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Obeagu EI. The dynamic role of soluble urokinase plasminogen activator receptor (suPAR) in monitoring coagulation dysfunction during COVID-19 progression: a review. Ann Med Surg (Lond) 2025; 87:635-640. [PMID: 40110334 PMCID: PMC11918634 DOI: 10.1097/ms9.0000000000002791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 11/20/2024] [Indexed: 03/22/2025] Open
Abstract
COVID-19, caused by the severe acute respiratory syndrome coronavirus 2, has led to significant morbidity and mortality worldwide, with severe complications often involving coagulation dysfunction and thromboembolic events. Identifying reliable biomarkers for early detection and monitoring of these complications is crucial for improving patient outcomes. The soluble urokinase plasminogen activator receptor (suPAR) has emerged as a potential biomarker in this context, given its role in inflammation and immune response. Elevated suPAR levels correlate with disease severity and inflammatory markers, making it a valuable indicator of the complex interplay between inflammation and coagulation observed in COVID-19. Elevated suPAR levels have been linked to an increased risk of thromboembolic events, such as deep vein thrombosis and pulmonary embolism. Combining suPAR measurement with other coagulation markers, such as D-dimer, enhances the predictive accuracy for thrombotic complications. Furthermore, higher suPAR levels are associated with increased disease severity, intensive care requirements, and higher mortality rates, underscoring its significance in risk stratification and therapeutic decision-making. The integration of suPAR measurement into routine clinical practice for COVID-19 could significantly aid in early diagnosis, risk assessment, and monitoring of therapeutic interventions. By providing insights into the patient's inflammatory and coagulation status, suPAR can guide the timely initiation of anticoagulant therapy and other treatments aimed at reducing thromboembolic complications. As research continues to validate suPAR's utility across diverse populations and clinical settings, it holds promise for becoming an integral component of clinical management strategies to mitigate the morbidity and mortality associated with COVID-19.
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Mirzaei A, Zynivand M, Karimi Rouzbahani A, Moghimian M, Yarimir S, Sedighi M, Ghorbanzadeh V, Nazari A. The combination effect of treadmill exercise and valerian hydroalcoholic extract on the heart of type 2 diabetic rats. Ann Med Surg (Lond) 2025; 87:113-120. [PMID: 40109600 PMCID: PMC11918646 DOI: 10.1097/ms9.0000000000002764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 11/10/2024] [Indexed: 03/22/2025] Open
Abstract
Objectives Diabetes mellitus is a metabolic disorder recognized for inducing endothelial dysfunction in coronary arteries. This study aimed to investigate the synergistic effects of valerian hydroalcoholic extract and exercise in diabetic rats. Methods Thirty-five Wistar rats were randomly divided into five groups: control, diabetes, diabetic rats undergoing treadmill exercise, diabetic rats administered valerian extract (200 mg/kg, oral), and diabetic rats receiving a combination of valerian extract and treadmill exercise for 8 weeks. Antioxidants and lipoproteins were assessed via blood sampling at the study's conclusion. Hemodynamic parameters and the response of the coronary artery bed to constrictors and dilators were evaluated by connecting the heart to a Langendorff device. Results Diabetes was associated with a diminished vascular vasodilator response, which was enhanced by the combined treatment of valerian extract and 8 weeks of exercise. Moreover, elevated levels of glutathione peroxidase (GPx) and superoxide dismutase (SOD) were observed in groups receiving both valerian extract and exercise. Conclusions The findings suggest that the combination of treadmill exercise and hydroalcoholic extract may hold promise in managing cardiovascular complications in diabetic patients by leveraging their antioxidant properties.
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Affiliation(s)
- Alireza Mirzaei
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mahtab Zynivand
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Arian Karimi Rouzbahani
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
- USERN Office, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Maryam Moghimian
- Department of Physiology, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Samira Yarimir
- Reproduction Health and Population Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mehrnoosh Sedighi
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Vajihe Ghorbanzadeh
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Afshin Nazari
- Cardiovascular Research Center, Shahid Rahimi Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
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3
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Ahmed H, Ismayl M, Palicherla A, Kalathil R, Patterson C, Pusapati S, Petraskova T, Dufani J, Kabach A, Aboeata A. Fractional flow reserve versus intravascular ultrasound during percutaneous intervention. Ann Med Surg (Lond) 2024; 86:6361-6363. [PMID: 39525736 PMCID: PMC11543201 DOI: 10.1097/ms9.0000000000002313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/14/2024] [Indexed: 11/16/2024] Open
Affiliation(s)
- Hasaan Ahmed
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha
| | - Mahmoud Ismayl
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Anirudh Palicherla
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha
| | - Ruth Kalathil
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha
| | - Christian Patterson
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha
| | - Suma Pusapati
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha
