Current Cardiology Reviews[JOURNAL]
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200 papers
State-of-the-Art Strategies in Heart Failure Screening.
Ramadan MM, Nouh A, Haj-Mohamed H … +5 more , Alayyaf AE, Salloum RH, Haj OM, Sahli HW, Mustafa NS
Curr Cardiol Rev · 2026 Apr · PMID 42003005 · Publisher ↗
INTRODUCTION: Heart Failure (HF) is a major global health concern affecting approximately 64 million individuals. Because early asymptomatic stages are frequently overlooked, many patients are diagnosed late, after preve...
INTRODUCTION: Heart Failure (HF) is a major global health concern affecting approximately 64 million individuals. Because early asymptomatic stages are frequently overlooked, many patients are diagnosed late, after preventable morbidity and hospitalization. Screening that identifies high-risk individuals earlier may enable timely intervention and disease modification. METHODS: This narrative review searched PubMed and Embase for English-language literature published between 2018 and 2025 on HF screening. Search themes included heart failure, early detection, screening strategies, natriuretic peptides, biomarkers, echocardiography, cardiac imaging, digital health, wearable technologies, and Artificial Intelligence (AI). Relevant guidelines, clinical studies, meta-analyses, and review articles were evaluated and synthesized with emphasis on diagnostic performance, feasibility, and implementation across different healthcare settings. RESULTS: Targeted screening of high-risk groups (e.g., hypertensives, diabetics, those with established cardiovascular diseases) was consistently more effective than symptom-based evaluation. Natriuretic peptides (BNP/NT-proBNP) showed high sensitivity for ruling out HF in non-acute settings and for biomarker triage of individuals at increased risk, while echocardiography remained the cornerstone for confirmatory structural and functional assessment. Digital health tools, including wearables and AI-driven algorithms, showed promise for widely applicable risk stratification and remote monitoring, although performance and feasibility varied by setting. DISCUSSION: Key gaps include limited prospective outcome-driven trials, heterogeneity of screening thresholds and pathways, disparities in access to biomarkers and imaging, and unresolved issues in data quality, privacy, bias, and workflow integration for digital/AI approaches in practice. CONCLUSION: Integrated, stepwise HF screening frameworks that combine risk stratification, biomarker triage, confirmatory imaging, and context-appropriate digital support may facilitate earlier detection and link positive screens to practical preventive and therapeutic care. Future research should prioritize context-adapted pathways and randomized evaluations of patientcentred outcomes and cost-effectiveness.
Unlocking the Potential of Biomarkers in Varied Cardiovascular Associated Conditions with Individualized Treatment Approaches: A Comprehensive Review.
Guleria M, Malhan A, Goyal D … +7 more , Sharma D, Singh S, Sahu KK, Syukri DM, Chidrawar VR, Datta D, Nagime PV
Curr Cardiol Rev · 2026 Apr · PMID 41968843 · Publisher ↗
INTRODUCTION: Biomarkers play a pivotal role in the prognosis, risk stratification, and management of cardiovascular diseases (CVDs), which remain the foremost cause of morbidity and mortality globally. METHODS: A compre...
INTRODUCTION: Biomarkers play a pivotal role in the prognosis, risk stratification, and management of cardiovascular diseases (CVDs), which remain the foremost cause of morbidity and mortality globally. METHODS: A comprehensive review explores the various types of biomarkers utilized in the treatment of different CVD conditions, presenting the information clearly and concisely. Additionally, this overview summarizes recent clinical trial findings and advances in biomarker research. RESULTS: Recent advancements in biomarker research have identified a range of circulating biomarkers, including high-sensitivity C-reactive protein (hsCRP), cardiac troponins (cTn) and various microRNAs, that enhance the predictive accuracy for cardiovascular events. These biomarkers are derived from diverse pathophysiological processes such as inflammation, endothelial dysfunction and MI. DISCUSSION: As versatile tools, biomarkers serve as prognostic indicators, diagnostic markers, intermediate and surrogate endpoints, and safety monitors, making them essential in personalized medicine. In this context, biomarker-guided cardiovascular therapies represent an advanced approach, allowing clinicians to customize treatment choices and track therapeutic effectiveness in real time. In addition, nanobiotechnology-based systems are also pivotal in personalized medicine, offering targeted therapeutic delivery for CVDs, particularly in addressing heart cell death. Moreover, artificial intelligence, which is emerging as a useful tool in biomarker-guided, personalized cardiovascular treatment, is improving patient care and aiding cardiologists. CONCLUSION: Recent strides in biomarker research suggest that personalized medicine guided by circulating biomarkers could revolutionize CVD management by enhancing risk prediction and tailoring treatments to each patient. Future research should focus on refining these biomarkers and addressing current limitations to optimise their clinical utility in improving cardiovascular health outcomes.
Maternal Obesity and Risk of Congenital Heart Defects.
Meneses H, Guedes-Martins L
Curr Cardiol Rev · 2026 Apr · PMID 41968842 · Publisher ↗
Congenital heart defects are the most common malformations in newborns and the leading cause of morbidity and mortality due to congenital abnormalities. As a result of genetic susceptibility and environmental exposure, a...
