Skip Navigation
Skip to contents

CPP : Cardiovascular Prevention and Pharmacotherapy

Sumissioin : submit your manuscript
SEARCH
Search

Most view

Page Path
HOME > Browse articles > Most view
49 Most view
Filter
Filter
Article category
Keywords
Publication year
Authors
Funded articles

Most-read articles are from the articles published in 2020 during the last three month.

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
  • 3,863 View
  • 47 Download
  • 8 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.
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
  • 1,874 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.
Review Articles
Adverse effects of statin therapy and their treatment
Dae Young Cheon, Sang-Ho Jo
Cardiovasc Prev Pharmacother. 2022;4(1):1-6.   Published online January 20, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e4
  • 2,397 View
  • 144 Download
Abstract PDF
Statins are one of the most widely used drugs worldwide as first-line drugs for the treatment of hyperlipidemia and the prevention and treatment of cardiovascular diseases. Most of the side effects of statins are known to be mild, and mainly hepatotoxicity and various muscle symptoms are known. Recently, there have been studies on concerns about an increase in the incidence of diabetes after using statins, but it was found that the benefits sufficiently outweigh the risk of side effects. Therefore, the use of statins in the appropriate group should be actively performed, and it seems that the side effects can be prevented through close physical observation and appropriate examination.
De-escalation strategies of dual antiplatelet therapy in patients undergoing percutaneous coronary intervention for acute coronary syndrome
Young Bin Song
Cardiovasc Prev Pharmacother. 2022;4(2):63-69.   Published online April 26, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e11
  • 995 View
  • 26 Download
Abstract PDF
Antiplatelet therapy is important for reducing systemic and local thrombotic events in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Antiplatelet treatment regimens, along with dual antiplatelet therapy consisting of aspirin and a P2Y12 inhibitor for patients receiving PCI, have frequently changed over the years. With improvements in the understanding of the prognostic relevance of bleeding events in patients with PCI, as well as the safety and efficacy of drug-eluting stents, several randomized controlled trials (RCTs) have been conducted on antiplatelet treatment strategies associated with a more favorable balance between ischemic and bleeding risks. Several key RCTs for appropriate antiplatelet therapy in patients receiving PCI for ACS have been reported, and practical guidelines have been updated. This manuscript presents the results of major RCTs on de-escalation strategies of dual antiplatelet treatment in patients receiving PCI for ACS.
Severe hypoglycemia as a risk factor for cardiovascular outcomes in patients with type 2 diabetes: is it preventable?
Seung-Hyun Ko
Cardiovasc Prev Pharmacother. 2022;4(3):106-113.   Published online July 29, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e13
  • 481 View
  • 7 Download
Abstract PDF
Hypoglycemia in people with type 2 diabetes mellitus (T2DM) is troublesome and an important barrier to diabetes management. Although more intensive glycemic control is emphasized to prevent diabetes-related long-term complications, it raises the risk of hypoglycemia in people with T2DM. Severe hypoglycemia (SH), defined as critical events characterized by altered mental and/or physical status requiring assistance for recovery, is considered an advanced and life-threatening form of hypoglycemia. The detection of SH is an important issue because it is associated with further adverse clinical outcomes such as cardiovascular events, mortality, cognitive impairment, and decreased quality of life. By identifying the potential risk factors for SH and introducing measures to minimize SH, SH itself and subsequent harmful clinical outcomes could be prevented in people with T2DM. The traditional risk factors for SH in T2DM, such as older age, long-standing diabetes with decreased insulin secretion, advanced vascular complications, serious comorbidities, and insulin use, are usually unmodifiable. However, unhealthy lifestyle factors, defined as current smoking, heavy alcohol consumption, and lack of regular exercise, can be improved through active patient education. In recent research, greater adherence to healthy lifestyle factors and any improvement in unhealthy lifestyle habits were found to be associated with a substantially lower risk of SH in individuals with T2DM. As well as being an essential component of diabetes self-care and optimal glycemic control, lifestyle modification probably contributes to the prevention of SH in individuals with T2DM.
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
  • 988 View
  • 17 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.
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
