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Want to hear the latest in cardiology research, reviews, and perspectives? Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Our summaries are available monthly.
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March 31, 2025
<p><strong>The “Silent Enemy” Called Renal Artery Stenosis: A Mini-Review:</strong></p><p>J. Vasc. Dis. 2025, 4(1), 10; <a href="https://doi.org/10.3390/jvd4010010">https://doi.org/10.3390/jvd4010010</a><strong></strong></p><p>Renal artery stenosis (RAS) is a vascular condition characterized by narrowing of one or both renal arteries, leading to reduced blood flow to the kidneys, activation of the renin–angiotensin–aldosterone system (RAAS), and subsequent renovascular hypertension. Overactivation of the same cascade potentiates the production of angiotensin II, which induces systemic vasoconstriction, increases sodium and water retention via aldosterone, and activates the sympathetic nervous system. Angiotensin II is also implicated in endothelial dysfunction, oxidative stress,and chronic inflammation, thus impairing vascular remodeling and arterial stiffness, all of which serve to accelerate cardiovascular complications, suchas left ventricular hypertrophy, heart failure, and myocardial infarction. Renal artery stenosis is usually due in at least 90% of cases to atherosclerosis, which typically affects older people with diabetes and smoking as risk factors.There are two types of Renal artery stenosis: unilateral and bilateral. Bilateral Renal artery stenosis is commonly associated with flash pulmonary edema, a life-threatening emergency condition in which alveolar space floodingcan occur within minutes. Renal artery stenosis typically remains asymptomatic until the late stage with complications of hypertension, ischemic nephropathy,or chronic kidney disease. FMD tends to create structural abnormalities of the artery, whereas atherosclerosis causes plaque formation and endothelial dysfunction of the artery. Epidemiological surveys have revealed that theprevalence of Renal artery stenosis ranges from 4% to 53% and is especially high among patients with hypertension, cardiovascular disease, or CKD. Diagnosis is based on clinical suspicion and supported by imaging studies, including Doppler ultrasound, computed tomography angiography, and magnetic resonance angiography. Early detection also relies on certain laboratory biomarkers, especially in identifying high-risk patients. These markers wouldinclude increased plasma renin activity, elevated aldosterone-renin ratio, and inflammatory markers, including C-reactive protein and endothelin-1. Treatmentwould also involve pharmacological approaches, including the renin–angiotensin–aldosterone system inhibitors, beta-blockers, and statins, and interventional treatments, including angioplasty and stenting in patientswith severe forms of the disease. However, the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) Trial showed that most patients would likelyrequire medical therapy, and that intervention should be reserved for those with uncontrolled hypertension, progressive renal dysfunction, or recurrent episodes of pulmonary edema. Other emerging therapies include drug-eluting balloons, bioresorbable stents, and gene-editing techniques, all of which have shown great promise in the few studies that have been conducted, although further evaluation is needed. Despite these advances, there are still gaps in knowledge regarding patient stratification, biomarker validation, and the development of personalized treatment strategies. This article reviews thecomplexities of the renin–angiotensin–aldosterone system and its systemic impact on cardiovascular and renal health. Future research can therefore focus on improving early diagnosis, optimizing patient selection for intervention,and developing new therapies to slow disease progression and mitigate complications.</p><p><br></p><p> </p><p></p>
March 31, 2025
<p><strong>Impact of Metabolic Syndrome on Clinical Profile and Prognosis in Patients with Acute ST-Elevation MyocardialInfarction: a Cross-Sectional Study</strong><br><strong></strong><a href="https://link.springer.com/article/10.1007/s42399-025-01822-6"><strong>https://link.springer.com/article/10.1007/s42399-025-01822-6</strong></a><strong></strong></p><p><strong>Abstract</strong></p><p>Metabolic syndrome (MS) has gained attention as a newly discovered risk factor for coronary artery disease (CAD).Studies have demonstrated that individuals with MS have a higher risk for coronary artery disease (CAD), and the risk is higher in females compared to males. Patients with metabolic syndrome have a higher incidence of ST-elevationmyocardial infarction (STEMI), making it a significant risk factor that has to be well-treated for successful secondary prevention. The study’s objective is to determine the frequency of MS in patients with acute STEMI according to the new “obesity-centric” IDF definition and to compare the clinical outcomes of acute STEMI patients with and without MS. A total of 132 consecutive patients with acute STEMI were analyzed, and 100 patients were included. MS wasidentified using criteria based on the “International Diabetes Federation 2005.” The frequency of metabolic syndrome in patients with STEMI was 46%. The frequency was greater in females (53.2%) than in males (43.2%). Patients whohad MS had poor clinical outcomes when compared to patients without MS, including mortality. Mortality due to STEMI in patients with MS was 15.2%, whereas in patients without MS was just 2% (p < 0.05). In addition to being a significant risk factor for cardiovascular disease, metabolic syndrome can also be a strong predictor of the severity and immediate prognosis of the condition.</p><p><strong>Disclaimer:</strong></p><p>Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the STARUPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.</p><p></p><p><br></p><p><br></p><p> </p><p></p>
March 31, 2025
<p><strong>Early β-Blocker Use and Clinical Outcomes in Acute Myocardial Injury: A Retrospective Cohort Study</strong></p><p><a href="https://doi.org/10.1016/j.amjmed.2025.02.029" target="_blank"><strong>https://doi.org/10.1016/j.amjmed.2025.02.029</strong></a><strong></strong></p><p><strong>Abstract</strong></p><p><strong>Background</strong></p><p>Acute myocardial injury is defined by elevated cardiactroponin (cTn) levels with a rising and/or falling pattern, and is associated with increased mortality risk compared to patients without myocardial injury. The role of β-blockers in patients with acute myocardial injury remains unclear.</p><p><strong>Methods</strong></p><p>This multicenter, retrospective cohort study used data fromthe Tianjin Health and Medical Data Platform to assess the impact of early β-blocker use on 1-year all-cause mortality and major adverse cardiovascular events (MACE) in acute myocardial injury patients, employing a new user andtarget trial emulation design. Propensity score matching (PSM) was applied, and Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI).</p><p><strong>Results</strong></p><p>After PSM, a total of 25,966 participants were included:8,667 to the β-blocker group and 17,299 to the non-β-blocker group. A total of 3,487 deaths (13.5%) and 5,795 MACE (22.3%) occurred. Compared with non-users,β-blocker was associated with the reduced risk of all-cause mortality (HR: 0.89, 95% CI: 0.83-0.95) and MACE (HR: 0.90, 95% CI: 0.85-0.95). In the subgroup analysis, β-blockers were associated with a significantly reduced risk of mortality in patients without stroke (HR 0.85, 95% CI: 0.78–0.93),while no significant association was observed in patients with stroke (HR 1.04, 95% CI: 0.93–1.16).</p><p><strong>Conclusions</strong></p><p>Early use of β-blockers is associated with the reduced riskof 1-year mortality in patients with acute myocardial injury. To more accurately assess the therapeutic effects, prospective trials are necessary, and these data provide key research directions for future trials.</p><p> </p><p><strong>Disclaimer:</strong></p><p>Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability, or completeness of any scientific information shared by the HCP on the STARUPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.</p><p></p>
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