Cardiovascular Prevention and Pharmacotherapy

Review Article

Next-generation PCSK9 inhibitors: clinical evidence and future directions for cardiovascular prevention: Hyun-Jin Kim; Cardiovasc Prev Pharmacother. 2025;7(4):141-145. Published online October 22, 2025; DOI: https://doi.org/10.36011/cpp.2025.7.e17

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Low-density lipoprotein cholesterol (LDL-C) is a causal and modifiable risk factor for atherosclerotic cardiovascular disease, and intensive reduction of LDL-C is central to prevention strategies. Meta-analyses have shown that each 1 mmol/L (approximately 38.7 mg/dL) decrease in LDL-C confers about a 22% relative risk reduction in major vascular events, independent of baseline LDL-C levels. Despite the proven efficacy of statins and ezetimibe, many patients fail to reach recommended LDL-C targets due to inadequate response, intolerance, or poor adherence to daily therapy. The development of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors has transformed lipid management, providing substantial LDL-C reduction. Recently, next-generation agents with extended dosing intervals have emerged, including recaticimab, a fully human monoclonal antibody, and inclisiran, a small interfering RNA therapy. Recaticimab binds circulating PCSK9, preventing degradation of the low-density lipoprotein receptor, and achieves sustained LDL-C reductions of about 50% with dosing every 8 to 12 weeks. Inclisiran employs N-acetylgalactosamine (GalNAc)-mediated hepatocyte delivery to silence PCSK9 messenger RNA, producing comparable LDL-C reductions with twice-yearly maintenance dosing after an initial loading dose. Their extended dosing schedules offer potential benefits in adherence and long-term lipid control, particularly for high-risk patients who struggle with frequent dosing or have statin intolerance. As outcome data accumulate, these therapies may further reduce residual atherosclerotic cardiovascular disease risk and become increasingly important in comprehensive prevention strategies.

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Safety and Efficacy of Recaticimab in Dyslipidemia: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Mohammed R. Abdeldayem, Ahmed Elsherbeeny
Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy.2026;[Epub] CrossRef

Original Article

Variation in blood viscosity based on the potential cause of stroke of undetermined etiology: Jinyoung Oh, Youngchan Jung, Jin Kim, Sun Ki Min, Sang Won Han, Jong Sam Baik; Cardiovasc Prev Pharmacother. 2023;5(4):144-150. Published online October 25, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e14

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Abstract PDF

Background
This study investigated potential differences in blood viscosity (BV) among patients with stroke of undetermined etiology, negative evaluation (SUDn), specifically those with potential atherothrombosis (SUDn-AT) and those with possible embolism (SUDn-E).
Methods
This single-center study employed a retrospective observational design. The participants were patients over 20 years old with the SUDn stroke subtype who were admitted within 5 days of symptom onset. These patients were categorized as SUDn-AT or SUDn-E. Patients in the SUDn-AT group had nonsignificant stenosis (<50%) of a major brain artery relevant to their symptoms and exhibited one or more signs of systemic atherosclerosis, including atherosclerosis of at least one major brain artery other than those clinically relevant, coronary artery disease, and/or peripheral artery disease. For the SUDn-E group, the SUDn criteria from the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification system were strictly applied.
Results
The final analysis included 153 patients, with 104 (68%) classified as SUDn-E and the remaining 32% as SUDn-AT. Patients in the SUDn-AT group had a higher systolic BV (P=0.012) and diastolic BV (P=0.020) than those in the SUDn-E group. Multivariable logistic regression analysis revealed that age (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.03–1.13; P=0.003), systolic BV (OR, 3.11; 95% CI, 1.41–6.85; P=0.005), and diastolic BV (OR, 1.08; 95% CI, 1.02–1.14; P=0.009) were associated with SUDn-AT.
Conclusions
Within the TOAST system, two SUDn entities may be distinguishable, with potentially different underlying etiologies: atherothrombosis and embolic stroke of undetermined source.

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Significance of Whole Blood Viscosity in Acute Ischemic Stroke
Irena Velcheva, Nadia Antonova, Tsocho Kmetski
Life.2025; 15(12): 1869. CrossRef
Association of Cerebral Artery Stenosis with Blood Viscosity in Patients with Transient Ischemic Attack
Young Chan Jung, Sang Won Han, Joong Hyun Park
Journal of Neurosonology and Neuroimaging.2024; 16(1): 8. CrossRef
A Comprehensive Study of Risk Factors, Etiology, and Infarction Patterns in Cerebrovascular Accidents at a Tertiary Care Hospital in India
Raju Hansini Reddy, Pradnya Diggikar, Mayank Mundada, Arun Oommen, Tushar Pancholi, Bhavya Yammanuru, Sree Vidya Yekkaluru, Advit Sangwan
Cureus.2024;[Epub] CrossRef
The Effect of Organic Vegetable Mixed Juice on Blood Circulation and Intestine Flora: Randomized, Double-Blinded, Placebo-Controlled Clinical Trial
Yun-Ha Lee, Jae-Ho Lee, Soo-Min Jeon, Il-Kyu Park, Hyun-Bin Jang, Soo-A Kim, Soo-Dong Park, Jae-Jung Shim, Seong-Soo Hong, Jae-Hwan Lee
Diseases.2024; 12(9): 223. CrossRef

