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CPP : Cardiovascular Prevention and Pharmacotherapy

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From articles published in Cardiovascular Prevention and Pharmacotherapy during the past two years (2020 ~ ).

Special Articles
Update on the Pharmacotherapy of Heart Failure with Reduced Ejection Fraction
Eui-Soon Kim, Jong-Chan Youn, Sang Hong Baek
Cardiovasc Prev Pharmacother. 2020;2(4):113-133.   Published online October 31, 2020
DOI: https://doi.org/10.36011/cpp.2020.2.e17
  • 3,191 View
  • 39 Download
  • 7 Citations
Abstract PDF
Heart failure (HF) is an important cardiovascular disease because of the increasing prevalence, high morbidity and mortality, and rapid expansion of health care costs. Over the past decades, efforts have been made to modify the prognosis of patients with HF. Regarding HF with reduced ejection fraction (HFrEF), several drugs have shown to improve mortality and morbidity, based on large-scale randomized controlled trials, leading to a critical paradigm shift in its pharmacological treatment. The paradigm of HFrEF pathophysiology has shifted from cardiorenal disease to hemodynamic changes, and neurohormonal activation is currently considered the prime pathophysiological mechanism of HFrEF. This review summarizes evidence on the pharmacological management of HFrEF derived from major randomized controlled trials, which have accomplished improvements in survival benefits.
Geriatric Considerations in the Management of Elderly Patients with Cardiovascular Diseases
Doo Soo Jeon
Cardiovasc Prev Pharmacother. 2021;3(2):38-46.   Published online April 30, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e6
  • 973 View
  • 18 Download
  • 1 Citations
Abstract PDF
Cardiovascular disease (CVD) is the most frequently diagnosed disease as well as the leading cause of death in the elderly. It usually results from long-term effects of cardiovascular risk factors as well as the aging process itself. Elderly people commonly have geriatric syndrome, which is an age-specific problem that is complicated by the presence of cardiovascular, cognitive, and physical dysfunction and is accompanied by many other chronic diseases. While caring for the elderly, in addition to CVD, various inherent problems must be considered. The patient-centered approach, instead of evidence-based guidelines that are designed for young adult patients, is the most important concept when it comes to elderly patients with CVD and multiple comorbidities. This approach should be used to maintain the functionality, independence, quality of life, and dignity of these patients.
Tafamidis for Cardiac Transthyretin Amyloidosis
Darae Kim, Jin-Oh Choi, Eun-Seok Jeon
Cardiovasc Prev Pharmacother. 2021;3(1):1-9.   Published online January 31, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e1
  • 921 View
  • 17 Download
  • 1 Citations
Abstract PDF
Transthyretin amyloid (ATTR) cardiomyopathy is a progressive disease caused by the infiltration of ATTR fibrils in the myocardium. Although it is a rare disease, ATTR cardiomyopathy is an important cause of heart failure with preserved ejection fraction, and its incidence is increasing due to improved diagnostic imaging tools. There has been a breakthrough in the field of transthyretin amyloidosis, which opens a new therapeutic door for the patients. In this review, an overview of tafamidis therapy in ATTR cardiomyopathy with recent results from clinical trials will be discussed.
Logistic Regression and Least Absolute Shrinkage and Selection Operator
Hyunyong Lee, Hun-Sung Kim
Cardiovasc Prev Pharmacother. 2020;2(4):142-146.   Published online October 31, 2020
DOI: https://doi.org/10.36011/cpp.2020.2.e15
  • 836 View
  • 9 Download
  • 1 Citations
Abstract PDF
Logistic regression, a model that forms a binary dependent variable and one or more independent variable(s), is used especially in epidemiological studies. By understanding the logistic model and its applications, such as odds ratio (OR) and performance efficiency, the concept of logistic regression can be easily grasped. The purpose of this article is to 1) introduce logistic regression, including odds and OR, 2) present predictive efficiency, such as area under the curve, and 3) explain the caution of logistic regression analysis.
Original Article
Changes in Target Achievement Rates after Statin Prescription Changes at a Single University Hospital
Seon Choe, Jiwon Shinn, Hun-Sung Kim, Ju Han Kim