  • 1,207 View
  • 24 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.
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
  • 960 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
Indirect comparison of nonvitamin K oral anticoagulants and left atrial appendage occlusion
Sung-Hwan Kim, So-Yoon Park, Seung-Sik Hwang
Cardiovasc Prev Pharmacother. 2022;4(1):18-25.   Published online January 18, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e1
  • 1,188 View
  • 27 Download
Abstract PDFSupplementary Material
Background
Anticoagulation is important in atrial fibrillation (AF) patients to reduce the occurrence of thrombotic events. We evaluated the efficacy and safety of percutaneous left atrial appendage occlusion (LAAO) as an alternative to systemic anticoagulation through an indirect comparative analysis.
Methods
An indirect comparative analysis of nonvitamin K oral anticoagulants (NOACs) and LAAO was conducted. Comparisons were made using data from four landmark randomized clinical trials (RE-LY, ROCKET-AF, ARISTOTLE, and PROTECT AF). Using warfarin as the common comparator, an indirect comparison was performed using data from each trial, and the relative risk was calculated between NOACs and LAAO.
Results
NOACs and LAAO showed similar results for the reduction of stroke and systemic embolism, with a non-statistically significant trend favoring NOACs (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.37–1.46 for dabigatran; HR, 0.99; 95% CI, 0.50–1.92 for rivaroxaban; HR, 0.89; 95% CI, 0.45–1.74 for apixaban). Significantly fewer major bleeding and procedure-related complications were found in patients treated with apixaban compared with LAAO (HR, 0.45; 95% CI, 0.26–0.75). Cardiovascular death occurred more frequently in patients administered NOACs than in patients with LAAO (HR, 2.28; 95% CI, 1.03–5.10 for dabigatran; HR, 2.41; 95% CI, 1.09–5.42 for rivaroxaban; HR, 2.40; 95% CI, 1.10–5.36 for apixaban).
Conclusions
The rate of all-cause death was similar between NOACs and LAAO. Compared with LAAO, NOACs led to a nonsignificant numerical decrease in stroke and embolism in AF patients. Significantly fewer safety events occurred in patients treated with apixaban. LAAO significantly reduced cardiovascular death.
Special Article
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
  • 1,099 View
  • 22 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.
Review Article
Blood pressure control in hypertensive disorders of pregnancy
Helsi Rismiati, Hae-Young Lee
Cardiovasc Prev Pharmacother. 2022;4(3):99-105.   Published online July 29, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e16
  • 395 View
  • 22 Download
Abstract PDF
Hypertension is a major cause of maternal morbidity and occurs as a complication in up to one in ten pregnancies. Hypertensive disorders of pregnancy encompass gestational hypertension, preeclampsia, chronic hypertension, and chronic hypertension with superimposed preeclampsia. However, the management of hypertensive disorders of pregnancy remains a matter of debate, particularly the blood pressure thresholds and targets for managing hypertension in pregnancy. Previously, there was no clear evidence of the effectiveness of aggressive blood pressure control in pregnancy due to the risk of fetal growth restriction. Recent clinical trials have shown that aggressive control of blood pressure in pregnant women is safe for both the mother and fetus. The purpose of this paper is to present a clinically oriented guide to the drugs of choice in patients with hypertension during pregnancy, present contrasts among different guidelines and recent clinical trials, and discuss the blood pressure thresholds and targets for hypertension during pregnancy based on recent studies.
Special Article
Competing Risk Model in Survival Analysis
Yena Jeon, Won Kee Lee
Cardiovasc Prev Pharmacother. 2020;2(3):77-84.   Published online July 31, 2020
DOI: https://doi.org/10.36011/cpp.2020.2.e11
  • 1,040 View
  • 47 Download
Abstract PDF
Survival analysis is primarily used to identify the time-to-event for events of interest. However, there subjects may undergo several outcomes; competing risks occur when other events may affect the incidence rate of the event of interest. In the presence of competing risks, traditional survival analysis such as the Kaplan-Meier method or the Cox proportional hazard regression introduces biases into the estimation of survival probability. In this review, we discuss several methods that can be used to consider competing risks in survival analysis: the cumulative incidence function, the cause-specific hazard function, and Fine and Gray's Subdistribution hazard function. We also provide a guide for conducting competing risk analysis using SAS with the bone marrow transplantation dataset presented by Klein and Moeschberger (1997).
Original Article
Development of a predictive model for the side effects of liraglutide
Jiyoung Min, Jiwon Shinn, Hun-Sung Kim