| | - Terezia Petraskova
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha
| | - Jalal Dufani
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha
| | - Amjad Kabach
- Department of Medicine, Division of Cardiovascular Disease, Creighton University School of Medicine, Omaha, NE
| | - Ahmed Aboeata
- Department of Medicine, Division of Cardiovascular Disease, Creighton University School of Medicine, Omaha, NE
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Mahapatro A, Bozorgi A, Obulareddy SU, Jain SM, Reddy Korsapati R, Kumar A, Patel K, Soltani Moghadam S, Arya A, Jameel Alotaibi A, Keivanlou MH, Hassanipour S, Hasanpour M, Amini-Salehi E. Glucagon-like peptide-1 agonists in cardiovascular diseases: a bibliometric analysis from inception to 2023. Ann Med Surg (Lond) 2024; 86:6602-6618. [PMID: 39525800 PMCID: PMC11543192 DOI: 10.1097/ms9.0000000000002592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 09/15/2024] [Indexed: 11/16/2024] Open
Abstract
Background In recent years, glucagon-like peptide-1 (GLP-1) agonists have garnered increasing attention for their potential cardiovascular benefits beyond glycemic control in patients with diabetes. Understanding the research landscape surrounding GLP-1 agonists and cardiovascular diseases (CVDs) is crucial for informing clinical practice and guiding future research endeavors. This bibliometric analysis aimed to comprehensively assess the scholarly output and trends in this field, shedding light on the evolving landscape of GLP-1 agonists' role in cardiovascular health. Methods The publications concerning GLP-1 agonists in CVDs were gathered from the Web of Science Core Collection, and visualizations were created utilizing Excel 2019, Cite Space, and VOS viewer software. Results and Conclusion Using bibliometric and visual methods, the research hotspots and trends regarding GLP-1 agonists in cardiovascular diseases were pinpointed. Additionally, a thriving interest in GLP-1 agonists research within cardiovascular medicine was observed, with a notable surge in publications from 2016 onwards. The analysis revealed that the United States and China are the leading contributors, accounting for over 50% of the total publications. The University of Copenhagen and the University of Toronto emerged as the most prolific institutions in this field. Co-citation analysis highlighted the influential role of landmark clinical trials, such as the LEADER, ELIXA, and EXSCEL. Keyword trend analysis identified the emergence of newer GLP-1 agonists, such as tirzepatide and semaglutide, as well as a growing focus on topics like 'healthy obesity' and chronic kidney disease. These findings suggest that the research landscape is evolving, with a focus on expanding the therapeutic applications of GLP-1 agonists beyond glycemic control. Overall, this bibliometric analysis provided insights into the current state and future directions of research on GLP-1 agonists and their impact on cardiovascular health, guiding future research endeavors, and informing clinical practice.
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Affiliation(s)
| | - Ali Bozorgi
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shika M. Jain
- MVJ Medical College and Research Hospital, Bengaluru, India
| | | | | | - Kristina Patel
- Shenyang North New Area, Shenyang, Liaoning Province, People’s Republic of China
| | - Saman Soltani Moghadam
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Arash Arya
- Department of Internal Medicine III, Halle University Hospital, Halle (Saale), Germany
| | | | | | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Hasanpour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Amini-Salehi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
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5
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Wei RY, Zhu JH, Li X, Wu JY, Liu JW. Diffuse arterial atherosclerosis presenting with acute ischemic gastritis: A case report. World J Clin Cases 2023; 11:8357-8363. [PMID: 38130621 PMCID: PMC10731197 DOI: 10.12998/wjcc.v11.i35.8357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/11/2023] [Accepted: 12/04/2023] [Indexed: 12/14/2023] Open
Abstract
BACKGROUND Ischemic gastritis is a clinically rare disease with high mortality that infrequently reported in the medical literature and under-recognized clinically and histopathologically. Early diagnosis and treatment can only be achieved through upper gastrointestinal endoscopy after symptoms appear. CASE SUMMARY A 68-year-old woman with a history of intracranial aneurysm developed dizziness, chest tightness and unconsciousness for 2 d. Computed tomography angiography showed diffuse coronary atherosclerosis, moderate to severe stenosis in the proximal end of the left anterior descending branch, multiple calcified plaques in the proximal end of the circumflex branch and right coronary artery, and mild to moderate stenosis. The patient also developed diffuse atherosclerosis in the splenic and mesenteric arteries, with mild lumen stenosis and atherosclerosis in the abdominal aorta and its branches. Endoscopy showed submucosal congestion and damage of the entire gastric mucosa, of which the fundus and body of the stomach were most seriously affected. The mucosa was swollen, with a deep purple color, surface erosion and dark red oozing blood. Pathological examination showed bleeding and necrosis of the gastric mucosa, with residual contours of the gastric glands, consistent with ischemic gastritis. CONCLUSION Ischemic gastritis is a rare disease that may be difficult to diagnose as its symptoms may be similar to those of other gastrointestinal diseases. Diagnosis is usually based on endoscopic and pathological examinations, which show insufficient blood supply to the gastric mucosa leading to mucosal damage and necrosis.