Congenital heart defects are the most common malformations in newborns and the leading cause of morbidity and mortality due to congenital abnormalities. As a result of genetic susceptibility and environmental exposure, a few of these anomalies could be prevented by managing modifiable risk factors. Given that maternal obesity is a predisposing factor for obstetric and fetal complications, this review aims to explore its association with congenital heart disease, while addressing mechanisms underlying its pathophysiology at the cellular and molecular levels. For this purpose, a series of searches was carried out on the PubMed database, and additional articles were identified via citation searches. Studies suggest a 17 - 32% increase in risk of the offspring developing a congenital heart defect when compared to normal weight mothers, with an estimate of 7% increased risk per 5 kg/m2 body mass index rise. This review highlights the role of placental dysfunction, a pro-inflammatory state, systemic oxidative stress, and decreased adiponectin, all caused by maternal obesity, in disrupting fetal cardiac development and leading to the development of congenital heart disease. Overall, obesity seems to impair essential cellular processes involved in cardiogenesis, inflicting long-lasting damage to fetal cells. Literature remains inconsistent regarding the role of confounding factors, such as gestational weight gain, gestational diabetes and maternal diet. Further investigation is needed concerning preconceptional and gestational prevention and management strategies suited for these mothers. This narrative review aims to offer an integrated overview of maternal obesity and its physiological consequences, with a particular focus on placental function, fetal cardiac development, and the risk of congenital heart disease.
Cost-Effectiveness of Empagliflozin in Patients with Chronic Heart Failure and Chronic Kidney Disease: A Systematic Review.
Nargiza S, Shohista M, Shakhnoz U … +1 more , Guzal M
Curr Cardiol Rev · 2026 Apr · PMID 41968841 · Publisher ↗
INTRODUCTION: To evaluate the cost-effectiveness of empagliflozin in patients with chronic heart failure with preserved ejection fraction (CHFpEF) and moderately reduced ejection fraction (CHFmrEF) across various healthc...
INTRODUCTION: To evaluate the cost-effectiveness of empagliflozin in patients with chronic heart failure with preserved ejection fraction (CHFpEF) and moderately reduced ejection fraction (CHFmrEF) across various healthcare systems. MATERIALS AND METHODS: A systematic review was conducted according to PRISMA 2024 guidelines. A total of 6 studies were included after screening 225 records from PubMed, Web of Science, ScienceDirect, and Google Scholar. Studies evaluating cost-effectiveness outcomes, including incremental cost-effectiveness ratios (ICER), quality-adjusted life years (QALY), and healthcare costs, were analyzed. RESULTS: All included studies applied a Markov model over a 10-year time horizon. Empagliflozin was associated with a 15-18% reduction in hospitalizations, an increase in QALYs by 0.11-0.67, and ICERs ranging from €5,089/QALY to $174,053/QALY, depending on the healthcare setting and model assumptions. Examples include: Spain: €5,089/QALY, China: $11,292/QALY, USA: $25,974-$174,053/QALY, Australia: A$29,202/QALY. ICER per life year (LY) ranged from $6,246 to $151,929, indicating variable cost-effectiveness based on country-specific cost structures and thresholds. CONCLUSIONS: Empagliflozin appears to be a cost-effective add-on therapy to standard care for CHFpEF and CHFmrEF, especially in healthcare systems with high hospitalization costs. However, its value is highly sensitive to drug pricing and national willingness-to-pay thresholds. Further real-world studies are needed to confirm long-term economic benefits. The review was registered with PROSPERO (CRD420250654439). Available from: https://www.crd.york.ac.uk/PROSPERO/view/CRD420250654439.
Clinical Characteristics of Congenital Heart Disease in Eastern Indonesia: A Retrospective Study from a Major Referral Center.
Saini PPPA, Yunita L, Fernandez SA
Curr Cardiol Rev · 2026 Apr · PMID 41968840 · Publisher ↗
BACKGROUND/OBJECTIVE: Congenital Heart Disease (CHD) is an abnormality in the heart's structure or function present from birth. Indonesia reports over 40,000 new cases annually. Despite the heavy burden, data on CHD char...
BACKGROUND/OBJECTIVE: Congenital Heart Disease (CHD) is an abnormality in the heart's structure or function present from birth. Indonesia reports over 40,000 new cases annually. Despite the heavy burden, data on CHD characteristics in East Nusa Tenggara remain limited. OBJECTIVE: To investigate the clinical and demographic characteristics of CHD patients in Kupang, East Nusa Tenggara, and to describe their presenting symptoms and complications. METHODS: We conducted a retrospective study of 148 CHD patients enrolled between August 1, 2023, and December 31, 2024, at Prof. W.Z. Johannes Regional Hospital, Kupang. Clinical profiles and demographic data were collected from the cardiology department's registers. Statistical analysis was performed using IBM SPSS® version 30. RESULTS: Acyanotic CHD (ACHD) was more prominent, accounting for 83.7% of cases, with atrial septal defect (ASD) being the most common (30.4%). Tetralogy of Fallot (TOF) was the most common type of cyanotic CHD (4.1%). The largest age group was neonates (37.2%). Almost half (45.3%) of the patients were underweight. Respiratory infections (25%) were the most common complication. CONCLUSION: The results of this study demonstrate the dominance of acyanotic lesions and reveal a high prevalence of malnutrition among CHD patients in Kupang. These findings provide baseline data to enhance early detection, nutritional optimization, and the strengthening of CHD care services in areas of eastern Indonesia.
Nationwide Trends in PCI Outcomes for Older Acute Coronary Syndrome Patients with a History of CABG.
Senapati S, Mishra T, Gupta A … +9 more , Suchday P, Patel R, Swamy DSN, Pinnamaneni S, Anne R, Rathod U, Patel R, Desai R, Jena N
Curr Cardiol Rev · 2026 Apr · PMID 41968839 · Publisher ↗
BACKGROUND: Techniques for percutaneous coronary intervention (PCI) have evolved over the last decade. However, there is not enough data on recent trends among high-risk groups, particularly patients with a Coronary Arte...