Cardiovasc Prev Pharmacother. 2022;4(2):87-93.   Published online April 27, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e12
  • 656 View
  • 13 Download
Abstract PDFSupplementary Material
Background
Liraglutide, a drug used for the management of obesity, has many known side effects. In this study, we developed a predictive model for the occurrence of liraglutide-related side effects using data from electronic medical records (EMRs).
Methods
This study included 237 patients from Seoul St. Mary's Hospital and Eunpyeong St. Mary's Hospital who were prescribed liraglutide. An endocrinologist obtained medical data through an EMR chart review. Model performance was evaluated using the mean of the area under the receiver operating characteristic curve (AUROC) with a 95% confidence interval (CI).
Results
A predictive model was developed for patients who were prescribed liraglutide. However, 37.1% to 75.5% of many variables were missing, and the AUROC of the developed predictive model was 0.630 (95% CI, 0.551–0.708). Patients who had previously taken antiobesity medication had significantly fewer side effects than those without previous antiobesity medication use (20.7% vs. 41.4%, P<0.003). The risk of side effect occurrence was significantly higher in patients with diabetes than in patients without diabetes by 2.389 times (odds ratio, 2.389; 95% CI, 1.115–5.174).
Conclusions
This study did not successfully develop a predictive model for liraglutide-related side effects, primarily due to issues related to missing data. When prescribing antiobesity drugs, detailed records and basic blood tests are expected to be essential. Further large-scale studies on liraglutide-related side effects are needed after obtaining high-quality data.
Review Article
Antiplatelet Therapy for Secondary Stroke Prevention in Patients with Ischemic Stroke or Transient Ischemic Attack
Kyung-Yul Lee
Cardiovasc Prev Pharmacother. 2021;3(4):86-94.   Published online October 31, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e10
  • 1,303 View
  • 36 Download
Abstract PDF
The risk of stroke recurrence is highest in the acute phase after transient ischemic attack (TIA) or ischemic stroke. Therefore, patients with TIA or ischemic stroke should be treated with antiplatelet medication for stroke prevention. The short-term use of dual antiplatelet therapy between 21 and 90 days may be considered in those with acute minor stroke or TIA and highrisk of recurrence. However, the long-term use of dual antiplatelet therapy is not recommended due to the risk of bleeding. The current stroke guideline does not specify the administration of an antiplatelet for the secondary prevention of ischemic stroke. However, as clinical studies progress, antiplatelet therapy may become a personalized treatment in the future.
Original Article
Effect of the addition of thiazolidinedione to sodium-glucose cotransporter 2 inhibitor therapy on lipid levels in type 2 diabetes mellitus: a retrospective study using Korean National Health Insurance Service data
Taegyun Park, Kyungdo Han, Dongwook Shin, Jongho Park
Cardiovasc Prev Pharmacother. 2022;4(3):114-122.   Published online July 29, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e15
  • 368 View
  • 19 Download
Abstract PDF
Background
Dyslipidemia is common in patients with type 2 diabetes mellitus (T2D) and contributes to an increased risk of cardiovascular disease. Previous studies have shown that treatment with thiazolidinediones (TZDs) and sodium-glucose cotransporter-2 inhibitors (SGLT2-i) may help to improve dyslipidemia in T2D patients. In this study, we investigated whether patients treated with TZD and SGLT2-i showed greater improvement in high-density lipoprotein cholesterol (HDL-C) levels than those treated with only SGLT2-i.
Methods
From the National Health Insurance Service database of Korea, we extracted all patients who first received SGTL2-i from 2014 to 2016. Propensity score matching was performed to balance the two groups: group A (SGTL2-i and TZD, regardless of other antidiabetic medications) and group B (SGTL2-i only without TZD, regardless of other antidiabetic medications). Posttreatment HDL-C levels were compared by the Student t-test.
Results
In total, 1,400 T2D patients (700 in each group) were matched by propensity score matching. There was a significant posttreatment increase in HDL-C in group A (49.54±20.03 to 51.6±12.92 mg/dL, P=0.007), but not in group B (49.14±13.52 to 49.1±2.15 mg/dL, P=0.937). Group A also showed significantly higher posttreatment HDL-C levels than group B (51.4±12.92 vs. 49.1±12.15 mg/dL, P<0.001). Regarding the secondary endpoints, posttreatment triglyceride levels were lower (P<0.001), but total cholesterol (P=0.131) and low-density lipoprotein cholesterol levels (P=0.054) were not different after treatment.
Conclusions
The combination of SGTL2-i and TZD may be more effective in ameliorating dyslipidemia in T2D patients than SGLT2-i alone. However, further studies are needed to confirm this finding.

CPP : Cardiovascular Prevention and Pharmacotherapy