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Targeting Higher Intraoperative Blood Pressures Does Not Reduce Adverse Cardiovascular Events Following Noncardiac Surgery
Patrick M.WannerMDa?Dirk U.WulffPhDbMirjanaDjurdjevicaWolfgangKorteMDcThomas W.SchniderMDaMiodragFilipovicMDa
doi : 10.1016/j.jacc.2021.08.048
Volume 78, Issue 18, 2 November 2021, Pages 1753-1764
Intraoperative arterial hypotension is strongly associated with postoperative major adverse cardiovascular events (MACE); however, whether targeting higher intraoperative mean arterial blood pressures (MAPs) may prevent adverse events remains unclear.
Intraoperative Hypotension and Complications?
Daniel I.SesslerMDaTimothy G.ShortMDb
doi : 10.1016/j.jacc.2021.08.049
Volume 78, Issue 18, 2 November 2021, Pages 1765-1767
Safety and Effectiveness of Paclitaxel Drug-Coated Devices in Peripheral Artery Revascularization: Insights From VOYAGER PAD
Connie N.HessMD, MHSabManesh R.PatelMDcRupert M.BauersachsMDdSonia S.AnandMDeE. SebastianDebusMD, PhDfMark R.NehlerMDbgFabrizioFanelliMDhRobert W.YehMDiEric A.SecemskyMD, MSciJoshua A.BeckmanMDjLauraMauriMDkNicholasGovsyeyevMDbgWarren H.CapellMDblTaylorBrackinMSbScott D.BerkowitzMDmEvaMuehlhoferMDnLloyd P.HaskellMDoWilliam R.HiattMDabMarc P.BonacaMD, MPHab
doi : 10.1016/j.jacc.2021.08.052
Volume 78, Issue 18, 2 November 2021, Pages 1768-1778
Paclitaxel drug-coated devices (DCDs) were developed to improve lower extremity revascularization (LER) patency in peripheral artery disease (PAD) but have been associated with long-term mortality.
Antiproliferative Device Coatings: Efficacy Without Adverse Drug Effect??
ThomasZellerMDTanjaBöhmeMD
doi : 10.1016/j.jacc.2021.08.046
Volume 78, Issue 18, 2 November 2021, Pages 1779-1781
Matrix-Degrading Enzyme Expression and Aortic Fibrosis During Continuous-Flow Left Ventricular Mechanical Support
Amrut V.AmbardekarMDabMatthew S.StrattonPhDab?EvgeniaDobrinskikhPhDcKendall S.HunterPhDdPhilip D.TatmanBSeMadeleine E.LemieuxPhDfJoseph C.ClevelandMDgRubin M.TuderMDcMary C.M.Weiser-EvansPhDbhKaren S.MoultonMDabTimothy A.McKinseyPhDab
doi : 10.1016/j.jacc.2021.08.047
Volume 78, Issue 18, 2 November 2021, Pages 1782-1795
The effects of nonphysiological flow generated by continuous-flow (CF) left ventricular assist devices (LVADs) on the aorta remain poorly understood.
Aortic Smooth Muscle Detraining in Continuous Flow LVAD: Out of Practice?
EloisaArbustiniMDaNavneetNarulaMDb
doi : 10.1016/j.jacc.2021.08.045
Volume 78, Issue 18, 2 November 2021, Pages 1796-1799
Adverse Cardiovascular and Pulmonary Events Associated With Chimeric Antigen Receptor T-Cell Therapy
AdamGoldmanMD, MPHabEladMaorMD, PhDabDavidBomzeMD, MPH, MScbJennifer E.LiuMDcdJoergHerrmannMDeJoshuaFeinMDfRichard M.SteingartMDcdSyed S.MahmoodMD, MPHgWendy L.SchafferMD, PhDcdMiguel-AngelPeralesMDdhRoniShouvalMD, PhDdh
doi : 10.1016/j.jacc.2021.08.044
Volume 78, Issue 18, 2 November 2021, Pages 1800-1813
Pivotal trials of chimeric antigen receptor T-cell (CAR-T) have identified common toxicities but may have been underpowered to detect cardiovascular and pulmonary adverse events (CPAEs).
