This literature review aimes to summarize current evidence on the clinical usefulness of plaque characterization using contemporary intracoronary imaging and the effects of high-intensity lipid-lowering therapies on vulnerable plaque features.
Transcatheter mitral valve implantation (TMVI) is used for treating severe mitral valve regurgitation in patients deemed unsuitable for open-heart surgery. However, delays between preoperative workup and therapy can lead to changes in the clinical condition and structural valve findings, necessitating a meticulous reevaluation of diagnostic and therapeutic options.
Bempedoic acid is a fairly small molecule acting as a prodrug which is converted into the active compound bempedoyl-CoA in the liver. This active metabolite of bempedoic acid inhibits the enzyme ATP citrate lyase leading to low-density lipoprotein (LDL) reduction.
The CLEAR (Cholesterol Lowering via Bempedoic Acid, an ACL-Inhibiting Regimen) Harmony trial showed that bempedoic acid reduced LDL cholesterol (LDL-C) by 12.6–16.5% and the CLEAR Tranquility and Serenity showed a reduction of LDL-C in statin-intolerant patients by a mean of 21% in monotherapy and 38% in combination with ezetimibe.
Despite an extensive body of literature, there are still many gaps in the evidence surrounding the lifetime management of aortic stenosis (AS) and upstream interventions to prevent or slow down the progression of the disease are yet to be developed.
His bundle pacing is the most physiological form of pacing as it replicates the patient’s natural ventricular activation. Its adoption has significantly grown over the last years. However, the technique has several limitations, including suboptimal thresholds. Left bundle branch area pacing has been introduced more recently and has gained much interest as it also delivers physiological pacing but with more favorable electrical parameters. However, there are also several unresolved issues with this technique. This article compares these strategies and highlights their advantages and disadvantages to provide guidance on which technique to select for a specific patient.
Dose-dependent statin-related myotoxicity (SRM) is a rare adverse effect of statin treatment. Differences in the pharmacokinetics and interactions with environmental and genetic factors constitute important risk factors for the development of SRM. We present the case of an 82-year-old female patient with severe simvastatin-related myotoxicity and several risk factors of SRM, namely a pharmacokinetic interaction with verapamil, a pharmacogenetic interaction with a SLCO1B1*1/*5 variant, high age, female gender and impaired renal function. A comprehensive evaluation of distinct pharmacokinetic and pharmacogenetic properties of different statins and a pharmacogenetic panel test guided the diagnosis and options for further clinical management. Inspired by this and other similar cases, we developed a pocket card as practical companion for statin prescribing in clinical practice and provide it as an addition to this report.
