Cardiovascular Prevention and Pharmacotherapy

From articles published in Cardiovascular Prevention and Pharmacotherapy during the past two years (2022 ~ ).

Review Article

Calcium channel blockers for hypertension: old, but still useful: Eun Mi Lee; Cardiovasc Prev Pharmacother. 2023;5(4):113-125. Published online October 30, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e16

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Calcium channel blockers (CCBs) constitute a heterogeneous class of drugs that can be divided into dihydropyridines (DHPs) and non-DHPs. DHP-CCBs are subcategorized into four generations based on the duration of activity and pharmacokinetics, while non-DHP-CCBs are subcategorized into phenylethylamine and benzodiazepine derivatives. DHP-CCBs are vascular-selective and function as potent vasodilators, whereas non-DHP-CCBs are cardiac-selective and are useful for treating tachyarrhythmia, but reduce cardiac contractility and heart rate. Traditional DHP-CCBs (nifedipine) mainly block L-type calcium channels, whereas novel CCBs block N-type (amlodipine) and/or T-type channels (efonidipine) in addition to L-type channels, leading to organ-protective effects. DHP-CCBs have a potent blood pressure–lowering effect and suppress atherosclerosis and coronary vasospasm. Diltiazem, a non-DHP-CCB, is highly effective for vasospasm control. CCBs reduce left ventricular hypertrophy and arterial stiffness. Amlodipine, a DHP-CCB, reduces blood pressure variability. L/N- and L/T-type CCBs combined with renin-angiotensin system blockers reduce proteinuria and improve kidney function compared with L-type CCBs. According to large-scale trials, DHP-CCBs reduce cardiovascular events in patients with isolated systolic hypertension, as well as in elderly and high-risk patients. Accordingly, CCBs are indicated for hypertension in elderly patients, isolated systolic hypertension, angina pectoris, and coronary vasospasm. Non-DHP-CCBs are contraindicated in high-grade heart block, bradycardia (<60 beats per minute [bpm]), and heart failure with reduced ejection fraction (HFrEF). DHP-CCBs should be used with caution in patients with tachyarrhythmia, HFrEF, and severe leg edema, and non-DHP-CCBs should be used carefully in those with constipation. Each CCB has distinct pharmacokinetics and side effects, underscoring the need for meticulous consideration in clinical practice.

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Synthesis, Characterization, DFT Analysis, Pharmacokinetics, and Inhibition of Mpro and RdRp of SARS-CoV-2 by Two Dihydropyrimidines Derivatives
Samia Mammeri, Rachida Kerkour, Nadjib Chafai, Hassina Harkat, Saleh Chafaa
Journal of Molecular Structure.2025; 1324: 140797. CrossRef
Design of Experimental Approach for Development of Rapid High Performance Liquid Chromatographic Process for Simultaneous Estimation of Metoprolol, Telmisartan, and Amlodipine from Formulation: Greenness and Whiteness Evaluation
Mahesh Attimarad, Mohammed Jassim Alali, Hussain Ali Alali, Dana Hisham Alabdulmuhsin, Aljohara Khalid Alnajdi, Katharigatta Narayanaswamy Venugopala, Anroop B. Nair
Molecules.2024; 29(5): 1087. CrossRef
The Evolving Role of Calcium Channel Blockers in Hypertension Management: Pharmacological and Clinical Considerations
Kamryn E. Jones, Shaun L. Hayden, Hannah R. Meyer, Jillian L. Sandoz, William H. Arata, Kylie Dufrene, Corrado Ballaera, Yair Lopez Torres, Patricia Griffin, Adam M. Kaye, Sahar Shekoohi, Alan D. Kaye
Current Issues in Molecular Biology.2024; 46(7): 6315. CrossRef
Home blood pressure-lowering effect of esaxerenone versus trichlormethiazide for uncontrolled hypertension: a predefined subanalysis of the EXCITE-HT randomized controlled trial by basal calcium channel blocker versus angiotensin receptor blocker
Kazuomi Kario, Hiroyuki Ohbayashi, Masami Hashimoto, Naoki Itabashi, Mitsutoshi Kato, Kazuaki Uchiyama, Kunio Hirano, Noriko Nakamura, Takahide Miyamoto, Hirotaka Nagashima, Hidenori Ishida, Yusuke Ebe, Tsuguru Hatta, Toshiki Fukui, Tatsuo Shimosawa, Tomo
Hypertension Research.2024;[Epub] CrossRef
Endothelial Cell Dysfunction: Onset, Progression, and Consequences
Hojjat Naderi-Meshkin, Wiwit Ananda Wahyu Setyaningsih
Frontiers in Bioscience-Landmark.2024;[Epub] CrossRef
Rationale and Design of a Randomized, Open‐Label, Parallel‐Group Study of Esaxerenone Versus Angiotensin Receptor Blockers in Older Patients With Uncontrolled Hypertension on Calcium Channel Blocker Monotherapy (ESCORT‐HT)
Kazuomi Kario, Tomohiro Katsuya, Tatsuo Shimosawa, Takashi Taguchi, Ayumi Tanabe, Mitsuru Ohishi
The Journal of Clinical Hypertension.2024;[Epub] CrossRef
Angiotensin II Exposure In Vitro Reduces High Salt-Induced Reactive Oxygen Species Production and Modulates Cell Adhesion Molecules’ Expression in Human Aortic Endothelial Cell Line
Nikolina Kolobarić, Nataša Kozina, Zrinka Mihaljević, Ines Drenjančević
Biomedicines.2024; 12(12): 2741. 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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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 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