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Affiliation(s)
- Rui-Yao Wei
- Department of Traditional Chinese Medicine, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
| | - Jia-Hui Zhu
- Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
| | - Xiang Li
- Department of Gastroenterology, Songyang Chinese Medicine Hospital, Lishui 323000, Zhejiang Province, China
| | - Jian-Yong Wu
- Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
| | - Jun-Wei Liu
- Department of Gastroenterology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, Zhejiang Province, China
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Naseem MA, Qadeer A, Zain A. Comment on: Physician Radiation Exposure during Endomyocardial Biopsy and Right Heart Catheterization. Curr Probl Cardiol 2023; 48:101930. [PMID: 37422034 DOI: 10.1016/j.cpcardiol.2023.101930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
Affiliation(s)
| | - Ahsan Qadeer
- King Edward Medical University, Lahore, Pakistan
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7
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Wazir M, Olanrewaju OA, Yahya M, Kumari J, Kumar N, Singh J, Abbas Al-Itbi AY, Kumari K, Ahmed A, Islam T, Varrassi G, Khatri M, Kumar S, Wazir H, Raza SS. Lipid Disorders and Cardiovascular Risk: A Comprehensive Analysis of Current Perspectives. Cureus 2023; 15:e51395. [PMID: 38292957 PMCID: PMC10825376 DOI: 10.7759/cureus.51395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 12/31/2023] [Indexed: 02/01/2024] Open
Abstract
The increasing worldwide prevalence of cardiovascular diseases (CVDs) highlights the need to understand the complex relationships between lipid abnormalities and elevated cardiovascular risk. This review thoroughly investigates the complex terrain of lipid abnormalities, highlighting their crucial significance in developing CVDs. Dyslipidemia, which is closely connected to atherosclerosis, is a significant risk factor for CVDs, including coronary artery disease, myocardial infarction, and stroke. This review thoroughly examines the intricate relationship between lipoproteins, cholesterol metabolism, and the inflammatory cascade, providing a detailed comprehension of the mechanisms that contribute to atherogenic processes. An extensive analysis of the occurrence and distribution of lipid diseases worldwide indicates a concerning high frequency, which calls for a reassessment of public health approaches. Dyslipidemia is caused by a combination of genetic predispositions, lifestyle factors, and metabolic abnormalities, as supported by significant data. Moreover, investigating different types of lipoproteins and their specific functions in the development of atherosclerosis provides insight into the complex causes of CVDs. In addition to conventional lipid profiles, newly identified biomarkers and advanced imaging techniques are being carefully examined for their ability to improve risk classification and treatment strategies' effectiveness. From a critical perspective, the review thoroughly examines the current state of lipid-modifying medicines, specifically statins, fibrates, and new therapeutic approaches. The text discusses the emerging concept of precision medicine, which involves tailoring treatment approaches to individuals based on their genetic and molecular characteristics. This approach has the potential to improve treatment outcomes. In addition, this study critically assesses the effects of lifestyle changes and nutritional interventions on lipid homeostasis, offering a comprehensive view of preventive strategies. This review consolidates current viewpoints on lipid diseases and their complex correlation with cardiovascular risk. This review contributes to the ongoing cardiovascular disease prevention and management dialogue by clarifying the molecular mechanisms, exploring new therapeutic options, and considering broader societal implications.
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Affiliation(s)
- Maha Wazir
- Department of Medicine, Khyber Teaching Hospital, Peshawar, PAK
| | - Olusegun A Olanrewaju
- Department of Pure and Applied Biology, Ladoke Akintola University of Technology, Ogbomoso, NGA
- Department of General Medicine, Stavropol State Medical University, Stavropol, RUS
| | - Muhammad Yahya
- Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Jaya Kumari
- Department of Internal Medicine, Mehran Medical Centre, Karachi, PAK
| | - Narendar Kumar
- Department of Internal Medicine, Burjeel Hospital, Abu Dhabi, ARE
| | - Jagjeet Singh
- Department of Internal Medicine, Lahore General Hospital, Lahore, PAK
| | | | - Komal Kumari
- Department of Medicine, NMC Royal Family Medical Centre, Abu Dhabi, ARE
| | - Aqsa Ahmed
- Department of Medicine, Medicare Hospital, Faisalabad, PAK
| | - Tamur Islam
- Department of Internal Medicine, Allied Hospital, Faisalabad, PAK
| | | | - Mahima Khatri
- Department of Internal Medicine/Cardiology, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Hina Wazir
- Department of Internal Medicine, Khyber Medical College, Peshawar, PAK
| | - Syed S Raza
- Department of Physiology, Gajju Khan Medical College, Swabi, PAK
- Department of Physiology, Khyber Medical College, Peshawar, PAK
- Robert and Suzanne Tomsich Department of Cardiothoracic Surgery, Cleveland Clinic Florida, Peshawar, PAK
- Department of Physiology, Gandhara University, Peshawar, PAK
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8
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Sharma R, Kashyap J, Olanrewaju OA, Jabbar A, Someshwar F, Saeed H, Varrassi G, Qadeer HA, Kumar S, Cheema AY, Khatri M, Wazir M, Ullah F. Cardio-Oncology: Managing Cardiovascular Complications of Cancer Therapies. Cureus 2023; 15:e51038. [PMID: 38269231 PMCID: PMC10806352 DOI: 10.7759/cureus.51038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/24/2023] [Indexed: 01/26/2024] Open
Abstract
This narrative review explores the complex relationship between cancer medicines and cardiovascular health in the junction of oncology and cardiology, known as cardio-oncology. The study examines the historical development of cancer treatments and highlights the growing importance of cardiovascular problems in patient care. This text delves into the topic of cardiotoxicity, examining both conventional chemotherapeutic drugs like anthracyclines and more recent tyrosine kinase and immune checkpoint inhibitors. The complex molecular and cellular mechanisms that control cardiovascular problems are explained, including an understanding of how genetic predisposition influences an individual's sensitivity. The narrative expands into the crucial realm of risk stratification and evaluation, revealing advanced instruments for identifying cardiovascular risk in cancer patients. The importance of non-invasive imaging methods and biomarkers in early detection and continuous monitoring is emphasized. The prioritization of preventive tactics emphasizes the need to take proactive measures incorporating therapies to protect the heart throughout cancer treatment. It also highlights the significance of making lifestyle improvements to reduce risk factors. The narrative emphasizes the changing collaborative treatment environment, advocating for merging oncologists and cardiologists in a coordinated endeavor to maximize patient outcomes. In addition to clinical factors, the review explores the critical domain of patient education and support, acknowledging its crucial role in promoting informed decision-making and improving overall patient well-being. The latter portions of the text anticipate and consider upcoming treatments and existing research efforts that offer the potential for the future of cardio-oncology. This review seeks to provide a detailed viewpoint on the intricate connection between cancer treatments and cardiovascular well-being. Its objective is to encourage a more profound comprehension of the subject and prompt careful contemplation regarding the comprehensive care of cancer patients who confront the intricate difficulties presented by their treatment plans.