BACKGROUND: Techniques for percutaneous coronary intervention (PCI) have evolved over the last decade. However, there is not enough data on recent trends among high-risk groups, particularly patients with a Coronary Artery Bypass Graft (CABG). This study examines current PCI outcomes in older patients with Acute Coronary Syndrome (ACS) and a history of CABG. It aims to provide useful insights for this vulnerable group. METHODS: We analyzed the 2016-2020 National Inpatient Sample database along with the relevant ICD-10-CM codes. The focus was on PCI outcomes for ACS patients aged 65 and older who have a history of CABG. We measured primary outcomes to evaluate observed trends. RESULTS: Out of 94,610 patients, 74.5% were male, and 84.1% were white, with a median age of 75 years. A significant 94.6% underwent non-elective PCI. Common additional health issues included hyperlipidemia (83.7%), smoking (40%), complicated diabetes (34.6%), and hypertension (53.7%). We found statistically significant differences in post-catheterization-related bleeding, post-procedural respiratory failure, and Impella usage after PCI (all P<0.001). There were declining trends in PC-B (1.5% in 2016 vs. 0.7% in 2020, P<0.001) and PP-RF (0.3% in 2016 vs. 0.2% in 2020, P<0.001), with an increase in Impella usage post-PCI (1.2% in 2016 vs. 2.1% in 2020). There were declining trends in postcatheterization bleeding (1.5% [95% CI: 1.2-1.8] in 2016 vs. 0.7% [95% CI: 0.5-0.9] in 2020, P<0.001) and post-procedural respiratory failure (0.3% [95% CI: 0.2-0.4] vs. 0.2% [95% CI: 0.1-0.3], P<0.001), with an increase in Impella use (1.2% [95% CI: 1.0-1.5] vs. 2.1% [95% CI: 1.8-2.4], P<0.001). Following PCI, there were no statistically significant differences in outcomes such as All-Cause Mortality (ACM), Intracranial Bleed (IC-B), Cardiac arrest (CA), Postprocedural Stroke (PP-S), Cardiogenic Shock (CS), and intra-aortic balloon pump (IABP) and Intra-Aortic Balloon Pump (IABP) usage. DISCUSSION: Our study showed improved bleeding outcomes and postprocedural respiratory failure. We also noticed a rising trend in Impella use among older CABG patients with ACS. This trend reflects advances in coronary intervention technology and improved access techniques. However, there were no statistical differences in ACM, IC-B, CA, PP-S, CS, and IABP use. This underscores the complexity of the anatomy, the challenges of the procedure, and the high-risk nature of the population. It calls for a tailored approach to these patients to achieve better outcomes.
A Narrative Review on Repurposing Azithromycin for Rheumatic Heart Disease: Exploring its Therapeutic Potential and Mechanisms of Action.
Wal P, Wal A, Kumar A … +6 more , Verma R, Rawat A, Chellammal HSJ, Ashesh AM, Kumar D, Gasmi A
Curr Cardiol Rev · 2026 Apr · PMID 41968838 · Publisher ↗
INTRODUCTION: Despite effective preventative measures, rheumatic heart disease (RHD) continues to be a significant contributor to cardiovascular morbidity and mortality in low- and middle- income nations. Azithromycin (A...
INTRODUCTION: Despite effective preventative measures, rheumatic heart disease (RHD) continues to be a significant contributor to cardiovascular morbidity and mortality in low- and middle- income nations. Azithromycin (AZM) has drawn attention due to its antibacterial, antiinflammatory, and immunomodulatory properties that are pertinent to the pathophysiology of RHD. In the context of RHD and acute rheumatic fever (ARF), this narrative review synthesises mechanistic, preclinical, and limited clinical information on AZM, differentiating between evidence-based therapeutic application and hypothesis-generating biological plausibility. METHODS: Through May 2025, a systematic narrative literature search was conducted in PubMed, Scopus, and Google Scholar to find research on AZM's immunoregulatory effects, modulation of inflammatory pathways, and antibacterial activity. Key findings were summarized using conceptual synthesis and reference screening. RESULTS: According to experimental research, AZM reduces inflammatory mediators like MUC5AC, MMP-9, and IL-8 by influencing molecular pathways like MAPK, NF-κB, and AP-1. These processes may be important for reducing immune-mediated tissue damage in RHD. Clinical data is still limited and inconsistent, nevertheless. Benzathine penicillin G (BPG) is still the best option for secondary prophylaxis, according to comparative research; AZM only exhibits theoretical or situationspecific benefits (e.g., oral dose, patient adherence, or allergy scenarios). DISCUSSION: Research indicates that azithromycin's three distinct mechanisms-antibacterial, antiinflammatory, and immunomodulatory-may provide a tactical edge in the treatment of RHD, particularly in situations where conventional therapies are ineffective. A wider use in secondary prevention and possible disease modification is suggested by its effects on important inflammatory mediators and signalling pathways. However, pharmacogenomic research and long-term clinical trials are necessary to confirm its effectiveness and customise therapies. CONCLUSIONS: Rather than being a proven treatment for RHD prophylaxis, AZM should be considered an experimental supplement. Although well-designed, context-specific randomised trials integrating safety, resistance surveillance, and cost-effectiveness assessments are necessary to translate their molecular effects into therapeutic benefit, they do offer useful information for idea formulation. AZM may only be taken into consideration in situations of penicillin intolerance or as part of an implementation or feasibility study in places with limited resources.
The First 21-year Bibliometric Analysis of Renal Denervation for Heart Failure (2004-2024): Mapping Global Trends and Future Directions.
Liu J, Wang X, Zong G … +4 more , Liu Y, Sheng Y, Ye J, Yuan R
Curr Cardiol Rev · 2026 Mar · PMID 41941346 · Publisher ↗
INTRODUCTION: This pioneering bibliometric analysis aims to evaluate the global research landscape and evolving trends of Renal Denervation (RDN) as an emerging therapy for Heart Failure (HF) over the past two decades (2...