Cardiovasc Prev Pharmacother. 2020;2(3):103-111.   Published online July 31, 2020
DOI: https://doi.org/10.36011/cpp.2020.2.e14
  • 503 View
  • 2 Download
  • 1 Citations
Abstract PDF
Background
We investigated the changes in low-density lipoprotein cholesterol (LDL-C) target achievement rates (<70 and <100 mg/dL) when the prescription changed from various statins to Lipilou®, a generic formulation of atorvastatin.
Methods
This was a retrospective cohort study of patients who had been prescribed Lipilou® for more than 3 months at Seoul National University Hospital from 2012 to 2018. For patients who were treated with a previous statin before the prescription of Lipilou®, changes in target achievement rates of LDL-C less than 70 and less than 100 mg/dL were confirmed 3–6 months after the prescription of Lipilou®.
Results
Among the 683 enrolled patients, when their prescription was changed to Lipilou®, the target achievement rate of LDL-C significantly increased for LDL-C less than 70 mg/dL (from 22.1% to 66.2%, p<0.001) and less than 100 mg/dL (from 26.8% to 75.3%, p<0.001). In particular, when a moderate-low potency statin was changed to Lipilou® (10 mg), the target achievement rates for LDL-C less than 70 mg/dL (from 28.9% to 66.7%, p<0.001) and less than 100 mg/dL (from 42.2% to 86.7%, p<0.001) significantly increased. The change from a moderate-high potency statin to Lipilou® (20 mg) showed an increased target achievement rates for LDL-C <70 mg/dL (from 33.3% to 80.0%, p=0.008) and 100 mg/dL (from 40.0% to 73.3%, p<0.025).
Conclusions
We cannot simply conclude that Lipilou® is superior to other statins. However, when the target LDL-C was not reached with previous statin treatments, a high target achievement rate could be achieved by changing the prescription to Lipilou®. Physicians should always consider aggressive statin prescription changes for high target achievement rates.
Special Articles
Pragmatic Clinical Trials for Real-World Evidence: Concept and Implementation
Na-Young Jeong, Seon-Ha Kim, Eunsun Lim, Nam-Kyong Choi
Cardiovasc Prev Pharmacother. 2020;2(3):85-98.   Published online July 31, 2020
DOI: https://doi.org/10.36011/cpp.2020.2.e12
  • 762 View
  • 13 Download
  • 1 Citations
Abstract PDF
The importance of real-world evidence (RWE) has been highlighted in recent years, and the limitations of the classical randomized controlled trials, also known as explanatory clinical trials (ECTs), have been emphasized. Post-marketing observational studies have several problems, such as biases and incomparability between patient groups, and RWE can only be obtained after a certain period. Therefore, pragmatic clinical trials (PCTs) have garnered attention as an alternative to obtaining scientifically robust RWE in a relatively short time. PCTs are clinical trials that have a pragmatic concept, i.e., the opposite of ECTs and are intended to help decision makers by evaluating the effectiveness of interventions in routine clinical practice. The characteristics of PCTs are the inclusion of various patients in clinical practice, recruitment of patients in heterogeneous settings, and comparison with actual clinical treatments rather than a placebo. Thus, the results of PCTs are likely to be generalized and can have a direct impact on clinical and policy decision-making. This study aimed to describe the characteristics and definitions of PCTs compared with those of ECTs and to highlight the important considerations in the planning process of PCTs. To perform PCTs for the purpose of obtaining RWE, the contents covered in this study will be helpful.
Effects of Low-Carbohydrate, High-Fat Diets on Weight Loss, Cardiovascular Health and Mortality
Bo-Yeon Kim
Cardiovasc Prev Pharmacother. 2020;2(2):43-49.   Published online April 30, 2020
DOI: https://doi.org/10.36011/cpp.2020.2.e7
  • 1,541 View
  • 16 Download
  • 1 Citations
Abstract PDF
Obesity is a worldwide health challenge. The clinical consequences of obesity include nonalcoholic fatty liver disease, type 2 diabetes, and coronary heart disease. Numerous diets have been developed to reduce the incidence of cardiovascular diseases and induce weight loss. Low-carbohydrate, high-fat diets (LCHFDs) have become increasingly popular for weight loss. LCHFDs have led to weight loss in some clinical studies. However, the safety of LCHFDs and their long-term effects on the human body are still controversial. In this review, I will discuss the effects of LCHFDs on weight loss, cardiovascular health, and mortality.

CPP : Cardiovascular Prevention and Pharmacotherapy