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Affiliation(s)
- Roshan Sharma
- Medicine, Sanjay Gandhi Memorial Hospital, Delhi, IND
| | - Jyoti Kashyap
- Medicine, Sri Balaji Action Medical Institute, Delhi, IND
| | - Olusegun A Olanrewaju
- Pure and Applied Biology, Ladoke Akintola University of Technology, Ogbomoso, NGA
- General Medicine, Stavropol State Medical University, Stavropol, RUS
| | - Abdul Jabbar
- Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Fnu Someshwar
- Medicine, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Hira Saeed
- Medicine, Federal Medical College, Islamabad, PAK
| | | | | | - Satish Kumar
- Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Asfand Yar Cheema
- Medicine, Services Hospital Lahore, Lahore, PAK
- Internal Medicine, Lahore Medical & Dental College, Lahore, PAK
| | - Mahima Khatri
- Internal Medicine/Cardiology, Dow University of Health Sciences, Karachi, PAK
| | - Maha Wazir
- Medicine, Khyber Teaching Hospital, Peshawar, PAK
| | - Farhan Ullah
- Internal Medicine, Khyber Teaching Hospital, Peshawar, PAK
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9
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Ashraf FUN, Ghouri K, Someshwar F, Kumar S, Kumar N, Kumari K, Bano S, Ahmad S, Khawar MH, Ramchandani L, Salame T, Varrassi G, Khatri M, Kumar S, Mohamad T. Insulin Resistance and Coronary Artery Disease: Untangling the Web of Endocrine-Cardiac Connections. Cureus 2023; 15:e51066. [PMID: 38269234 PMCID: PMC10806385 DOI: 10.7759/cureus.51066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/26/2024] Open
Abstract
The relationship between insulin resistance and coronary artery disease (CAD) is a crucial study area in understanding the complex connection between metabolic dysregulation and cardiovascular morbidity. This scholarly investigation examines the intricate relationship between insulin resistance, a key characteristic of metabolic syndrome, and CAD development. The goal is to understand the detailed molecular and physiological connections that underlie the dangerous connection between the endocrine and cardiac systems. The recognition of insulin resistance as a key player in cardiovascular disease highlights the need to study the complex relationships between insulin signaling pathways and the development of atherosclerosis. This research analyzes the molecular processes by which insulin resistance leads to disruptions in lipid metabolism, inflammatory reactions, and malfunction of the blood vessel's inner lining. These processes create an environment that promotes the development and advancement of CAD. As we begin this scientific exploration, it becomes clear that insulin resistance acts as a metabolic indicator and a potent mediator of endothelial dysfunction, oxidative stress, and systemic inflammation. The complex interaction between insulin-sensitive tissues and the vascular endothelium plays a crucial role in defining the pathophysiological landscape of CAD. Furthermore, this discussion highlights the mutual interaction between the endocrine and cardiac systems, where CAD produced by myocardial ischemia worsens insulin resistance through complex molecular pathways. Discovering new therapeutic targets that disrupt the harmful cycle between insulin resistance and the development of CAD shows potential for creating specific therapies to reduce cardiovascular risk in people with insulin resistance. This study aims to clarify the complexities of the connection between the endocrine system and the heart, establishing the basis for a thorough comprehension of how insulin resistance contributes to the development and advancement of CAD.
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Affiliation(s)
- Fakhar Un Nisa Ashraf
- Medicine, The Royal Wolverhampton National Health Service (NHS) Trust, Wolverhampton, GBR
| | | | - Fnu Someshwar
- Medicine, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Sunny Kumar
- Medicine, Liaquat National Hospital and Medical College, Karachi, PAK
| | | | - Komal Kumari
- Medicine, New Medical Centre (NMC) Royal Family Medical Centre, Abu Dhabi, ARE
| | - Saira Bano
- Medicine, Faisalabad Medical College and University, Faisalabad, PAK
| | - Saad Ahmad
- Medicine, Shalamar Medical and Dental College, Lahore, PAK
| | | | - Lata Ramchandani
- Medicine, People's University of Medical and Health Sciences for Women, Nawabshah, PAK
| | | | | | - Mahima Khatri
- Internal Medicine/Cardiology, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Satish Kumar
- Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
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10
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Majid M, Yahya M, Ansah Owusu F, Bano S, Tariq T, Habib I, Kumar B, Kashif M, Varrassi G, Khatri M, Kumar S, Iqbal A, Khan AS. Challenges and Opportunities in Developing Tailored Pain Management Strategies for Liver Patients. Cureus 2023; 15:e50633. [PMID: 38226103 PMCID: PMC10789475 DOI: 10.7759/cureus.50633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/16/2023] [Indexed: 01/17/2024] Open
Abstract
Chronic liver illnesses pose a substantial worldwide health challenge, with various causes that span from viral infections to metabolic problems. Individuals suffering from liver problems frequently face distinct difficulties in pain control, requiring a customized strategy that takes into account both the fundamental disease and the complexities of liver function. The liver, a vital organ responsible for metabolic control and detoxification, is pivotal in multiple physiological processes. Chronic liver illnesses, such as cirrhosis and non-alcoholic fatty liver disease (NAFLD), are marked by a gradual process of inflammation and fibrosis, resulting in reduced liver function. These disorders often come with pain, varying from internal discomfort to intense abdominal pain, which impacts the quality of life and general well-being of patients. The review explores the complex aspects of pain perception in liver illnesses, including inflammation, modified neuronal signaling, and the influence of comorbidities. It highlights the significance of a detailed comprehension of the pain experience in individuals with hepatic conditions for the implementation of successful pain management treatments. In addition, the review emphasizes the difficulties involved in treating pain in this group of patients, such as the possible complications linked to commonly prescribed pain relievers and the necessity for collaboration between hepatologists, pain specialists, and other healthcare professionals. Moreover, it examines new possibilities in the domain, such as the significance of innovative pharmacological substances, non-pharmacological treatments, and personalized medicine strategies designed for specific patient characteristics. This study thoroughly analyzes the difficulties and possibilities involved in creating personalized pain management approaches for individuals with liver conditions. Its purpose is to guide physicians, researchers, and healthcare providers, enabling them to implement more efficient and patient-focused interventions. As our comprehension of liver-related pain progresses, the potential for enhancing the quality of life for persons with chronic liver disorders through tailored pain management measures becomes more and more encouraging.