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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.

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Efficacy, side effects, adherence, affordability, and procurement of dietary supplements for treating hypercholesterolemia: a narrative review
Isabel von Känel-Cordoba, Katharina Wirnitzer, Katja Weiss, Pantelis T. Nikolaidis, Asli Devrim-Lanpir, Lee Hill, Thomas Rosemann, Beat Knechtle
Journal of Health, Population and Nutrition.2024;[Epub] CrossRef
The Link between Magnesium Supplements and Statin Medication in Dyslipidemic Patients
Roxana Nartea, Brindusa Ilinca Mitoiu, Ioana Ghiorghiu
Current Issues in Molecular Biology.2023; 45(4): 3146. CrossRef
The effects of L-carnitine in reducing hepatotoxicity of statins in rats
Doaa Ibrahim, Shahad Bader, Omar Bader
Medicinski casopis.2023; 57(3): 59. CrossRef

Decision-making for recurrent atrial fibrillation after catheter ablation: Jum Suk Ko, Sung Soo Kim, Hyung Ki Jeong, Nam Ho Kim; Cardiovasc Prev Pharmacother. 2023;5(4):102-112. Published online October 27, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e15

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Abstract PDF

Catheter ablation for atrial fibrillation (AF), especially pulmonary vein (PV) isolation, is widely used for rhythm control. However, AF recurrence remains a challenge, affecting 20% to 50% of cases. This review focuses on AF recurrence after catheter ablation. AF recurrence can be categorized into early recurrence (ER) within 3 months after index procedure, late recurrence (LR) within 1 year, and very LR (VLR) occurring beyond 1 year. ER has emerged as a significant predictor of LR, contrary to the traditional understanding. LR is primarily caused by PV reconnection, while VLR more involves non-PV triggers or substrates. Managing AF recurrence includes antiarrhythmic drugs, steroids, colchicine, and repeat ablation. Antiarrhythmic drugs reduce ER but have a limited impact on LR. Steroids have been shown to reduce ER, but not long-term recurrence. Colchicine, an anti-inflammatory agent, shows promise in reducing both ER and LR, although further research is necessary. Whether to perform early repeat ablation after ER remains uncertain, as not all patients require immediate intervention. In conclusion, AF recurrence after ablation remains a complex issue. Understanding the underlying mechanisms is essential for personalized management. Tailored approaches, considering individual characteristics, are crucial for long-term success. Future research should focus on improving therapeutic strategies for AF recurrence.

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Meta-analysis of Pulsed Field Ablation Versus Thermal Ablation for Pulmonary Vein Isolation in AF: A Broad Overview Focusing on Efficacy, Safety and Outcomes
Mohammad Iqbal, William Kamarullah, Raymond Pranata, Iwan Cahyo Santosa Putra, Giky Karwiky, Chaerul Achmad, Young Hoon Kim
Arrhythmia & Electrophysiology Review.2024;[Epub] CrossRef
Beyond Clinical Factors: Harnessing Artificial Intelligence and Multimodal Cardiac Imaging to Predict Atrial Fibrillation Recurrence Post-Catheter Ablation
Edward T. Truong, Yiheng Lyu, Abdul Rahman Ihdayhid, Nick S. R. Lan, Girish Dwivedi
Journal of Cardiovascular Development and Disease.2024; 11(9): 291. CrossRef

