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1.
Curr Probl Cardiol ; 49(1 Pt C): 102125, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37806645

ABSTRACT

Heart Failure with Preserved Ejection Fraction (HFpEF) is a prevalent cardiovascular condition characterized by a complex pathophysiology and limited therapeutic options. Coinciding iron deficiency often compounds the clinical picture, contributing to symptom burden and adverse outcomes. The review underscores the urgency for effective treatments in light of its increasing incidence and considerable healthcare burden. It highlights the clinical significance of addressing iron deficiency in HFpEF patients. FCM emerges as a promising therapeutic modality, demonstrating the ability to rapidly restore iron stores and enhance patients' quality of life while reducing hospitalization rates and mortality. The review thoroughly elucidates the impact of iron deficiency on HFpEF symptoms and outcomes, elucidating how FCM effectively mitigates these challenges. Detailed discussions encompass FCM's mechanism of action, pharmacokinetics, and safety profile. Notably, FCM's adaptability to diverse patient profiles and clinical settings is emphasized, reinforcing its clinical utility. Clinical evidence, including study designs, patient cohorts, and key findings, affirms FCM's potential as a valuable therapeutic option. Real-world data analysis further underscores FCM's practicality and safety beyond controlled clinical trials. The review concludes by addressing future research directions and critical research gaps, accentuating the need for mechanistic insights, long-term outcome studies, and refined patient selection criteria. As FCM increasingly integrates into clinical practice, it offers promise in revolutionizing HFpEF management, addressing an unmet need in this intricate cardiovascular condition.


Subject(s)
Anemia, Iron-Deficiency , Heart Failure , Iron Deficiencies , Humans , Anemia, Iron-Deficiency/drug therapy , Anemia, Iron-Deficiency/etiology , Heart Failure/complications , Stroke Volume , Quality of Life
2.
Cureus ; 12(7): e9375, 2020 Jul 24.
Article in English | MEDLINE | ID: mdl-32850243

ABSTRACT

Pro-protein convertase subtilisin/Kexin type 9 (PCSK9) inhibitors are relatively new, non-statin, lipid-lowering drugs that reduce low-density lipoprotein cholesterol (LDL-C) by 60%. PCSK9 inhibitors reduce the blood concentrations of cholesterol by the degradation of LDL receptors, which subsequently extracts cholesterol from cells. This leads to cardiovascular risk reduction in various at-risk populations, including atherosclerotic coronary artery disease. Despite their promise for advanced lipid-lowering ability, cost-effectiveness is a barrier to their routine use. While searching PubMed, we extracted land-mark trials on two of the anti-PCSK9 monoclonal antibodies, alirocumab and evolocumab. When combined with statins or ezetimibe, they show an exponential fall in LDL-C levels, helping achieve target values in high-risk populations and decreasing cardiovascular adverse events. Ongoing research is exploring the long-term efficacy of these antibodies in established coronary artery disease and familial hypercholesterolemia with more prospects for this novel lipid-lowering therapy.

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