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Affiliation(s)
- Manahil Majid
- General Medicine, Diana Princess of Wales Hospital, Grimsby, GBR
| | - Muhammad Yahya
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | | | - Saira Bano
- Medicine, Faisalabad Medical College and University, Faisalabad, PAK
| | - Taha Tariq
- Medicine, Lahore Medical and Dental College, Lahore, PAK
| | - Iqra Habib
- Medicine, Mohtarma Benazir Bhutto Shaheed Medical College, Mirpur, PAK
| | - Beesham Kumar
- Medicine, Jinnah Medical and Dental College, Karachi, PAK
| | - Maham Kashif
- Medicine, Khawaja Muhammad Safdar Medical Collge, Sialkot, PAK
| | | | - Mahima Khatri
- Internal Medicine/Cardiology, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Satesh Kumar
- Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Arham Iqbal
- Medicine and Surgery, Dow University of Health Sciences, Dow International Medical College, Karachi, PAK
| | - Alina S Khan
- Medicine, Liaquat National Hospital and Medical College, Karachi, PAK
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11
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Sapna F, Raveena F, Chandio M, Bai K, Sayyar M, Varrassi G, Khatri M, Kumar S, Mohamad T. Advancements in Heart Failure Management: A Comprehensive Narrative Review of Emerging Therapies. Cureus 2023; 15:e46486. [PMID: 37927716 PMCID: PMC10623504 DOI: 10.7759/cureus.46486] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Heart failure is a substantial and escalating global health challenge, affecting millions worldwide. This complex syndrome arises from diverse etiologies, encompassing ischemic heart disease, hypertension, valvular abnormalities, and cardiomyopathies. Heart failure is characterized by the heart's inability to pump blood efficiently to meet the body's metabolic demands, leading to debilitating symptoms, frequent hospitalizations, and high mortality rates. Traditionally, the management of Heart failure has focused on alleviating symptoms, reducing fluid retention, and enhancing cardiac contractility. These goals have been achieved through a combination of pharmacological therapies such as angiotensin-converting enzyme inhibitors, beta-blockers, and diuretics, often complemented by device-based interventions like implantable cardioverter-defibrillators and cardiac resynchronization therapy. However, despite these advances, the relentless progression of heart failure remains a significant clinical challenge. Neurohormonal activation, cardiac fibrosis, and cellular remodeling are just a few of the intricate processes contributing to the disease's progression. In recent years, researchers and clinicians have embarked on a quest to identify novel therapeutic approaches that address these underlying mechanisms. One such avenue of exploration involves the revolutionary field of gene therapy, with promising gene-editing techniques, such as CRISPR-Cas9, offering potential routes for correcting genetic mutations that contribute to heart failure. Additionally, regenerative medicine approaches, including stem cell therapy and tissue engineering, hold significant promise for repairing damaged cardiac tissue and restoring function. Furthermore, precision medicine initiatives have gained traction, aiming to tailor heart failure therapies to individual patient profiles, taking into account genetics, biomarkers, and comorbidities. Integrating artificial intelligence and machine learning in heart failure management has also enabled the development of predictive models for early intervention, risk stratification, and personalized treatment recommendations. This narrative review navigates the intricate landscape of emerging therapies for heart failure, emphasizing their potential to revolutionize the field by targeting the disease's fundamental mechanisms. By exploring these innovative approaches, we aspire to provide a comprehensive perspective on the evolving paradigm of heart failure management, fostering a hopeful outlook for patients and clinicians alike.
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Affiliation(s)
- Fnu Sapna
- Pathology, Albert Einstein College of Medicine, New York, USA
| | - Fnu Raveena
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Maria Chandio
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Karoona Bai
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | | | | | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Tamam Mohamad
- Cardiovascular Medicine, Wayne State University, Detroit, USA
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12
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Ullah A, Kumar M, Sayyar M, Sapna F, John C, Memon S, Qureshi K, Agbo EC, Ariri HI, Chukwu EJ, Varrassi G, Khatri M, Kumar S, Elder NM, Mohamad T. Revolutionizing Cardiac Care: A Comprehensive Narrative Review of Cardiac Rehabilitation and the Evolution of Cardiovascular Medicine. Cureus 2023; 15:e46469. [PMID: 37927717 PMCID: PMC10624210 DOI: 10.7759/cureus.46469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
Cardiovascular disease (CVD) stands as a global health crisis, with its complex web of conditions, including coronary artery disease, heart failure, hypertension, and stroke, continuing to exact a heavy toll on individuals and healthcare systems worldwide. Despite substantial advances in medical technology and pharmaceutical interventions, CVD remains a formidable adversary, necessitating innovative prevention, management, and rehabilitation approaches. In tracing the historical trajectory of CVD, the narrative reveals the antiquated practices of early 20th-century medicine, marked by extended bed rest as the primary modality for heart-related conditions. It underscores the critical juncture when exercise was first recognized as a therapeutic tool for cardiac health, setting the stage for the evolution of cardiac rehabilitation (CR). CR programs have transcended their initial focus on exercise, expanding to encompass dietary guidance, psychosocial support, and comprehensive risk factor modification. These holistic interventions enhance physical recovery and address the psychosocial and lifestyle aspects of CVD management, ultimately improving patients' overall well-being. CR programs increasingly leverage advanced technologies and personalized strategies to tailor interventions to individual patient needs, ultimately enhancing outcomes and reducing the burden of CVD. In conclusion, this narrative review illuminates the transformative journey of cardiac care, with a particular spotlight on the indispensable role of CR in reshaping the landscape of cardiovascular medicine. By evolving from historical practices to comprehensive, patient-centered interventions, CR has made significant strides in improving the prognosis, quality of life, and holistic well-being of individuals grappling with the complexities of CVD. Understanding this historical context and the contemporary advancements is paramount for healthcare professionals and policymakers as they navigate the intricate terrain of cardiovascular medicine and endeavor to mitigate the impact of this pervasive disease.
