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Preview: Nature Reviews Cardiology - Issue - science feeds

Nature Reviews Cardiology - Issue - science feeds

Nature Reviews Cardiology provides physicians and academics with authoritative and topical discussions of key developments in the field.


Atherosclerosis: PCSK9 inhibition reduces cardiovascular events in high-risk patients


The PCSK9 inhibitor evolocumab has been shown to reduce LDL-cholesterol levels, but whether this reduction translates into a decline in cardiovascular events was previously unknown. Now, findings from the FOURIER trial — presented at the ACC.17 Scientific Sessions and published in The New England Journal

Anticoagulation therapy: Uninterrupted dabigatran during ablation for AF


In patients with atrial fibrillation (AF) undergoing catheter ablation, uninterrupted anticoagulation with dabigatran, an oral, non-vitamin K antagonist, reduces the number of major bleeding events compared with uninterrupted anticoagulation with the vitamin K antagonist warfarin. This finding was presented at ACC.17 and simultaneously published in

Acute coronary syndromes: Similar bleeding risks with low-dose rivaroxaban versus aspirin


A dual-pathway antithrombotic treatment strategy combining low-dose rivaroxaban with a P2Y12-receptor inhibitor has a similar risk of bleeding as the conventional dual antiplatelet therapy (DAPT; aspirin plus P2Y12-receptor inhibitor) approach for the treatment of patients with acute coronary syndrome (ACS). These

Dyslipidaemia: Promising results with siRNA against PCSK9


Two single injections of inclisiran, a small interfering RNA (siRNA) that targets PCSK9 mRNA, induce a 50% reduction in LDL-cholesterol (LDL-C) levels in 6 months, according to findings from the phase II ORION-1 trial presented at ACC.17. A total of 501 patients at high

Diabetes: Sacubitril/valsartan improves glycaemic control


A post-hoc analysis of the PARADIGM-HF trial in a subgroup of patients with heart failure with reduced ejection fraction (HFrEF) and with known diabetes mellitus or an HbA1c level ≥6.5% at screening shows that long-term reduction in HbA1c level is greater with sacubitril/valsartan (a

Coronary artery disease: Urbanization is a risk factor for CAD


Results from a cross-sectional cohort study presented at ACC.17 show that Bolivian Tsimane have the lowest prevalence of coronary artery disease (CAD) of any population yet studied, with only 3% of the studied individuals having significant atherosclerotic disease, despite having a high infectious inflammatory burden.

Interventional cardiology: Adenosine-free assessment of stenosis severity


Measurement of the instantaneous wave-free ratio (iFR) is noninferior to measurement of the fractional flow reserve (FFR) for assessment of coronary artery stenosis to guide percutaneous coronary intervention. This finding was simultaneously reported by the DEFINE-FLAIR and iFR-SWEDEHEART studies, both presented at the ACC.17 Scientific

Venous thromboembolism: Risk of recurrence lower with rivaroxaban than aspirin


In patients with venous thromboembolism who have completed 6–12 months of anticoagulation therapy and are in equipoise for continued anticoagulation, rivaroxaban treatment was associated with lower risk of recurrence compared with aspirin. These findings were presented at the ACC.17 Scientific Sessions by the EINSTEIN CHOICE

Acute coronary syndromes: Complete revascularization for STEMI


In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization of both infarct-related and non-infarct-related coronary arteries reduces the risk of adverse cardiovascular outcomes compared with revascularization of the infarct-related (culprit) artery only. These findings come from a prospective, multicentre, randomized trial

Valvular disease: TAVI noninferior to surgery in intermediate-risk patients


Transcatheter aortic valve implantation (TAVI) with a self-expanding prosthesis is noninferior to surgery in patients with severe aortic stenosis and who are at intermediate surgical risk. This finding, from the randomized SURTAVI trial, was presented at the ACC.17 Scientific Sessions and published in NEJM.

Heart failure: No early benefits of adjunct therapy with tolvaptan for acute heart failure


Tolvaptan, a vasopressin 2-receptor antagonist that induces loss of free water, has been proposed as a good candidate for adjunct therapy to improve congestion and symptoms in patients with acute heart failure. Two clinical trials now show that tolvaptan as an adjunct to loop diuretics,

Surgery: Neutral results for levosimendan in cardiac surgery


Prophylactic use of levosimendan does not reduce the rate of death, renal replacement therapy, perioperative myocardial infarction, or use of a mechanical cardiac assist device in patients undergoing cardiac surgery, according to findings from the LEVO-CTS trial presented at ACC.17. “Despite neutral results on these

Valvular disease: Leaflet thrombosis after AVR


Aortic valve replacement (AVR) is the only effective treatment for aortic stenosis. A new study presented at ACC.17 and published in The Lancet shows that subclinical leaflet thrombosis is common following AVR, but more so after transcathether AVR (TAVR) than surgical AVR (SAVR). Anticoagulation

Stem cells: Cell therapy for cardiac repair: what is needed to move forward?


The ESC has updated its 2006 consensus statement on clinical investigation of autologous adult stem cells for the treatment of acute myocardial infarction and heart failure. This initiative by a group of leaders in the field stimulates much-needed reflection and provides guidance to make cell therapy a clinical reality. Here, we offer our own perspective.

Extracellular vesicles in coronary artery disease


Membrane vesicles released in the extracellular space are composed of a lipid bilayer enclosing soluble cytosolic material and nuclear components. Extracellular vesicles include apoptotic bodies, exosomes, and microvesicles (also known previously as microparticles). Originating from different subcellular compartments, the role of extracellular vesicles as regulators

Cardiovascular disease in Africa: epidemiological profile and challenges


From a global perspective, the large and diverse African population is disproportionately affected by cardiovascular disease (CVD). The historical balance between communicable and noncommunicable pathways to CVD in different African regions is dependent on external factors over the life course and at a societal level.

Single or dual antiplatelet therapy after PCI


The optimal duration and type of antiplatelet therapy after implantation of a drug-eluting stent (DES) remains uncertain. At the time of the first-in-man implantation of the sirolimus DES in 1999, the protocol-defined dual antiplatelet therapy (DAPT) duration was only 2 months. Subsequently, DAPT duration was

Natural killer T cells in atherosclerosis


Atherosclerosis is a chronic inflammatory disorder that develops in response to hyperlipidaemia. Cells from both the innate and adaptive immune systems contribute to the development of atherosclerotic lesions. The role of natural killer T (NKT) cells in response to microbial pathogens and inflammatory disorders such

Inflammatory processes in cardiovascular disease: a route to targeted therapies


Nature Reviews Cardiology14, 133–144 (2017)In the version of this article initially published online and in print, there were some inaccuracies in Table 1. These errors have been corrected for the HTML and PDF versions of the article.