ACS, acute coronary syndrome

ACS,急性冠脉综合征
  • 文章类型: Journal Article
    冠状动脉疾病(CAD)是癌症幸存者心血管负担的重要原因。这篇综述确定了可以帮助指导有关筛查的益处的决策的特征,以评估亚临床CAD的风险或存在。根据危险因素和炎症负担,筛选可能适用于选定的幸存者。在接受基因检测的癌症幸存者中,多基因风险评分和克隆造血标志物可能成为未来有用的CAD风险预测工具。癌症的类型(尤其是乳腺癌,血液学,胃肠,和泌尿生殖系统)和治疗的性质(放射治疗,铂剂,氟尿嘧啶,激素治疗,酪氨酸激酶抑制剂,内皮生长因子抑制剂,和免疫检查点抑制剂)在确定风险方面也很重要。积极筛查的治疗意义包括生活方式和动脉粥样硬化干预,在特定情况下,可能需要进行血运重建。
    Coronary artery disease (CAD) is an important contributor to the cardiovascular burden in cancer survivors. This review identifies features that could help guide decisions about the benefit of screening to assess the risk or presence of subclinical CAD. Screening may be appropriate in selected survivors based on risk factors and inflammatory burden. In cancer survivors who have undergone genetic testing, polygenic risk scores and clonal hematopoiesis markers may become useful CAD risk prediction tools in the future. The type of cancer (especially breast, hematological, gastrointestinal, and genitourinary) and the nature of treatment (radiotherapy, platinum agents, fluorouracil, hormonal therapy, tyrosine kinase inhibitors, endothelial growth factor inhibitors, and immune checkpoint inhibitors) are also important in determining risk. Therapeutic implications of positive screening include lifestyle and atherosclerosis interventions, and in specific instances, revascularization may be indicated.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    蛋白酶体抑制剂(PIs)是多发性骨髓瘤和AL淀粉样变性患者联合治疗的骨干,同时也出现在Waldenström巨球蛋白血症和其他恶性肿瘤中。PIs作用于蛋白酶体肽酶,由于积累聚集而导致蛋白质组不稳定,展开,和/或受损的多肽;持续的蛋白质组不稳定性然后诱导细胞周期停滞和/或细胞凋亡。卡菲佐米,静脉内不可逆PI,与口服给药的Ixazomib或静脉内可逆性PI如硼替佐米相比,表现出更严重的心血管毒性特征。心血管毒性包括心力衰竭,高血压,心律失常,和急性冠脉综合征。因为PI是血液系统恶性肿瘤和淀粉样变性治疗的关键组成部分,管理他们的心血管毒性包括识别有风险的患者,在临床前水平早期诊断毒性,并在需要时提供心脏保护。未来的研究需要阐明潜在的机制,改善风险分层,定义最优管理策略,并开发具有安全心血管特征的新PI。
    Proteasome inhibitors (PIs) are the backbone of combination treatments for patients with multiple myeloma and AL amyloidosis, while also indicated in Waldenström\'s macroglobulinemia and other malignancies. PIs act on proteasome peptidases, causing proteome instability due to accumulating aggregated, unfolded, and/or damaged polypeptides; sustained proteome instability then induces cell cycle arrest and/or apoptosis. Carfilzomib, an intravenous irreversible PI, exhibits a more severe cardiovascular toxicity profile as compared with the orally administered ixazomib or intravenous reversible PI such as bortezomib. Cardiovascular toxicity includes heart failure, hypertension, arrhythmias, and acute coronary syndromes. Because PIs are critical components of the treatment of hematological malignancies and amyloidosis, managing their cardiovascular toxicity involves identifying patients at risk, diagnosing toxicity early at the preclinical level, and offering cardioprotection if needed. Future research is required to elucidate underlying mechanisms, improve risk stratification, define the optimal management strategy, and develop new PIs with safe cardiovascular profiles.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    结节病是一种病因不明的慢性炎症性疾病,与高发病率和死亡率相关。其与心血管结局的关联记录不足。
    本研究的目的是评估结节病与非结节病患者的心血管不良结局。
    在线数据库,包括PubMed,Embase和Scopus从成立到2022年3月都受到了质疑。评估的结果包括全因死亡率(ACM)和室性心动过速(VT)的发生率,心力衰竭(HF)和房性心律失常(AA)。