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Affiliation(s)
- Atta Ullah
- Internal Medicine, Cavan General Hospital, Cavan, IRL
- Internal Medicine, Khyber Teaching Hospital, Peshawar, PAK
| | | | | | - Fnu Sapna
- Pathology, Albert Einstein College of Medicine, Bronx , USA
| | - Chris John
- Internal Medicine, University College Dublin, Dublin, IRL
| | - Siraj Memon
- Medicine, Liaquat University of Medical & Health Sciences, Jamshoro, PAK
| | - Kashifa Qureshi
- Medicine, Liaquat University of Medical & Health Sciences, Jamshoro, PAK
| | - Elsie C Agbo
- Internal Medicine, Kyiv Medical University, Kyiv, UKR
| | - Henry I Ariri
- Internal Medicine, All Saints University School of Medicine, Roseau, DMA
| | - Emmanuel J Chukwu
- Internal Medicine, All Saints University School of Medicine, Roseau, DMA
| | | | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Naji M Elder
- Medicine, Santa Clara University, Santa Clara, USA
| | - Tamam Mohamad
- Cardiovascular Medicine, Wayne State University, Detroit, USA
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13
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Chaudhary MH, Dev S, Kumari A, Kanwal K, Jadav DN, Rasool S, Tayyab Saleem M, Bhagat R, Prachi F, Puri P, Kashif M, Varrassi G, Khatri M, Kumar S, Mohamad T. Holistic Approaches to Arrhythmia Management: Combining Medication, Ablation, and Device Interventions. Cureus 2023; 15:e45958. [PMID: 37900386 PMCID: PMC10600027 DOI: 10.7759/cureus.45958] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
This narrative review investigates the severe health issue of arrhythmias, which affects millions of people worldwide. A multifaceted strategy incorporating medicine, catheter ablation, and advanced device interventions is necessary to manage these disorders effectively. Medication is the cornerstone, and as antiarrhythmic medications develop, their efficacy and side effects are reduced. Success depends on having individualized treatment strategies that consider patient profiles and arrhythmia type. Catheter ablation, a minimally invasive surgery that targets and removes faulty heart electrical circuits, has become a potent therapy when drugs are ineffective. Technological developments, including high-resolution mapping systems and customized catheters, improve precision. Pacemakers and implantable cardioverter-defibrillators (ICDs) are two examples of implantable cardiac devices essential to managing all types of arrhythmias. Pacemakers provide a regular heartbeat when the body's natural pacing mechanism fails. At the same time, ICDs, with cutting-edge algorithms, can identify and stop life-threatening arrhythmias and offer high-risk patients vital protection. As device technology advances, smaller, more durable devices become available, improving patient comfort and lowering the need for replacements. The seamless fusion of these three strategies is where holistic arrhythmia management shines. Even for difficult instances, customized combination therapy combining medicine, ablation, and device interventions offers complete solutions. Healthcare providers must collaborate for this integrated strategy to deliver personalized, efficient, and holistic care. In conclusion, the management of arrhythmias has developed into a dynamic, synergistic discipline where drugs, catheter ablation, and devices all work in concert to deliver comprehensive care. For those with arrhythmias, a patient-centered strategy that considers their particular patient features and best integrates different modalities can significantly enhance their quality of life. The effectiveness and accessibility of holistic arrhythmia management could be further improved because of ongoing developments in these fields, which is encouraging for patients and medical professionals.
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Affiliation(s)
| | - Shah Dev
- Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Ankeeta Kumari
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Kainat Kanwal
- Medicine, Khawaja Muhammad Safdar Medical College, Sialkot, PAK
| | | | - Sohaib Rasool
- Medicine, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | | | - Ridhi Bhagat
- Internal Medicine, Teerthanker Mahaveer Medical College and Reseach Center, Moradabad , IND
| | - Fnu Prachi
- Medicine, Guru Teg Bahadur Hospital, Delhi, IND
| | - Piyush Puri
- Internal Medicine, Adesh Institute of Medical Science and Research, Bathinda, IND
| | - Maham Kashif
- Medicine, Khawaja Muhammad Safdar Medical College, Sialkot, PAK
| | | | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Tamam Mohamad
- Cardiovascular Medicine, Wayne State University, Detroit, USA
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14
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Zakir M, Ahuja N, Surksha MA, Sachdev R, Kalariya Y, Nasir M, Kashif M, Shahzeen F, Tayyab A, Khan MSM, Junejo M, Manoj Kumar F, Varrassi G, Kumar S, Khatri M, Mohamad T. Cardiovascular Complications of Diabetes: From Microvascular to Macrovascular Pathways. Cureus 2023; 15:e45835. [PMID: 37881393 PMCID: PMC10594042 DOI: 10.7759/cureus.45835] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/23/2023] [Indexed: 10/27/2023] Open
Abstract
Diabetes mellitus, with a growing risk of developing complications, has a significant negative impact on cardiovascular health, including microvascular and macrovascular issues. This thorough narrative study methodically examines the complex connection between cardiovascular problems and diabetes. We start by thoroughly introducing diabetes mellitus, classifying its various forms, and discussing its growing global impact. Then, we examine retinopathy, nephropathy, and neuropathy in detail, illuminating their biology, clinical presentations, and treatment options. Moving on to macrovascular consequences, we investigate the complex relationships between diabetes and coronary artery disease, stroke, and peripheral arterial disease, emphasizing risk factors, diagnostic standards, and treatment plans designed for people with diabetes. The review analyzes the pathophysiological pathways that link diabetes to cardiovascular problems, including endothelial dysfunction, chronic inflammation, immune system dysregulation, and oxidative stress brought on by hyperglycemia. Additionally, we review the critical function of risk monitoring, assessment, and predictive tools in early detection. While highlighting current research paths and the need for tailored medical approaches to address this complex health issue, the story also includes prevention and management strategies, ranging from lifestyle changes to developing medications. This narrative review concludes by providing a thorough summary of current information, highlighting research gaps, and advocating for interdisciplinary efforts to reduce the cardiovascular effects of diabetes.