Original Articles

Changes in cardiovascular-related health behaviors during the COVID-19 pandemic: Eunji Kim, Chan-Hee Jung, Dae Jung Kim, Seung-Hyun Ko, Hae-Young Lee, Kyung-Yul Lee, Dae Ryong Kang, Sung Kee Ryu, Won-Young Lee, Eun-Jung Rhee, Hyeon Chang Kim; Cardiovasc Prev Pharmacother. 2023;5(1):15-23. Published online January 27, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e2

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Abstract PDF Supplementary Material

Background
The COVID-19 pandemic has been the most pressing health challenge in recent years. Meanwhile, prevention for other diseases, such as cardiovascular disease (CVD) has been less prioritized during the pandemic. COVID-19, a novel infectious disease, both had a direct impact on public health and provoked changes in health-related behaviors, including those for CVD prevention. This study sought to examine changes in CVD-related health behaviors during the COVID-19 pandemic and related sociodemographic factors.
Methods
We used data from the Cardiovascular Disease Prevention Awareness Survey conducted in Korea in June 2022. A total of 2,000 adults across Korea’s 17 provinces completed a structured questionnaire online or on a mobile device. Self-reported changes in CVD-related health behaviors were investigated. We used unadjusted and adjusted logistic regression models to explore the associations between negative changes and sociodemographic factors.
Results
In smoking, drinking, and healthcare service use, the proportion of those with positive changes surpassed the proportion of respondents who reported negative changes. In contrast, negative changes predominated for diet, exercise, and stress. Most individuals (52.6%) reported a deterioration of psychological distress. These negative changes were significantly associated with age, sex, marital status, and the presence of cardiometabolic disease.
Conclusions
The COVID-19 pandemic has affected CVD-related health behaviors. Based on these changes, CVD prevention should be encouraged with appropriate and prioritized strategies.

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Changes in cardiovascular-related health behaviors after the end of social distancing: the 2023 Cardiovascular Disease Prevention Awareness Survey
Jaeyong Lee, Eunji Kim, Won-Young Lee, Eun-Jung Rhee, Hyeon Chang Kim
Cardiovascular Prevention and Pharmacotherapy.2024; 6(2): 57. CrossRef
Cardiovascular-related health behavior changes: lessons from the COVID-19 pandemic and post-pandemic challenges
Inha Jung, Won-Young Lee
Cardiovascular Prevention and Pharmacotherapy.2023; 5(4): 99. CrossRef

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

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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.

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SGLT2 Inhibitor Use and Risk of Dementia and Parkinson Disease Among Patients With Type 2 Diabetes
Hae Kyung Kim, Geert Jan Biessels, Min Heui Yu, Namki Hong, Yong-ho Lee, Byung-Wan Lee, Eun Seok Kang, Bong-Soo Cha, Eun Jig Lee, Minyoung Lee
Neurology.2024;[Epub] CrossRef
A Green Approach: Optimization of the UPLC Method Using DoE Software for Concurrent Quantification of Pioglitazone and Dapagliflozin in a SNEDDS Formulation for the Treatment of Diabetes
Ehab M. Elzayat, Abdelrahman Y. Sherif, Mohamed W. Attwa, Mohammad A. Altamimi
ACS Omega.2024; 9(45): 45011. CrossRef

Effects of physical activity on cardiovascular outcomes and mortality in Korean patients with diabetes: a nationwide population-based cohort study: Inha Jung, Sun Joon Moon, Hyemi Kwon, Se Eun Park, Kyung-Do Han, Eun-Jung Rhee, Won-Young Lee; Cardiovasc Prev Pharmacother. 2022;4(1):42-55. Published online January 20, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e3

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Abstract PDF Supplementary Material

Background
Since a sedentary lifestyle is considered a modifiable risk factor for cardiovascular disease (CVD), physical activity (PA) is recommended for type 2 diabetes mellitus (T2DM) patients to prevent CVD. We investigated the association between different levels of PA and the risk for CVD and all-cause mortality in patients with T2DM using nationwide data.
Methods
We examined health examination data and claims records of 2,745,637 participants with T2DM at baseline from the Korean National Health Insurance Service who underwent health examinations between 2009 and 2012. We excluded subjects with a history of myocardial infarction or stroke. Each participant was asked to report their weekly PA levels according to three categories: vigorous, moderate, and walking. The incidence of CVD and death was analyzed until 2017.
Results
The risk of CVD was lower in regular exercisers than in nonexercisers after adjusting for confounding variables. A dose-response trend was evident in the association between the degree of PA and CVD risk. All categories of PA were inversely associated with CVD risk and mortality. The reduction in CVD risk and all-cause mortality was more profound in patients aged ≥65 years.
Conclusions
Augmenting PA might have positive effects on the prevention of CVD and all-cause death, especially in the elderly. The benefits of PA were consistently observed in various subgroups regardless of the presence of chronic conditions. Therefore, clinicians should encourage elderly patients with T2DM to increase their daily PA.

