN) on LpPLA activity and CV outcomes in patients with existing CV disease.
- Results showed that ERN significantly reduced LpPLA levels and altered the relationship between high LpPLA levels and CV events, but after adjusting for traditional risk factors, LpPLA did not enhance risk assessment.
Article Synopsis
- Stable ischemic heart disease (SIHD) is common among chronic kidney disease (CKD) patients, but it's unclear if they receive adequate guideline-directed medical therapy (GDMT).
- The study compared 563 patients with SIHD, examining the likelihood of achieving GDMT targets between those with CKD and those without.
- Results showed similar overall achievement rates for GDMT goals in both groups, but patients with CKD had lower rates of using renin-angiotensin-aldosterone system inhibitors (RAASi).
Article Synopsis
- A study investigated the link between right-sided colon cancer (RCC) and higher mortality compared to left-sided colon cancer (LCC), focusing on whether RCC is associated with increased cardiovascular issues.
- The research involved analyzing 546 colon cancer patients, with 486 undergoing CT scans to check for coronary artery disease (CAD) and calcifications.
- Results showed that RCC patients had higher rates of hypertension, hyperlipidemia, hypothyroidism, and clinical CAD, along with more calcifications compared to LCC patients, indicating a significant cardiovascular risk associated with RCC.
Article Synopsis
- Severe pulmonary hypertension (PH) is linked to poorer kidney transplant survival and more cardiovascular issues, but research on its impact in patients with mild-to-moderate PH is scarce.
- A study of 192 kidney transplant recipients revealed that 51 had elevated pulmonary artery systolic pressure (PASP), particularly in those with decreased heart function, but no significant demographic differences were found.
- While having elevated PASP didn't significantly affect 4-year mortality or graft loss, it was associated with lower kidney function (eGFR) at 1 and 2 years post-transplant, indicating the need for preoperative echocardiogram evaluations to better predict outcomes.
Article Synopsis
- - Atherosclerotic cardiovascular disease (ASCVD) significantly impacts patients with chronic kidney disease (CKD), especially those with reduced kidney function, yet there's limited trial data to inform doctors on how to manage this population effectively.
- - A survey was conducted among 450 nephrology and cardiology providers, yielding 113 responses, where over 90% recognized CVD's serious effects on CKD patients, but only 5% would screen asymptomatic patients with advanced CKD for ASCVD.
- - The study highlights a lack of agreement on treating ASCVD in advanced CKD and emphasizes the need for future clinical trials, although the findings are constrained by a small sample size and low response rates.