INTRODUCTION: This pioneering bibliometric analysis aims to evaluate the global research landscape and evolving trends of Renal Denervation (RDN) as an emerging therapy for Heart Failure (HF) over the past two decades (2004-2024). METHODS: Utilizing tools including Bibliometrix, VOSviewer, and CiteSpace, we analyzed 222 English publications (135 articles; 87 reviews) from the Web of Science Core Collection. The study assessed publication trends, international collaborations, keyword co-occurrence, and thematic evolution. RESULTS: Annual publications surged consistently post-2012. Leading contributing countries were the U.S. (37.4%), China (17.6%), and Germany (16.7%). Research focus shifted from foundational mechanistic insights to clinical applications, particularly in heart failure with reduced ejection fraction (HFrEF). Key findings demonstrated RDN's association with improved cardiac function, reduced NT-proBNP, and enhanced exercise tolerance. DISCUSSION: The findings affirm RDN's potential as a transformative intervention for sympathetic- driven HF, especially HFrEF, by addressing neurohormonal overactivation. Current evidence supports its efficacy, though limitations include a lack of randomized trials in HFpEF and standardized procedural protocols. Future directions should emphasize phenotype-specific trials and biomarker-guided patient selection. CONCLUSION: RDN represents a promising precision therapy for HF. Accelerating its clinical translation requires multidisciplinary collaboration, dedicated funding for trial validation, and integration of multi-omics and artificial intelligence for personalized treatment strategies.
Dietary Fiber in the Prevention and Management of Obesity, Diabetes, and Cardiovascular Disease: A Mini Review.
Kumar D, Sharma PK, Goyal K
Curr Cardiol Rev · 2026 Mar · PMID 41941345 · Publisher ↗
INTRODUCTION: Dietary fiber is a critical modulator of metabolic pathways underlying obesity, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD). METHODS: Literature published between 2000 and 2025 was sys...
INTRODUCTION: Dietary fiber is a critical modulator of metabolic pathways underlying obesity, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD). METHODS: Literature published between 2000 and 2025 was systematically searched in PubMed, ScienceDirect, Google Scholar, Scopus, SpringerLink, and Wiley Online Library using keywords related to dietary fiber and metabolic diseases. Only peer-reviewed, open-access studies with mechanistic or clinical evidence were included. RESULTS: Studies indicate that soluble, insoluble, and fermentable fibers confer protective effects against metabolic disorders through multiple mechanisms, including modulation of glycemic control, lipid metabolism, and inflammatory pathways. DISCUSSION: Fermentation of dietary fiber by gut microbiota generates short-chain fatty acids, which improve insulin sensitivity, modulate lipid metabolism, and attenuate inflammation. Fiber also delays gastric emptying, enhances glycemic control, and lowers serum cholesterol. These physiological effects are supported by randomized controlled trials and meta-analyses demonstrating improvements in body weight, LDL cholesterol, and glucose regulation. CONCLUSION: Incorporating dietary fiber into nutrition strategies effectively prevents and manages obesity, T2DM, and CVD, while further research is needed to understand individual variability in response.
Inflammatory Biomarkers in Coronary Artery Disease: Diagnostic and Prognostic Potential?
Ghelani R, Alaour B
Curr Cardiol Rev · 2026 Mar · PMID 41941344 · Publisher ↗
INTRODUCTION: Coronary artery disease (CAD) is a leading global cause of morbidity and mortality. Advances in treatment have resulted in a new, growing cohort of patients who require lifelong management. Although inflamm...
INTRODUCTION: Coronary artery disease (CAD) is a leading global cause of morbidity and mortality. Advances in treatment have resulted in a new, growing cohort of patients who require lifelong management. Although inflammation is firmly established as a driving force across all stages of atherosclerosis, the potential role of inflammatory biomarkers in improving disease prediction, phenotyping, and risk stratification remains uncertain and continues to be debated. OBJECTIVES: To examine the current evidence surrounding inflammatory biomarkers that demonstrate potential utility in the assessment of CAD across three key domains: (i) predicting incidence of CAD in asymptomatic individuals; (ii) predicting plaque rupture in patients with established CAD; and (iii) forecasting recurrent cardiovascular events and relevant adverse clinical outcomes, following an acute coronary syndrome. METHODS: We undertook a structured literature search using Embase (OVID), combining relevant MeSH terms and keywords. Boolean operators, truncation, and wildcards were used to further refine results, with sub-analyses undertaken on both recent (≤5 years) and earlier foundational studies. RESULTS: Biomarkers critically assessed range from established agents such as C-reactive protein and Fibrinogen to those currently utilised in a research capacity, including Interleukin-6, Galectin-3, Myeloperoxidase, and Tumour necrosis factor-alpha. We additionally discuss the conceivable clinical translation of each biomarker in the context of any key barriers to use. DISCUSSION AND CONCLUSIONS: Inflammatory biomarkers have the potential to improve coronary disease assessment, but do not currently hold an established place in the diagnosis, risk stratification, or prognostication of disease. Validating their clinical applications along different phases of the atherosclerotic process remains a distant but worthwhile target.
Impact of Vegetable Oils and the Effect of Repeatedly Heated Vegetable Oils on Cardiovascular Events: A Review.
Kaur A, Singh H, Misbah M
Curr Cardiol Rev · 2026 Mar · PMID 41941343 · Publisher ↗
Cardiovascular disease (CVD), including coronary heart disease (CHD), is the leading cause of mortality in India. It may result from interactions between various genetic and environmental factors, such as sedentary lifes...