From Detecting Signals to Understanding Cardiovascular Toxicities of Cancer Therapies: All the Light We Could See?
AnaBaracMD, PhDabcEladSharonMD, MPHd
doi : 10.1016/j.jacc.2021.09.008
Volume 78, Issue 18, 2 November 2021, Pages 1814-1816
New Therapies for Lowering Triglyceride-Rich Lipoproteins: JACC Focus Seminar 3/4
Robert S.RosensonMDaAleeshaShaikMD, MPHaWenliangSongMDb
doi : 10.1016/j.jacc.2021.08.051
Volume 78, Issue 18, 2 November 2021, Pages 1817-1830
Emerging evidence suggests that elevated concentrations of triglyceride-rich lipoprotein remnants (TRLs) derived from hepatic and intestinal sources contribute to the risk of atherosclerotic cardiovascular events. Natural selection studies support a causal role for elevated concentrations of remnant cholesterol and the pathways contributing to perturbations in metabolic pathways regulating TRLs with an increased risk of atherosclerotic cardiovascular disease events. New therapies targeting select catalytic pathways in TRL metabolism reduce atherosclerosis in experimental models, and concentrations of TRLs in patients with a vast range of triglyceride levels. Clinical trials with inhibitors of angiopoietin-like 3 protein and apolipoprotein C-III will be required to provide further guidance on the potential contribution of these emerging therapies in the paradigm of cardiovascular risk management in patients with elevated remnant cholesterol.
Familial Hypercholesterolemia: JACC Focus Seminar 4/4
JuliaBrandtsMDabKausik K.RayBSc (Hons), MBChB, MD, MPhil (Cantab)a
doi : 10.1016/j.jacc.2021.09.004
Volume 78, Issue 18, 2 November 2021, Pages 1831-1843
Detecting familial hypercholesterolemia (FH) early and “normalizing” low-density lipoprotein (LDL) cholesterol values are the 2 pillars for effective cardiovascular disease prevention in FH. Combining lipid-lowering therapies targeting synergistic/complementary metabolic pathways makes this feasible, even among severe phenotypes. For LDL receptor-dependent treatments, PCSK9 remains the main target for adjunctive therapy to statins and ezetimibe through a variety of approaches. These include protein inhibition (adnectins), inhibition of translation at mRNA level (antisense oligonucleotides or small interfering RNA), and creation of loss-of-function mutations through base-pair editing. For patients with little LDL receptor function, LDL receptor-independent treatment targeting ANGPTL3 through monoclonal therapies are now available, or in the future, antisense/small interfering RNA-based approaches offer alternative approaches. Finally, first-in-human studies are ongoing, testing adenovirus-mediated gene therapy transducing healthy LDLR DNA in patients with HoFH. Further development of the CRISPR cas technology, which has shown promising results in vivo on introducing PCSK9 loss-of-function mutations, will move a single-dose, curative treatment for FH closer.
Prognosis After Percutaneous Foramen Ovale Closure Among Patients With Platypnea-Orthodeoxia Syndrome
AhmadHayekMDGillesRioufolMD, PhDThomasBochatonMD, PhDRolandRossiMDNathanMewtonMD, PhDAlexandrePaccaletPhDEricBonnefoy-CudrazMD, PhDHélèneThibaultMD, PhDFrançoisDerimayMD, PhD
doi : 10.1016/j.jacc.2021.08.050
Volume 78, Issue 18, 2 November 2021, Pages 1844-1846
Applying High-Sensitivity Cardiac Troponin T
NoemiGlarnerMDPedroLopez-AyalaMDHaticeCakalMDMarioGrossenbacherMDÒscarMiróMD
doi : 10.1016/j.jacc.2021.07.060
Volume 78, Issue 18, 2 November 2021, Page e147
Reply: Applying High-Sensitivity Cardiac Troponin T
OlatundeOlaMD, MPHRamila A.MehtaMSDavid O.HodgeMSAllan S.JaffeMDYaderSandovalMD
doi : 10.1016/j.jacc.2021.08.042
Volume 78, Issue 18, 2 November 2021, Pages e149-e150
