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Background pharmacological therapy in the ANTHEM-HF: comparison to contemporary trials of novel heart failure therapies.

AIMS: Clinical trials of new heart failure (HF) therapies administer guideline-directed medical therapy (GDMT) as background pharmacologic treatment (BPT). In the ANTHEM-HF Pilot Study, addition of autonomic regulation therapy to GDMT significantly improved left ventricular function, New York Heart Association (NYHA) class, 6 min walk distance, and quality of life in patients with HF with reduced ejection fraction (HFrEF). A post hoc analysis was performed to compare BPT in ANTHEM-HF with two other trials of novel HF therapies: the PARADIGM-HF study of sacubitril-valsartan and the SHIFT study

New drugs: big changes in conservative heart failure therapy?

During the last 20 years, the prognosis for heart failure (HF) with reduced ejection fraction has steadily improved due to advances in drug treatment and the consistent implementation of guideline-recommended evidence-based drug therapy. Nevertheless, the morbidity and mortality rates of patients with HF can still be improved. The prevalence of HF is high and continues to increase steadily. Thus, timely and efficient drug treatment plays a central role in improving the quality of life and prognosis for patients with HF. Current therapeutic concepts combine inhibition of the renin-angiotensin-a

Ангина из-за обструкционистской болезни коронарной артерии в сочетании с периферической болезнью артерии.

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… Taking into consideration the presence of peripheral arterial disease, it was decided to switch the metoprolol succinate 50 mg once daily to ivabradine 10 mg twice daily to control the heart rate and to increase the atorvastatin dosage to 80 mg once daily. …

Prognostic Value of Holter Monitoring in Light Chain Amyloidosis.

(1) Background: To evaluate the predictive value of Holter monitoring for overall survival (OS) of patients with light chain amyloidosis (AL amyloidosis). (2) Methods: 137 patients with newly diagnosed AL amyloidosis who underwent Holter monitoring within 6 months of diagnosis were included. The primary outcome was OS. Landmark analysis was conducted at one-year follow-up. Independent predictors were determined using the log-rank test and multivariate Cox regression analysis. (3) Results: 131 (95.6%) patients received non-transplant therapy, and 32 (23.4%) underwent daratumumab-based chemother

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… . (%) | Anti-arrhythmic drugs | 23 (16.8) Beta-blockers | 21 (15.3) Amiodarone | 1 (0.7) Ivabradine | 1 (0.7) Pacemaker implantation | 4 (2.9) In the subgroup analysis of patients with and without CA, the prevalence of AT was higher in patients with CA compared to those without (58 (52.7%) vs. 7 (25.9% … Sinus with con duction delay | 15 (13.6) | 2 (7.4) | AF | 3 (2.7) | 1 (3.7) | VT/VF | 0 (0) | 0 (0) | Pacemaker | 0 (0) | 0 (0) | Anti-arrhythmic therapies—no. (%) | | | 0.245 $ Anti-arrhythmic drugs | 20 (18.2) | 3 (11.1) | Beta-blockers | 19 (17.3) | 3 (11.1) | Amiodarone | 1 (0.9) | 0 (0) | Ivabradine …

Carbohydrate Antigen-125-Guided Therapy in Acute Heart Failure: CHANCE-HF: A Randomized Study.

OBJECTIVES: This study sought to evaluate the prognostic effect of carbohydrate antigen-125 (CA125)-guided therapy (CA125 strategy) versus standard of care (SOC) after a hospitalization for acute heart failure (AHF). BACKGROUND: CA125 has emerged as a surrogate of fluid overload and inflammatory status in AHF. After an episode of AHF admission, elevated values of this marker at baseline as well as its longitudinal profile relate to adverse outcomes, making it a potential tool for treatment guiding. METHODS: In a prospective multicenter randomized trial, 380 patients discharged for AHF and hi

Cardiotoxicity after cancer treatment: a process map of the patient treatment journey.