Cardiovascular disease (CVD), including coronary heart disease (CHD), is the leading cause of mortality in India. It may result from interactions between various genetic and environmental factors, such as sedentary lifestyles and unhealthy eating habits. Vegetable oil is one of the most important nutritional components in daily meals. However, prolonged heating that induces lipid oxidation can diminish its health benefits. Thermal oxidation produces novel functional groups that may pose cardiovascular health risks. Consumption of repeatedly heated oils has been shown to raise blood pressure and total cholesterol, while also promoting vascular inflammation and structural changes that increase susceptibility to atherosclerosis. Coronary artery disease (CAD) is closely associated with dietary fats. Saturated fats, trans fats, and cholesterol-rich fats are detrimental, whereas monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA)-particularly Omega-3 PUFA- are beneficial for heart health. Choosing heart-healthy oils may help reduce the risk of developing CAD. This article evaluates the advantages and disadvantages of commonly consumed edible oils with respect to heart health. An optimal N-6 to N-3 ratio (< 4:1), high smoke point, low saturated fat content, high MUFA and PUFA levels, and the absence of cholesterol and trans fats are key characteristics of a heart-healthy oil. In this context, canola and mustard oils appear to be the most favorable options. Epidemiological studies indicate that CAD prevalence is lower among regular consumers of mustard oil than among users of other oils. The aim of this review is to examine the beneficial and adverse effects of various fresh vegetable oils by providing comprehensive information about them. A further objective is to educate the public about the harmful consequences of repeatedly consuming heated oils.
Impact of CTO Revascularization on Sudden Cardiac Death and/or Ventricular Arrhythmias: A Meta-Analysis of Observational Studies.
Sfairopoulos D, Bazoukis G, Liu H … +10 more , Saplaouras A, Efthymiou P, Yiannikourides A, Pagkalidou E, Liu T, Korantzopoulos P, Letsas KP, Efremidis M, Tse G, Brilakis ES
Curr Cardiol Rev · 2026 Mar · PMID 41941342 · Publisher ↗
INTRODUCTION: The presence of a chronic total occlusion (CTO) has been associated with increased risk of sudden cardiac death (SCD) and/or ventricular arrhythmias (VAs). This study aimed to evaluate the impact of CTO rev...
INTRODUCTION: The presence of a chronic total occlusion (CTO) has been associated with increased risk of sudden cardiac death (SCD) and/or ventricular arrhythmias (VAs). This study aimed to evaluate the impact of CTO revascularization on SCD and/or VAs. METHODS: A systematic review of the literature was performed to identify studies evaluating the association between CTO revascularization and risk of SCD and/or VAs. RESULTS: Six studies were included in the final meta-analysis. The total sample size included 2,017 participants for the assessment of the primary outcome of interest and 868 participants for the assessment of the secondary outcome of interest. In 5 studies examining the association between CTO revascularization and risk of SCD and/or VAs, CTO revascularization was not associated with a statistically significant reduction in the risk of SCD and/or VAs (HR: 0.78; 95% CI: 0.38 to 1.60; p = 0.50, I2 = 87%). Conversely, in 2 studies examining the association between IRA-CTO revascularization and risk of SCD and/or VAs, IRA-CTO revascularization was associated with 79% lower risk of SCD and/or VAs (HR: 0.21; 95% CI: 0.10 to 0.43; p < 0.0001, I2 = 0%). DISCUSSION: CTO revascularization overall was not associated with a lower risk of SCD and/or VAs. In contrast, IRA-CTO revascularization was associated with a lower risk of SCD and/or VAs. However, the study has several limitations, primarily due to the observational nature of the included studies. CONCLUSION: Successful revascularization of an IRA-CTO should be attempted to reduce the burden of VAs and reduce the risk of SCD.
Retrospective Analysis of Clinical Repurposing of Dipyridamole and L-Arginine for Treatment of Long COVID Endothelitis.
Kulkarni C, Haase E, Esparza E … +2 more , Blancke A, Sathyamoorthy M
Curr Cardiol Rev · 2026 Mar · PMID 41941341 · Publisher ↗
INTRODUCTION: The effect of treatment with L-arginine and dipyridamole for the reduction of symptoms of fatigue, difficulty performing activities of daily living (ADLs), dyspnea, and mental health decline in patients wit...
INTRODUCTION: The effect of treatment with L-arginine and dipyridamole for the reduction of symptoms of fatigue, difficulty performing activities of daily living (ADLs), dyspnea, and mental health decline in patients with Long COVID endothelitis was studied in this research, leading to conclusions that are presented. METHODS: Forty-four patients with documented Long COVID endothelitis were enrolled in this retrospective, IRB-approved analysis evaluating clinician-directed treatment strategies initiated during the COVID-19 pandemic. Patients received either dipyridamole alone, L-arginine alone, or combination therapy. Clinical responses were assessed at 6 weeks and 6 months postinitiation, and a subset of nine patients also completed a structured, patient-reported outcomes survey approximately two years after starting treatment. RESULTS: Of the 44 subjects identified, clinical follow-up at 6 weeks demonstrated a significant overall symptom improvement (p=0.0115). At 6 months, symptom improvement remained substantial but lost statistical significance (p=0.09). Combination therapy (dipyridamole and Larginine) showed sustained improvement at both 6 weeks (68.8%) and 6 months (62.5%). Dipyridamole alone demonstrated high early response (80%) but markedly reduced efficacy at 6 months (20%). Statistical comparisons between combination therapy and monotherapy groups did not yield significant results, likely due to limited sample sizes. Patient-reported outcomes supported clinical findings, with combination therapy yielding the lowest symptom burden in fatigue, dyspnea, and depression, and the highest functional capacity. DISCUSSION: This study addressed a critical unmet need in Long COVID management, a condition affecting middle-aged and older adults with substantial symptom burden, including fatigue (reported in up to 45% of patients), dyspnea, and cognitive dysfunction. The therapeutic benefit observed with dipyridamole and L-arginine likely stems from their complementary mechanisms: dipyridamole's antiplatelet and anti-inflammatory effects may reduce microvascular dysfunction and microthrombosis, while L-arginine enhances nitric oxide production, supporting endothelial function and vascular homeostasis. Both agents possess favorable safety profiles, making them reasonable options in the absence of validated alternatives for Long COVID endothelitis. CONCLUSION: Treatment with dipyridamole and L-arginine, particularly in combination, was associated with meaningful improvements in fatigue, dyspnea, ability to perform ADLs, and mental health symptoms in patients with Long COVID. These preliminary findings underscore the potential benefit of these therapeutic agents, though larger, randomized controlled studies are necessary to confirm efficacy and enhance statistical power.