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Incentivised physical activity intervention promoting daily steps among university employees in the workplace through a team-based competition
Ayazullah Safi, Sanjoy Deb, Adam Kelly, Matthew Cole, Natalie Walker, Mohammed Gulrez Zariwala
Frontiers in Public Health.2024;[Epub] CrossRef
Effect of physical activity on incident atrial fibrillation in individuals with varying duration of diabetes: a nationwide population study
JungMin Choi, So‑Ryoung Lee, Eue-Keun Choi, Kyung-Yeon Lee, Hyo-Jeong Ahn, Soonil Kwon, Kyung‑Do Han, Seil Oh, Gregory Y. H. Lip
Cardiovascular Diabetology.2024;[Epub] CrossRef

Review Articles

The emergence and clinical significance of artificial intelligence–enhanced electrocardiography: Yong-Soo Baek; Cardiovasc Prev Pharmacother. 2024;6(2):41-47. Published online April 26, 2024; DOI: https://doi.org/10.36011/cpp.2024.6.e7

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The integration of artificial intelligence (AI) with electrocardiography (ECG), a technology known as AI-ECG, represents a transformative leap in the field of cardiovascular medicine. This innovative approach has significantly advanced the capabilities of ECG, traditionally used for diagnosing heart diseases. AI-ECG excels in detecting subtle changes and interconnected patterns in cardiac waveforms, offering a level of precision and sensitivity that was previously unattainable with conventional methods. The scope of AI-ECG extends beyond the realm of heart diseases. It has shown remarkable potential in predicting and identifying the impacts of noncardiac conditions on heart health, thereby broadening the diagnostic capabilities of ECG. This is especially valuable given the complex nature of cardiovascular diseases and their interactions with other health conditions. Despite its groundbreaking potential, AI-ECG faces several challenges. One of the primary concerns is the "black box" nature of AI algorithms, which can make the decision-making process opaque and difficult to interpret. This poses a challenge in medical settings where understanding the rationale behind a diagnosis is crucial. Additionally, the effectiveness of AI-ECG is dependent on the quality and diversity of the datasets used to train the algorithms. Limited or biased datasets can lead to inaccuracies and diminish the reliability of the technology. However, the benefits of AI-ECG are significant. It enables faster, more accurate diagnoses and has the potential to greatly enhance the efficiency of cardiovascular care. As research and technology continue to evolve, AI-ECG is poised to become an indispensable tool in the diagnosis and management of heart diseases.

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AI-Enhanced ECG Applications in Cardiology: Comprehensive Insights from the Current Literature with a Focus on COVID-19 and Multiple Cardiovascular Conditions
Luiza Camelia Nechita, Aurel Nechita, Andreea Elena Voipan, Daniel Voipan, Mihaela Debita, Ana Fulga, Iuliu Fulga, Carmina Liana Musat
Diagnostics.2024; 14(17): 1839. CrossRef

COVID-19 vaccination–related cardiovascular complications: Jae Yeong Cho, Kye Hun Kim; Cardiovasc Prev Pharmacother. 2023;5(4):134-143. Published online October 27, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e17

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The global response to the COVID-19 pandemic has led to rapid vaccine development and distribution. As vaccination efforts continue, concerns have arisen regarding potential adverse events associated with COVID-19 vaccination. This article examines emerging evidence on adverse events, including myocarditis, pericarditis, and thrombotic complications, in relation to COVID-19 vaccination. Reports of myocarditis and pericarditis cases following messenger RNA vaccines have sparked interest, with discussions revolving around potential mechanisms and genetic predispositions. The contrasting findings on pericarditis risk postvaccination highlight the complexity of studying this phenomenon. Thrombotic events, particularly vaccine-induced thrombotic thrombocytopenia, have garnered attention, prompting investigations into antibody responses and mechanisms. This article underscores the importance of ongoing research, collaboration, and data analysis for accurately understanding adverse events. While the COVID-19 vaccination campaign may have ended, it is still vital to maintain vigilance, collect comprehensive data and foster interdisciplinary collaboration to uphold vaccine safety and steer public health strategies in the upcoming period.