    共有6项研究,有22,539,096名参与者(42,763例结节病,此分析包括22,496,354非结节病)。结节病的合并患病率为13.1%(95%CI1%至70%)。总体平均年龄为47岁。最常见的合并症是高血压(12.7%vs12.5%),和糖尿病(分别为5.5%和4%)。主要终点的汇总分析表明,全因死亡率(RR,2.08;95%CI:1.17~3.08;p=0.01)在结节病患者中显著升高。次要终点的汇总分析表明,VT的发生率(RR,15.3;95%CI:5.39至43.42);p<0.001),HF(RR,4.96;95%CI:2.02至12.14;p<0.001)和AA(RR,2.55;95%CI:1.47至4.44);p=0.01)与结节病相比,结节病分别显着高于非结节病。
    室性心动过速的发生率,CS患者中HF和AA显著增高。临床医生应该意识到这些与结节病相关的不良心血管事件。
    UNASSIGNED: Sarcoidosis is a chronic inflammatory disorder of unknown etiology associated with high morbidity and mortality. Its association with cardiovascular outcomes is under-documented.
    UNASSIGNED: The aim of this study was to assess the adverse cardiovascular outcomes in patients with sarcoidosis compared with that of non-sarcoidosis.
    UNASSIGNED: Online databases including PubMed, Embase and Scopus were queried from inception until March 2022. The outcomes assessed included all-cause mortality (ACM) and incidence of ventricular tachycardia (VT), heart failure (HF) and atrial arrhythmias (AA).
    UNASSIGNED: A total of 6 studies with 22,539,096 participants (42,763 Sarcoidosis, 22,496,354 Non-Sarcoidosis) were included in this analysis. The pooled prevalence of sarcoidosis was 13.1% (95% CI 1% to 70%). The overall mean age was 47 years. The most common comorbidities were hypertension (12.7% vs 12.5%), and diabetes mellitus (5.5% vs 4%) respectively. The pooled analysis of primary endpoints showed that all-cause mortality (RR, 2.08; 95% CI: 1.17 to 3.08; p = 0.01) was significantly increased in sarcoidosis patients. The pooled analysis of secondary endpoints showed that the incidence of VT (RR, 15.3; 95% CI: 5.39 to 43.42); p < 0.001), HF (RR, 4.96; 95% CI: 2.02 to 12.14; p < 0.001) and AA (RR, 2.55; 95% CI: 1.47 to 4.44); p = 0.01) were significantly higher with sarcoidosis respectively compared to non-sarcoidosis.
    UNASSIGNED: Incidence of VT, HF and AA was significantly higher in patients with CS. Clinicians should be aware of these adverse cardiovascular events associated with sarcoidosis.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    秋水仙碱的医学进化在历史上与地中海盆地有关,因为来自该地区的杰出研究人员强调了其宝贵的特性。随着岁月的流逝,秋水仙碱成为治疗风湿病和心血管疾病的必需药物。根据最近的发现,秋水仙碱的治疗价值已经增长。在临床实践中,鉴于秋水仙碱已被证明的疗效和安全性,秋水仙碱仍未得到充分利用。其复杂的药代动力学和多方面的抗炎作用仍在研究中。鉴于关键药物与药物的相互作用,当前的综述讨论了秋水仙碱的安全给药。最后,我们将简要介绍秋水仙碱未来的潜在应用。
    Colchicine\'s medical evolution is historically bound to the Mediterranean basin, since remarkable researchers from this region underscored its valuable properties. With the passing of years colchicine became an essential pharmaceutical substance for the treatment of rheumatologic and cardiovascular diseases. In light of recent findings, the therapeutic value of colchicine has grown. In clinical practice, colchicine remains underutilized in view of its proven efficacy and safety. Its complex pharmacokinetics and multifaceted anti-inflammatory role remain under investigation. The current review addresses the safe administration of colchicine in view of key drug to drug interactions. Finally, we are briefly presenting colchicine\'s future potential applications.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

       PDF(Pubmed)

公众号