SGLT2 Inhibitors as Mitochondrial Therapies in Heart Failure: A Bioenergetic Revolution in Cardiometabolic Medicine.
Epelde F
Curr Cardiol Rev · 2026 Mar · PMID 41941340 · Publisher ↗
INTRODUCTION: SGLT2 inhibitors improve outcomes in heart failure (HF), yet mechanisms beyond glycemic control remain debated. We synthesize evidence positioning mitochondrial bioenergetics as the central unifying mechani...
INTRODUCTION: SGLT2 inhibitors improve outcomes in heart failure (HF), yet mechanisms beyond glycemic control remain debated. We synthesize evidence positioning mitochondrial bioenergetics as the central unifying mechanism through which SGLT2 inhibitors exert cardioprotective effects, reframing them as mitochondrial therapies with systemic metabolic benefits. METHODS: Narrative critical synthesis of preclinical, translational, and clinical data. Sources were identified through database searches (2010-2025) and screened to include studies linking SGLT2 inhibitors to mitochondrial pathways and HF outcomes. RESULTS: Preclinical studies show improved oxidative phosphorylation, reduced reactive oxygen species, enhanced mitophagy, and a shift toward ketone oxidation. Translational data suggest AMPK/PGC-1α activation and improved myocardial energetics, while randomized trials consistently reduce HF hospitalizations across phenotypes (HFrEF/HFpEF), with early benefits independent of glycemia. DISCUSSION: Evidence supports a bioenergetic framework in which SGLT2 inhibitors enhance mitochondrial efficiency and systemic metabolic resilience. Nonetheless, human myocardial data remain limited and heterogeneous, warranting further mechanistic trials with imaging or biopsy endpoints. CONCLUSION: The cardioprotective actions of SGLT2 inhibitors are plausibly mediated, in part, by mitochondrial modulation. This reframes HF as an energy-deficit syndrome and motivates targeted translational studies to validate mitochondrial endpoints and refine patient selection.
Heart Failure in the Era of Precision Medicine: Advances, Challenges, and Future Directions.
Epelde F
Curr Cardiol Rev · 2026 Mar · PMID 41833020 · Publisher ↗
INTRODUCTION: Heart Failure (HF) remains a leading cause of morbidity and mortality worldwide, with a heterogeneous clinical spectrum requiring increasingly individualized care. Advances in pharmacotherapy, device interv...
INTRODUCTION: Heart Failure (HF) remains a leading cause of morbidity and mortality worldwide, with a heterogeneous clinical spectrum requiring increasingly individualized care. Advances in pharmacotherapy, device interventions, and precision medicine have transformed HF management. This review synthesizes recent developments, persistent challenges, and emerging opportunities in HF care. METHODS: We performed a narrative review of landmark clinical trials, guideline updates, and high-impact studies published between January 2020 and December 2024. Sources included PubMed/MEDLINE, Scopus, Web of Science, and major cardiology society publications. Studies were selected based on clinical relevance, robustness of evidence, and applicability to contemporary practice. RESULTS: Recent evidence supports the use of Sodium-Glucose Cotransporter-2 inhibitors (SGLT2i) across the EF spectrum, expanding HF treatment beyond traditional ejection fraction categories. Novel therapies, including vericiguat, omecamtiv mecarbil, and transthyretin amyloidosis- specific drugs, have addressed previously unmet needs. Precision medicine approaches, incorporating genetic testing, biomarker-guided care, and advanced imaging, show promise in tailoring interventions. However, disparities in access, underrepresentation in clinical trials, and implementation barriers persist. DISCUSSION: The integration of novel pharmacologic agents, disease-specific therapies, and precision medicine tools has broadened the therapeutic landscape for HF. Ongoing challenges include ensuring equitable access, validating emerging technologies, and translating trial findings into practical applications in real-world settings. Multidisciplinary care models and pragmatic clinical trials will be essential to address these gaps. CONCLUSION: Advances in HF therapeutics and precision medicine are reshaping patient care. Strategic implementation, equitable access, and continued innovation are critical to improving outcomes across diverse HF populations.
Comparing the Long-term Outcomes of Coronary Artery Bypass Grafting (CABG) vs. Percutaneous Coronary Intervention (PCI) in Patients with Multivessel Disease- A Systematic Review and Meta-Analysis.
Ray R, Singla S, Virk GS … +8 more , Hack S, Abbas Z, Murugesan HA, Mahmood A, Shah M, Khalid S, Afzal S, Izzat I
Curr Cardiol Rev · 2026 Mar · PMID 41833019 · Publisher ↗
INTRODUCTION: Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI) are standard treatments for Multivessel Coronary Artery Disease (MVD). Their long-term comparative effectiveness remains d...
INTRODUCTION: Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI) are standard treatments for Multivessel Coronary Artery Disease (MVD). Their long-term comparative effectiveness remains debated. METHOD: A systematic review and meta-analysis of randomized and observational studies was conducted, including patients with MVD followed for ≥5 years. Data were pooled using randomor fixed-effects models, depending on the level of heterogeneity. RESULTS: Thirteen studies met the inclusion criteria. CABG was associated with reduced all-cause mortality (RR 0.82, 95% CI 0.72-0.91) and fewer repeat revascularizations (RR 1.98, 95% CI 1.74-2.26) compared with PCI. Stroke risk was slightly higher after CABG. DISCUSSION: Findings suggest CABG provides superior survival and event reduction in long-term follow-up, particularly in higher-risk subgroups. However, the modestly increased stroke risk highlights the need for individualized decision-making, taking into account patient comorbidities, anatomy, and surgical suitability. CONCLUSION: CABG offers long-term survival and durability advantages over PCI in MVD, while PCI remains suitable for patients with lower-risk anatomy or when surgery is contraindicated.