Background/aimCardiotoxicity is a potential complication of anticancer therapy. While guidelines have been developed to assist practitioners, an effective, evidence based clinical pathway for the treatment of cardiotoxicity has not yet been developed. The aim of this study was to describe the journey of patients who developed cardiotoxicity through the healthcare system in order to establish baseline data to inform the development and implementation of a patient-centred, evidence-based clinical pathway.MethodsMixed-methods design with quantitative and qualitative components using process mappi

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… agents c Other drugs taken include: amiloride, amiodarone, amlodipine, atenolol, atorvastatin, bisoprolol, candesartan, carvedilol, cephalexin, cholecalciferol, clonidine, clopidogrel, digoxin, diltiazem, enalapril, enoxaparin, eprosartan, exemestane, frusemide, ibandronate, irbesartan, itraconazole, ivabradine … agents c Other drugs taken include: amiloride, amiodarone, amlodipine, atenolol, atorvastatin, bisoprolol, candesartan, carvedilol, cephalexin, cholecalciferol, clonidine, clopidogrel, digoxin, diltiazem, enalapril, enoxaparin, eprosartan, exemestane, frusemide, ibandronate, irbesartan, itraconazole, ivabradine …

An evidence-based review of recent advances in therapy for heart failure with reduced ejection fraction (HFrEF).

An estimated 5.1 million Americans have chronic heart failure and this is expected to increase 25% by 2030. Heart failure is a clinical syndrome that evolves from either functional or structural changes to the ventricles that lead to filling or ejection abnormalities. Thus far, pharmacotherapy has been show to be beneficial in patients only with reduced ejection fraction; however, new therapies have been developed in hopes of reducing the burden of heart failure. In this review, we will discuss current pharmacotherapies recommended in American College of Cardiology/American Heart Association g

Pharmacological treatment options for mast cell activation disease.

Mast cell activation disease (MCAD) is a term referring to a heterogeneous group of disorders characterized by aberrant release of variable subsets of mast cell (MC) mediators together with accumulation of either morphologically altered and immunohistochemically identifiable mutated MCs due to MC proliferation (systemic mastocytosis [SM] and MC leukemia [MCL]) or morphologically ordinary MCs due to decreased apoptosis (MC activation syndrome [MCAS] and well-differentiated SM). Clinical signs and symptoms in MCAD vary depending on disease subtype and result from excessive mediator release by MC

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… severely morbid osteonecrosis of the jaw in patients with poor dentition or recent invasive dental work) Non-cardiac chest pain ⇒ when needed, additional dose of a H 2 -histamine receptor antagonist; also, proton-pump inhibitors for proven gastroesophageal reflux Tachycardia ⇒ AT 1 -receptor antagonists; ivabradine … contrast media: iohexol, iopamidol, iopromida, ioxilan, ioversol, idolatran, iodixanol Plasma substitutes | Hydroxyethyl starch Gelatine | Albumin solution, 0.9 %-NaCl solution, Ringer’s solution Cardiovascular drugs | ACE inhibitors ß-Adrenoceptor antagonists | Sartans, calcium channel antagonists, ivabradine …

CSI position statement on management of heart failure in India.

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Cardiotoxicity Induced by Anticancer Therapies: A Call for Integrated Cardio-Oncology Practice.

The introduction of novel oncologic therapies, including targeted agents, immunotherapies, and antibody-drug conjugates, has transformed the therapeutic landscape of cancer care. This evolution has resulted in a dual clinical scenario; while survival outcomes have markedly improved, leading to a growing population of long-term cancer survivors, an increasing incidence of previously unrecognized treatment-related toxicities has emerged. Among these, cardiovascular adverse events represent some of the most prevalent and clinically significant complications observed in both conventional chemother

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… Other agents, such as ivabradine, and non-pharmacologic interventions, like remote ischemic preconditioning, have been tested in early trials, but so far have not demonstrated meaningful benefits in preventing CTRCD [ 143 , 144 ]. Furthermore, combination strategies are being explored. … Valsartan) | Neprilysin inhibition, natriuretic peptide enhancement, and RAAS inhibition | Under investigation for prevention of cardiotoxicity during breast cancer | Emerging: PRADAII [ 141 ]; ongoing MAINSTREAM trial [ 142 ] | No formal guideline recommendation; consider per general HF guidelines [ 47 ] Ivabradine …

A Systematic Review of the Cardiotoxic Effects of Targeted Therapies in Oncology.