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Affiliation(s)
- Mehreen Zakir
- Medicine, Sir Syed College of Medical Sciences, Karachi, PAK
| | - Neha Ahuja
- General Medicine, Chandka Medical College, Larkana, PAK
| | | | - Reya Sachdev
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Yash Kalariya
- Internal Medicine, Civil Hospital Rajkot, Rajkot, IND
| | - Muhammad Nasir
- Medicine, Rural Health Center (RHC) Dhonkal, Dhonkal, PAK
| | - Maham Kashif
- Medicine, Khawaja Muhammad Safdar Medical College, Sialkot, PAK
| | - Fnu Shahzeen
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | - Arslan Tayyab
- Internal Medicine, Quaid e Azam Medical College, Bahawalpur, PAK
| | | | | | | | | | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Tamam Mohamad
- Cardiovascular Medicine, Wayne State University, Detroit, USA
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15
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Zaree A, Dev S, Yaseen Khan I, Arain M, Rasool S, Khalid Rana MA, Kanwal K, Bhagat R, Prachi F, Puri P, Varrassi G, Kumar S, Khatri M, Mohamad T. Cardiac Rehabilitation in the Modern Era: Optimizing Recovery and Reducing Recurrence. Cureus 2023; 15:e46006. [PMID: 37900498 PMCID: PMC10602201 DOI: 10.7759/cureus.46006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Cardiovascular diseases (CVDs) continue to be a prominent issue in global health, emphasizing the necessity for efficient cardiac rehabilitation programs. This narrative review provides a detailed analysis of the current state of cardiac rehabilitation, focusing on maximizing recovery and minimizing the likelihood of recurrence. This paper examines the historical progression of cardiac rehabilitation, explores the epidemiological background of cardiovascular disease (CVD), and provides an overview of the many stages of the rehabilitation process. The assessment of patients plays a crucial role in healthcare, serving as a fundamental basis that incorporates medical, psychological, and social aspects. The utilization of risk stratification techniques further enhances this process. The present study investigates exercise training, particularly emphasizing the current recommendations and the mutually beneficial effects of aerobic and resistance regimens. In addition to physical therapies, this study emphasizes the importance of nutrition, lifestyle adjustments, and the significant effects of medication. Psychosocial assistance is a crucial element that addresses the significant psychological effects of cardiac disease and provides comprehensive techniques for overall well-being. Technological advancements are significantly transforming the domain of cardiac rehabilitation, encompassing the integration of wearable technologies and telemedicine solutions. The convergence of artificial intelligence and data analytics can enhance the customization of healthcare services. Through a comprehensive rehabilitation program, patients can achieve an improved quality of life and enhanced functional outcomes. However, it is essential to acknowledge that obstacles still hinder individuals from accessing and completing educational programs. Therefore, it is crucial to engage in a discourse on potential tactics that may be employed to address these issues, considering the various cultural and socioeconomic aspects that contribute to them. The analysis focuses on the economic dimension, examining the cost-effectiveness of rehabilitation programs and their congruence with healthcare policies. In anticipation of future developments, the study provides valuable perspectives on the prospective trajectory of cardiac rehabilitation. It delves into nascent patterns and examines the potential ramifications of precision medicine and genetics for tailoring treatment strategies to individual patients. In brief, this narrative review comprehensively examines the various dimensions of contemporary cardiac rehabilitation. It offers a comprehensive perspective on its significance in enhancing recuperation and mitigating the likelihood of the recurrence of cardiovascular ailments. The significance of this review lies in its ability to enhance patient outcomes, thereby making a valuable contribution to the worldwide endeavor to address the burden of cardiovascular disease.