Therapeutic and Side Effects of Enoxaparin over Heparin on Acute Coronary Syndrome Patients in Bali.
Noviyani R, Paramistya Devi IGAW, Swi Antara IMP … +2 more , Widtama A, Yowani SC
Curr Cardiol Rev · 2026 Mar · PMID 41833018 · Publisher ↗
INTRODUCTION: Acute Coronary Syndrome (ACS) is a major cause of morbidity and mortality worldwide. Anticoagulant therapies such as enoxaparin and heparin are commonly used to reduce thrombotic events, but their comparati...
INTRODUCTION: Acute Coronary Syndrome (ACS) is a major cause of morbidity and mortality worldwide. Anticoagulant therapies such as enoxaparin and heparin are commonly used to reduce thrombotic events, but their comparative efficacy and safety profiles remain to be fully established. This study aimed to compare the therapeutic effects and side effects of enoxaparin versus heparin in patients with ACS treated at hospitals in Bali. No randomization or blinding was performed in this observational study due to its retrospective design. This study was conducted as a cross-sectional observational study by reviewing medical records of patients diagnosed with Acute Coronary Syndrome (ACS) treated at Prof. Dr. I.G.N.G. Ngoerah Hospital and RSUD Tabanan from January 2021 to December 2023, Bali, Indonesia. METHODOLOGY: A retrospective cross-sectional observational study was conducted by reviewing medical records of ACS patients treated at Prof. Dr. I.G.N.G. Ngoerah Hospital and RSUD Tabanan, Bali, Indonesia, from January 2021 to December 2023. No randomization or blinding was performed due to the observational design. Sample size was calculated using the Lemeshow formula, with a minimum of 66 patients required. The primary outcomes were recurrence of myocardial infarction (MI) and mortality, while bleeding events were secondary outcomes. Logistic regression was employed to adjust for confounders, including age, sex, hypertension, diabetes, chronic kidney disease, and ACS subtype, Bali, Indonesia. RESULTS: Among 73 patients (60 receiving enoxaparin, 13 receiving heparin), MI recurrence rates were 6.7% and 0%, mortality rates were 3.3% and 30.8%, and bleeding incidence was 5% and 7.7%, respectively. Mortality was significantly lower in the enoxaparin group (p = 0.008). Adjusted logistic regression revealed that hypertension significantly increased bleeding risk (adjusted OR = 29.4; 95% CI: 1.02-844.0; p = 0.049), while other factors showed no significant association. DISCUSSION: The results suggest that enoxaparin is associated with lower mortality compared to heparin without significant differences in MI recurrence or bleeding events. The strong association between hypertension and bleeding highlights the need for careful management of hypertensive ACS patients. However, wide confidence intervals and small sample size warrant cautious interpretation, and further large-scale prospective studies are needed. CONCLUSION: Enoxaparin appears to be more effective in reducing mortality than heparin in ACS patients, with hypertension identified as a significant risk factor for bleeding. These findings support the preferential use of enoxaparin in this population, pending validation from larger studies.
Outcomes of Cerebral and Organ Perfusion Protection Following Reconstructive Surgeries on the Aortic Arch in Newborns.
Velyukhanov IA, Soynov IA, Gorbatykh AV … +7 more , Manukian SN, Anikina OS, Kulyabin YY, Nichay NR, Arkhipov AN, Nepomniashikh VA, Kornilov IA
Curr Cardiol Rev · 2026 Mar · PMID 41833017 · Publisher ↗
INTRODUCTION: To assess the efficacy and safety of whole-body perfusion in newborn patients after reconstructive surgeries on the aortic arch. METHODS: In this retrospective study with propensity score matching (PSM), we...
INTRODUCTION: To assess the efficacy and safety of whole-body perfusion in newborn patients after reconstructive surgeries on the aortic arch. METHODS: In this retrospective study with propensity score matching (PSM), we evaluated the efficacy and safety of surgical treatment in newborn patients after reconstructive surgeries on the aortic arch using whole-body perfusion (n=43) and selective antegrade cerebral perfusion (n=117). RESULTS: After PSM, patients were divided into two well-balanced groups: the whole-body perfusion (WBP) group (n=40) and the selective antegrade cerebral perfusion (SACP) group (n=40). Acute kidney injury was observed in 22.5% of patients in the WBP group, compared to 47.5% of patients in the SACP group (p=0.034). Risk factors for acute kidney injury included the method of SACP (OR 95% CI 6.1 [1.6, 19.8]) and the inotropic index on the first day (OR 95% CI 1.09 [1.01, 1.20]). Neurological complications occurred in 9.3% of patients in the WBP group and 11.6% in the SACP group (p>0.99). The only risk factor for neurological complications was low birth weight (OR 95% CI 4.5 [2.8, 16.2], p=0.042). Postoperative mortality did not differ between groups: 2.4% in the WBP group versus 4.6% in the SACP group (p>0.99). DISCUSSION: Perfusion techniques for neonatal aortic arch reconstruction have evolved from deep hypothermic circulatory arrest to selective antegrade cerebral perfusion with a recent trend toward combining SACP with lower body perfusion, a strategy known as whole-body perfusion. While DHCA is still utilized in pediatric cardiac surgery, it is associated with a high risk of postoperative complications, particularly affecting the brain and internal organs. SACP has demonstrated effective cerebral protection and has been widely adopted. Detailed studies of SACP's neuroprotective strategy have enabled its safe implementation without deep hypothermia, allowing procedures to be performed at temperatures up to 26°C. CONCLUSION: Whole-body perfusion during aortic arch surgery in newborns is an effective and safe organ protection technique that may reduce the incidence of acute kidney injury. A high vasoactiveinotropic score (VIS) was identified as a significant postoperative risk factor for acute kidney injury. However, prospective studies are needed to further validate the advantages of whole-body perfusion.