Cancer therapy advancements have improved survival rates but also introduced significant cardiotoxic risks. Cardiotoxicity, a critical adverse effect of cancer treatments such as doxorubicin, trastuzumab, and radiotherapy, poses substantial challenges. This systematic review synthesizes findings from studies on cardiotoxicity induced by cancer therapies, focusing on detection and management. Key predictors of chemotherapy-induced myocardial toxicity (CIMT) include advanced age, hypertension, hyperlipidemia, diabetes, and elevated N-terminal pro-B-type natriuretic peptide levels. Regular echoca

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… Continuous cardiac monitoring beyond 90 days and management with beta-blockers, ACE inhibitors, and ivabradine are essential. … Notably, high-dose corticosteroids were commonly used in these patients, and management strategies involved beta blockers, ACE inhibitors, and ivabradine for symptomatic relief and recovery of LV function. …

Cardio-Oncology and Multi-Imaging Modalities.

Early detection and the rise of targeted cancer treatment have led to increased overall survival and decreased mortality among cancer patients. As the cancer survivor population ages, there is an increased risk for cardiovascular disease due to pre-existing comorbidities, deconditioning during therapy, or the natural progression of aging. Furthermore, with emerging oncologic therapies, there is an increased recognition of their potential cardiovascular toxicities. Indeed, heart disease is the leading cause of death in cancer survivors, which may reflect upon both the success of novel oncologic

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… Treatment is dependent on the symptoms and includes lifestyle modification, midodrine or pyridostigmine, rate control with metoprolol or ivabradine (for inappropriate sinus tachycardia), or fullerenol or dexrazoxane, which may prevent anthracycline-associated cardiotoxicity [ 15 ]. 2.5. …

PROCEEDINGS OF THE XVII CONGRESS OF THE ITALIAN ASSOCIATION OF MYOLOGY Siracusa, Italy May 31 - June 3, 2017.

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… (Messina, Roma) P.88 Effectiveness of treatment with ivabradine on clinical and instrumental endpoints in patients with Duchenne Muscular Dystrophy Distefano M.G., Vita G.L., Sframeli M., Di Bella G., Pugliatti P., Recupero A., Barcellona C., La Rosa M., Nicocia G, Carerj S., Lunetta C., Messina S., …

Risk sharing arrangements for pharmaceuticals: potential considerations and recommendations for European payers.

BackgroundThere has been an increase in 'risk sharing' schemes for pharmaceuticals between healthcare institutions and pharmaceutical companies in Europe in recent years as an additional approach to provide continued comprehensive and equitable healthcare. There is though confusion surrounding the terminology as well as concerns with existing schemes.MethodsA literature review was undertaken to identify existing schemes supplemented with additional internal documents or web-based references known to the authors. This was combined with the extensive knowledge of health authority personnel from

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… The current scheme in Italy covers ivabradine for chronic angina pectoris, as well as exenatide, sitagliptin and vildagliptin for patients with Type 2 diabetes resistant to current oral treatments [ 34 , 51 ]. …

Diagnosis, Treatment, and Prevention of Cardiovascular Toxicity Related to Anti-Cancer Treatment in Clinical Practice: An Opinion Paper from the Working Group on Cardio-Oncology of the Korean Society of Echocardiography.