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Affiliation(s)
- Amna Zaree
- Medicine, Shalamar Medical and Dental College, Lahore, PAK
| | - Shah Dev
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | | | - Mustafa Arain
- Internal Medicine, Civil Hospital Karachi, Karachi, PAK
| | - Sohaib Rasool
- Medicine, Bakhtawar Amin Medical and Dental College, Multan, PAK
| | | | - Kainat Kanwal
- Medicine and Surgery, Khawaja Muhammad Safdar Medical College, Sialkot, PAK
| | - Ridhi Bhagat
- Internal Medicine, Teerthanker Mahaveer Medical College and Reseach Center, Moradabad, IND
| | - Fnu Prachi
- Medicine, Guru Teg Bahadur Hospital, Delhi, IND
| | - Piyush Puri
- Internal Medicine, Adesh Institute of Medical Science and Research, Bathinda, IND
| | | | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Tamam Mohamad
- Cardiovascular Medicine, Wayne State University, Detroit, USA
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16
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Mohamad T, Jyotsna F, Farooq U, Fatima A, Kar I, Khuwaja S, Memon UA, Kumari V, Puri P, Aslam ZM, Elder Z, Varrassi G, Paladini A, Khatri M, Kumar S, Muzammil MA. Individualizing Medicinal Therapy Post Heart Stent Implantation: Tailoring for Patient Factors. Cureus 2023; 15:e43977. [PMID: 37746355 PMCID: PMC10516147 DOI: 10.7759/cureus.43977] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
The field of cardiovascular medicine is undergoing a transformative shift towards personalized medicinal therapy, particularly in the context of post stent implantation. This narrative review explores the significance, challenges, and future directions of individualized treatment strategies for patients with coronary stents. The review highlights the pivotal role of personalized approaches in optimizing treatment efficacy and minimizing adverse events. Real-world clinical studies and trials underscore the importance of tailoring antiplatelet therapy based on platelet function testing, genetic testing, and risk scoring. These studies reveal that personalized medicinal treatment improves clinical outcomes by balancing preventing thrombotic events and mitigating bleeding risks. Challenges, including cost, test availability, patient adherence, and ethical considerations, are discussed in depth, shedding light on the complexities of implementing personalized approaches. Technological advancements, including omics data integration, artificial intelligence, and big data analytics, shape the future of personalized medicinal therapy. These tools enable precise pharmacogenomic selection of medications and the development of integrated risk-scoring systems. Patient engagement and education are also central, with empowered patients and remote monitoring contributing to collaborative decision-making. In conclusion, the narrative review underscores that personalized medicinal therapy post stent implantation holds immense promise for revolutionizing cardiovascular care. By embracing a comprehensive approach that considers genetics, clinical factors, and patient preferences, healthcare providers can optimize treatment outcomes and improve patient quality of life. The evolving landscape of personalized medicine offers a glimpse into a future where tailored treatment strategies become the cornerstone of precision cardiovascular care.
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Affiliation(s)
| | - Fnu Jyotsna
- Medicine, Dr. B.R. Ambedkar State Institute of Medical Sciences, Mohali, IND
| | - Umer Farooq
- Medicine, CMH (Combined Military Hospital) Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Aroob Fatima
- Medicine, Ejaz Sikandar Memorial Hospital, Kanganpur, PAK
| | - Indrani Kar
- Medicine, Lady Hardinge Medical College, New Delhi, IND
| | - Sundal Khuwaja
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Unaib Ahmed Memon
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Versha Kumari
- Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Piyush Puri
- Medicine, Adesh Institute of Medical Science and Research, Bathinda, IND
| | - Zaid M Aslam
- Internal Medicine, Ziauddin University, Karachi, PAK
| | - Zachary Elder
- Medical Education, American University of the Caribbean School of Medicine, Cupecoy, SXM
| | | | - Antonella Paladini
- Department of MESVA (Life, Health, and Environmental Sciences), University of L'Aquila, L'Aquila, ITA
| | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
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17
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Jyotsna F, Ikram J, Nageeta F, Komal F, Anjlee F, Patel H, Nassri T, Kumari M, Kumar R, Shah SU, Kashif M, Varrassi G, Kumar S, Patel T. Unlocking the Potential of Immunotherapy in Cardiovascular Disease: A Comprehensive Review of Applications and Future Directions. Cureus 2023; 15:e42790. [PMID: 37664375 PMCID: PMC10469982 DOI: 10.7759/cureus.42790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Immunotherapy has emerged as a pioneering therapeutic approach that harnesses the immune system's abilities to combat diseases, particularly in the field of oncology where it has led to significant advancements. However, despite its significant impact in the field of oncology, the potential of immunotherapy in the context of cardiovascular disease (CVD) has not been thoroughly investigated. The purpose of this narrative review is to address the existing knowledge and potential uses of immunotherapy in the field of cardiovascular disease (CVD), with the intention of filling the existing gap in understanding. Furthermore, the review thoroughly examines the future prospects of this swiftly advancing field, providing insights into the aspects that necessitate further investigation and addressing the forthcoming challenges. The review is organized into four distinct sections to enhance comprehension. The first section introduces immunotherapy, presenting the fundamental concepts and principles. The second section explores the immunomodulatory mechanisms in cardiovascular disease (CVD), with a specific focus on the intricate interplay between the immune system and the development of cardiovascular pathogenesis. The utilization of immunotherapy in specific cardiovascular conditions will be examined, investigating the application of immunotherapy in the context of different cardiovascular diseases. The future prospects and challenges in immunotherapy for cardiovascular diseases will be discussed, highlighting the potential areas for future research and addressing the barriers that must be overcome to effectively implement immunotherapeutic interventions in the management of cardiovascular diseases.
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Affiliation(s)
- Fnu Jyotsna
- Medicine, Dr. B.R. Ambedkar Medical College & Hospital, Mohali, IND
| | - Jibran Ikram
- Orthopaedics and Trauma, Rehman Medical Institute, Peshawar, PAK
| | - Fnu Nageeta
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Fnu Komal
- Medicine, Chandka Medical College, Larkana, PAK
| | - Fnu Anjlee
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Harshkumar Patel
- Internal Medicine, PDU (Pandit Dindayal Upadhyay) Medical College, Rajkot, IND
| | - Taleb Nassri
- Medicine, Heart and Vascular Institute, Dearborn, USA
| | - Meena Kumari
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Rajesh Kumar
- Business Intelligence and Data Analytics, Westcliff University, Irvine, USA
| | | | - Maham Kashif
- Medicine, Khawaja Muhammad Safdar Medical College, Wazirabad, PAK
| | | | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Tirath Patel
- Medicine, American University of Antigua, St. John, ATG
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