Mental Health and Substance Use Disorders in Advanced Heart Failure Patients Undergoing VAD Implantation and Cardiac Transplantation: How Much do We Know?
Nair N, Grzyb C, Du D … +1 more , Mahesh B
Curr Cardiol Rev · 2026 Mar · PMID 41833016 · Publisher ↗
Patients who undergo cardiac transplantation or implantation of LVADs are significantly affected by mental health disorders and substance use problems, which can negatively impact their compliance and quality of life. Th...
Patients who undergo cardiac transplantation or implantation of LVADs are significantly affected by mental health disorders and substance use problems, which can negatively impact their compliance and quality of life. There is a paucity of research regarding mental health and substance abuse disorders in the post-LVAD implant/ cardiac transplant population. This narrative review will focus on the knowledge gaps </P> Methods: A qualitative review was performed by conducting a literature search using PubMed and Google Scholar. Adults 18 years and older with LVAD or cardiac transplant were included. The keywords used were anxiety, depression, mood disorder, panic disorder, PTSD, adjustment disorder, and eating disorders in LVAD patients, and anxiety, depression, mood disorder, panic disorder, PTSD, and adjustment disorder in heart transplant patients. No geographical parameters were used in the search. All papers retrieved were reviewed qualitatively, and relevant information obtained was synthesized to arrive at the results and conclusions presented in this review. </P> Results: This narrative review showed that anxiety, depression, mood disorder, panic disorder, PTSD, adjustment disorder, and eating disorder exist in patients undergoing advanced surgical therapies (durable LVADs and cardiac transplantation). Most of the relevant studies are retrospective chart analyses done in single centers. Incidence and prevalence vary widely. </P> Discussion: This review highlights the importance of mental health surveillance in patients undergoing LVAD and cardiac transplantation to enhance outcomes by improving behavioral health and compliance. </P> Conclusions: There are no granular guidelines to address psychosocial evaluation in this population. The current literature does not help to distinguish any differences mechanical support would have on the psychology of these patients as compared to cardiac transplantation. Knowledge gaps exist in risk assessment and risk stratification of patients, which need further investigation.
Chemotherapy-Induced Cardiotoxicity: A Comprehensive Review of Current Understanding and Future Directions.
Rama Rao L, Mylavarapu M, Prakash K … +10 more , Manoukian G, Abraham AT, Kabassakalian E, Sreekumar A, Sara Dileep H, Arshad A, Bilgi AT, Usman R, Azhar M, Majumder K
Curr Cardiol Rev · 2026 Mar · PMID 41832729 · Publisher ↗
INTRODUCTION: Chemotherapy-Induced Cardiotoxicity (CIC) has become a growing concern in modern oncology. While chemotherapy remains one of the most effective treatments against cancer, its potential to harm the heart oft...
INTRODUCTION: Chemotherapy-Induced Cardiotoxicity (CIC) has become a growing concern in modern oncology. While chemotherapy remains one of the most effective treatments against cancer, its potential to harm the heart often limits its use. The underlying mechanisms involve oxidative stress, mitochondrial dysfunction, and inflammation, all contributing to the gradual weakening of cardiac muscle. As cancer survival improves, the burden of cardiovascular complications is more visible than ever, emphasizing the need for early recognition, prevention, and long-term management. METHODS: This review draws upon published literature, recent clinical trials, and translational research to explore current understanding and future directions in CIC. Studies on anthracyclines and HER2 inhibitors were reviewed in depth, along with new data on diagnostic biomarkers, imaging techniques, and evolving therapeutic strategies. Particular attention was given to the role of pharmacogenomics, preventive interventions, and emerging therapies aimed at protecting or restoring cardiac function in patients undergoing chemotherapy. RESULTS: CIC can present as heart failure, arrhythmia, hypertension, myocardial ischemia, or thromboembolism. Factors such as age, obesity, cumulative drug exposure, and genetic predisposition significantly raise the risk. Recent advances have improved early detection-troponins, natriuretic peptides, and echocardiography with Global Longitudinal Strain (GLS) allow for identification before overt symptoms appear. Preventive strategies, including dose adjustments, liposomal formulations, and the cardioprotective agent dexrazoxane, have shown measurable benefits. Established cardiotoxicity can be managed with conventional heart failure medications, antihypertensives, and anticoagulants. Experimental approaches-ranging from mitochondrial stabilizers and histone deacetylase inhibitors to mesenchymal stem cell therapy-show promise in reversing cardiac injury. DISCUSSION: CIC reflects a complex interaction between cancer biology, treatment intensity, and patientspecific vulnerability. A proactive, multidisciplinary approach involving both oncologists and cardiologists is key to balancing cancer control with heart health. Lifestyle measures such as regular exercise and dietary optimization can further strengthen cardiovascular resilience. Advances in genetic testing, molecular imaging, and regenerative therapy are gradually shifting the field toward more personalized cardio-oncology care. CONCLUSION: Chemotherapy-induced cardiotoxicity continues to challenge clinicians striving for a cure without compromise. The future of cancer care lies in integrating precision medicine with preventive cardiology to minimize cardiac injury while maintaining therapeutic efficacy. Continued research into molecular targets, biomarkers, and cell-based therapies offers genuine hope for improving both survival and quality of life in cancer patients.
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