Management of acute coronary syndromes (ACS) has moved rapidly in parallel with our understanding of the pathophysiological basis of the disease. In the eighties, the demonstration of the pivotal role of coronary thrombosis in the etiology of a ACS led to administration of aspirin and unfractionated heparin. In recent years, new medical and invasive therapies have been developed: anti-platelets (thienopyridines and glycoprotein Ilb/IlIa inhibitors), antithrombins (low molecularweight heparins) and most recently, factor Xa inhibitors (pentasaccharides). As new treatments are rapidly added, clinicians are constantly challenged to incorporate new information and guidelines into their practices in a timely fashion.
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Alzheimers Dement
December 2024
University of Kansas Alzheimer's Disease Research Center, Fairway, KS, USA.
Background: Aerobic exercise may positively affect brain health, although relationships with cognitive change are mixed. This likely is due to individual differences in the systemic physiological response to exercise. However, the acute effects of exercise on brain metabolism and biomarker responses are not well characterized in older adults or cognitively impaired individuals.
View Article and Find Full Text PDFCirc Cardiovasc Qual Outcomes
January 2025
Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, NC. (N.P.A., A.C.S., M.W.S., M.J.M., T.H., S.A.M.).
Background: The High-STEACS (High-Sensitivity Troponin in the Evaluation of Patients With Acute Coronary Syndrome) pathway risk stratifies emergency department patients with possible acute coronary syndrome. This study aims to determine if the High-STEACS hs-cTnT (high-sensitivity cardiac troponin T) pathway can achieve the ≥99% negative predictive value (NPV) safety threshold for 30-day cardiac death or myocardial infarction (CDMI) in a multisite US cohort of patients with and without known coronary artery disease (CAD).
Methods: A secondary analysis of the STOP-CP (High-Sensitivity Cardiac Troponin T [Gen 5 STAT Assay] to Optimize Chest Pain Risk Stratification) cohort, which enrolled adult emergency department patients with possible acute coronary syndrome at 8 US sites (January 25, 2017-September 6, 2018).
Curr Cardiol Rev
January 2025
Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India.
Cardiovascular-kidney-metabolic (CKM) syndrome is the association between obesity, diabetes, CKD (chronic kidney disease), and cardiovascular disease. GDF-15 mainly acts through the GFRAL (Glial cell line-derived neurotrophic factor Family Receptor Alpha-Like) receptor. GDF-15 and GDFRAL complex act mainly through RET co-receptors, further activating Ras and phosphatidylinositol-3-kinase (PI3K)/Akt pathways through downstream signaling.
View Article and Find Full Text PDFDiabetes Obes Metab
January 2025
Sydney Medical School, Faculty of Medicine & Health, University of Sydney, Sydney, Australia.
Aim: SGLT2 inhibitors may be underused in older adults with type 2 diabetes due to concerns about safety and tolerability. This pooled analysis of the CANVAS Program and CREDENCE trial examined the efficacy and safety of canagliflozin according to age.
Methods: Pooled individual participant data from the CANVAS Program (n = 10 142) and CREDENCE trial (n = 4401) were analysed by baseline age (<65 years, 65 to <75 years, and ≥75 years).
Eur Stroke J
January 2025
Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Introduction: The efficacy and safety of statins for secondary prevention in patients who have experienced a cardioembolic stroke are not well-defined. However, previous observational data reported hyperlipidemia as a risk factor for both ischemic and bleeding complications in patients with AF and previous stroke. Based on these premises, we conducted a sub-analysis of the RAF and RAF-NOAC studies to evaluate the efficacy and safety of statins in secondary prevention in patients with acute ischemic stroke and AF.
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