Review Article

Characteristics of Patients with Vasospastic Angina in Korea: Data from a Large Cohort (VA-KOREA): Sung Eun Kim, Sang-Ho Jo, Won-Woo Seo, Min-Ho Lee, Hyun-Jin Kim, Seong-Sik Cho, Kwan Yong Lee, Dong-Soo Kim, Tae-Hyun Yang, Sung-Ho Her, Seung Hwan Han, Byoung-Kwon Lee, Youngkeun Ahn, Seung-Woon Rha, Hyeon-Cheol Gwon, Dong-Ju Choi, Sang Hong Baek; Cardiovasc Prev Pharmacother. 2021;3(3):47-53. Published online July 31, 2021; DOI: https://doi.org/10.36011/cpp.2021.3.e8

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Abstract PDF

The Variant Angina Korea (VA-KOREA) registry is a nationwide prospective multicenter registry designed to reflect the real-world clinical data of Korean patients with vasospastic angina (VSA). A total of 2,960 patients with chest pain and presumed VSA who underwent coronary angiography (CAG) and an ergonovine provocation test were enrolled. The primary endpoint composite of death from any cause, acute coronary syndrome, and newonset symptomatic arrhythmia during the 3-year follow-up was investigated for patient characteristics, laboratory findings, CAG findings, and medications. This article reviewed the current status of VSA in Korea and new findings from VA-KOREA registries to improve the treatment and prognosis of patients with VSA.

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Association Between Serum Cortisol Levels and Variant Angina
Jeen Hwa Lee, Sung Rok Lee, Yeon Jung Lee, Myung Soo Park, Jaehyuk Choi, Sook Jin Lee, Seongwoo Han, Dae Young Cheon
Korean Circulation Journal.2026;[Epub] CrossRef
Systemic Vasculopathy Associated With Homozygous RNF213 Mutation Presenting as Peripheral Pulmonary Artery Stenosis and Coronary Vasospasm Without Moyamoya Disease: A Case Report
So-Min Lim, Ga Yun Kim, Dayoung Pack, Jang Ho Lee, Jae-Seung Lee, Seongsoo Jang, Jong-Min Song, Dae-Hee Kim
Journal of Korean Medical Science.2025;[Epub] CrossRef

Special Article

Vasopressin Receptor Antagonist, Tolvaptan, for Treating Hyponatremia in Patients with Heart Failure: Kyung-Jin Kim; Cardiovasc Prev Pharmacother. 2021;3(1):10-14. Published online January 31, 2021; DOI: https://doi.org/10.36011/cpp.2021.3.e3

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Abstract PDF

Hyponatremia is common in hospital setting in patients with heart failure and is associated with increased morbidity and mortality. However, despite these complications, appropriate treatment strategies other than established therapies such as hypertonic saline, loop diuretics, and fluid restriction are limited. Tolvaptan, a vasopressin receptor antagonist, has aquaretic effects that excrete free water and dilutes urine, thereby increasing serum sodium concentration. This new approach might be a landmark in the treatment of hyponatremia as there is a lack of controlled studies in this field. However, regardless of the associated advantage, tolvaptan is recommended to be used for less than 30 days owing to the possibility of liver injury. This study is aimed to present the clinical use of tolvaptan for hyponatremia in patients with heart failure.

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Safety and Efficacy of Tolvaptan for Acute Refractive Hyponatremia Associated with Traumatic Brain Injury
Shashvat Desai, Kathleen Holsaeter, Alexandra Winski, Jeffrey F. Barletta, Frank Bauer
Journal of Clinical Medicine.2025; 14(17): 6138. CrossRef
The role of tolvaptan add-on therapy in patients with acute heart failure: a systematic review and network meta-analysis
Vireza Pratama, Jordan Budiono, Jarir At Thobari, Bambang Widyantoro, Vita Yanti Anggraeni, Lucia Kris Dinarti
Frontiers in Cardiovascular Medicine.2024;[Epub] CrossRef

Review Article

Recent Technology-Driven Advancements in Cardiovascular Disease Prevention: Jisan Lee, Hun-Sung Kim, Dai-Jin Kim; Cardiovasc Prev Pharmacother. 2019;1(2):43-49. Published online October 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e7

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Abstract PDF Supplementary Material

Recent dramatic developments in information and communication technologies have been widely applied to medicine and healthcare. In particular, biometric sensors in wearable devices linked to smartphones are collecting vast amounts of personal health data. To best use these accumulated data, personalized healthcare services are emerging, and digital platforms are being developed and studied to enable data integration and analysis. The implementation of biometric sensors and smartphones for cardiovascular and cerebrovascular healthcare emerged from the research on the feasibility and efficacy of the devices in the clinical environment. It is important to understand the recent research trends in data generation, integration, and application to prevent and treat cardiovascular and cerebrovascular diseases. This paper describes these recent developments in treating cardiovascular diseases.

Citations

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Sex- and Age-Specific Trends in Cardiovascular Health in Korea, 2007–2018
So Mi Jemma Cho, Hokyou Lee, Hyeon Chang Kim
Korean Circulation Journal.2021; 51(11): 922. CrossRef
Lack of Acceptance of Digital Healthcare in the Medical Market: Addressing Old Problems Raised by Various Clinical Professionals and Developing Possible Solutions
Jong Il Park, Hwa Young Lee, Hyunah Kim, Jisan Lee, Jiwon Shinn, Hun-Sung Kim
Journal of Korean Medical Science.2021;[Epub] CrossRef
Lessons from Use of Continuous Glucose Monitoring Systems in Digital Healthcare
Hun-Sung Kim, Kun-Ho Yoon
Endocrinology and Metabolism.2020; 35(3): 541. CrossRef

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