Cardiovascular (CV) toxicity associated with anti-cancer treatment is commonly encountered and raises critical problems that often result in serious morbidity or mortality. Most cardiac toxicities are related to the cumulative dose of chemotherapy; however, the type of chemotherapy, concomitant agents, and/or conventional CV risk factors have been frequently implicated in CV toxicity. Approximately half of the patients exhibiting CV toxicity receive an anthracycline-based regimen. Therefore, serologic biomarkers or cardiac imagings are important during anti-cancer treatment for early detection

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… Recent trials and updated guidelines recommend an angiotensin receptor-neprilysin inhibitor (ARNI) (sacubitril/valsartan) rather than ACEIs (or ARBs) if symptoms persist, and ivabradine may be recommended in symptomatic patients with sinus rhythm and a heart rate above 70 bpm. 166) However, the data … on ARNI and ivabradine are currently limited. …

Best of JACC: Case Reports From ACC.23.

This dedicated issue of JACC: Case Reports highlights the top ranked Complex Clinical Cases from the ACC 2023 Scientific Sessions. These cases were reviewed and selected by a committee of peers in the months leading up to the annual meeting. These reviewers were ACC members with no affiliation to the JACC: Case Reports Editorial Board. While the cases were presented at the meeting and included in the formal Abstract Book from ACC, they have not been published elsewhere. These cases illustrate how the ACC can be a place for cardiovascular professionals to come together to learn, grow, and share

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… Pharmacotherapy (metoprolol, midodrine, diltiazem and ivabradine) had proven ineffective. Decision-making Following extensive discussions and ethics board approval, a novel transtracheal, ultrasound-guided deep cardiac plexus blockade was performed using liposomal Bupivacaine. …

Safety and Efficacy of the Intravenous Infusion of Umbilical Cord Mesenchymal Stem Cells in Patients With Heart Failure: A Phase 1/2 Randomized Controlled Trial (RIMECARD Trial [Randomized Clinical Trial of Intravenous Infusion Umbilical Cord Mesenchymal Stem Cells on Cardiopathy]).

RationaleUmbilical cord-derived mesenchymal stem cells (UC-MSC) are easily accessible and expanded in vitro, possess distinct properties, and improve myocardial remodeling and function in experimental models of cardiovascular disease. Although bone marrow-derived mesenchymal stem cells have been previously assessed for their therapeutic potential in individuals with heart failure and reduced ejection fraction, no clinical trial has evaluated intravenous infusion of UC-MSCs in these patients.ObjectiveEvaluate the safety and efficacy of the intravenous infusion of UC-MSC in patients with chronic

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… Ivabradine and sacubtril/valsartan were not included given their recent introduction in our country. …

Cancer survivorship at heart: a multidisciplinary cardio-oncology roadmap for healthcare professionals.

In cancer, a patient is considered a survivor from the time of initial diagnosis until the end of life. With improvements in early diagnosis and treatment, the number of cancer survivors (CS) has grown considerably and includes: (1) Patients cured and free from cancer who may be at risk of late-onset cancer therapy-related cardiovascular toxicity (CTR-CVT); (2) Patients with long-term control of not-curable cancers in whom CTR-CVT may need to be addressed. This paper highlights the importance of the cancer care continuum, of a patient-centered approach and of a prevention-oriented policy. The

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… Inappropriate sinus tachycardia secondary to autonomic dysfunction can be treated with BB, non-dihydropyridine calcium channel blockers and, in the rather frequent case of a hypotensive patient, ivabradine ( 115 ). Surgical treatment of RIHD is often challenging. …

Heart failure with preserved ejection fraction in cancer patients and survivors. A scientific statement of the Heart Failure Association of the ESC and the ESC Council of Cardio-Oncology.

Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized in cancer patients and survivors, yet it remains underdiagnosed and its epidemiology largely unknown. This statement underscores the imperative need to include HFpEF in the cardiotoxicities identified during or after anticancer treatments. It also highlights the prognostic value of pre-existing HFpEF for periprocedural and cardiotoxicity risk and it discusses the challenges in the diagnosis and treatment of HFpEF in cancer patients. It also explores the aetiologic role of anticancer therapies (chemotherapy, targe

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… and diastolic dysfunction. 103 There is a first double‐blind, randomized trial currently running in cancer patients in the palliative care setting that also present with cardiac wasting (EMPATICC, NCT05636774 ). 104 Here patients are randomized to either receive sacubitril/valsartan, empagliflozin, ivabradine …