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The Role of COVID-19 Vaccination for Patients With Atherosclerotic Cardiovascular Disease in the Upcoming Endemic Era
Kye Hun Kim
Journal of Lipid and Atherosclerosis.2024; 13(1): 21. CrossRef

Original Article

Correlation between metformin intake and prostate cancer: Raeun Kim, Minsun Song, Jiwon Shinn, Hun-Sung Kim; Cardiovasc Prev Pharmacother. 2023;5(3):91-97. Published online July 31, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e12

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Background
The relationship between metformin intake and prostate cancer incidence remains unclear. Therefore, we examined the correlation between prostate cancer and metformin use.
Methods
The subjects were diabetes patients aged ≥50 years who had been diagnosed with prostate cancer and had undergone surgery at Seoul St. Mary's Hospital. Groups taking metformin (MET(+) group) and not taking metformin (MET(–) group) were divided and compared.
Results
The mean preoperative prostate-specific antigen (PSA) levels in the MET(–) and MET(+) groups were 10.7±11.9 and 8.0±5.6 ng/mL, respectively, with no statistically significant difference between the two groups (P=0.387). The average prostate volume of the MET(–) group was 82.4±98.0 mL, and the average prostate volume of the MET(+) group was 55.4±20.1 mL, but there was no statistically significant difference between the two groups (P=0.226). The mean PSA velocity also did not show a significant difference between the two groups (0.025±0.102 ng/mL vs. 0.005±0.012 ng/mL, P=0.221).
Conclusions
We did not identify a significant positive correlation between metformin and prostate cancer. However, preoperational PSA and PSA velocity tended to be lower in the MET(+) group. A sophisticated prospective study with a large sample size should be planned.

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Metformin: Beyond Type 2 Diabetes Mellitus
Rahnuma Ahmad, Mainul Haque
Cureus.2024;[Epub] CrossRef

Review Articles

Diabetes mellitus and cancer: Jae Won Hong; Cardiovasc Prev Pharmacother. 2023;5(3):69-73. Published online July 27, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e9

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Diabetes mellitus and cancer are the most common life-threatening illnesses worldwide. Previous epidemiological studies have suggested a strong association between diabetes mellitus and an increased risk of cancer. Potential biological mechanisms underlying this relationship include obesity, hyperglycemia, hyperinsulinemia, chronic inflammation, and oxidative stress. The most common diabetes-related cancers are pancreatic, hepatocellular, breast, endometrial, and colorectal cancer. Special attention should be paid to patients with diabetes through careful cancer screening and preventive anticancer strategies.

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Repurposing metabolic regulators: antidiabetic drugs as anticancer agents
Yogita Dhas, Nupur Biswas, Divyalakshmi M.R., Lawrence D. Jones, Shashaanka Ashili
Molecular Biomedicine.2024;[Epub] CrossRef

Research on obesity using the National Health Information Database: recent trends: Eun-Jung Rhee; Cardiovasc Prev Pharmacother. 2023;5(2):35-40. Published online April 28, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e8

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The prevalence of obesity has increased markedly in Korea during the past few decades. Korea is one of the most well-organized countries in terms of its National Health Insurance System (NHIS), which conducts screening examinations. Since the NHIS is unified and managed by the government, its data—contained in the National Health Insurance Database (NHID)—are centralized. The Korean government has recently encouraged researchers to access the NHID, conduct research, and write papers to convey their findings. Expanded research using the NHID could shed light on the future of big data research. In this review, I would like to present an overview of current trends in obesity research using the NHID.

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Income-Related Disparities in Mortality Among Young Adults With Type 2 Diabetes
Ji Yoon Kim, Sojeong Park, Minae Park, Nam Hoon Kim, Sin Gon Kim
JAMA Network Open.2024; 7(11): e2443918. CrossRef

Original Article

Modifiable risk factors for coronary artery disease in the Indonesian population: a nested case-control study: Anggoro Budi Hartopo, Maria Patricia Inggriani, Brilliant Winona Jhundy, Jajah Fachiroh, Putri Tiara Rosha, Ratri Kusuma Wardani, Fatwa Sari Tetra Dewi; Cardiovasc Prev Pharmacother. 2023;5(1):24-34. Published online January 31, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e3

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Background
There is a lack of data on modifiable coronary artery disease (CAD) risk factors in the Indonesian population, hindering the implementation of assessments and prevention programs in this population. This study investigated modifiable risk factors for CAD among Indonesians by comparing them between CAD-proven patients and healthy subjects from a similar population.
Methods
In this nested, matched case-control study, the cases were patients from a referral hospital in Yogyakarta, Indonesia and the controls were respondents in a population surveillance system in Yogyakarta, Indonesia. The cases were 421 patients who had undergone coronary angiography, showing significant CAD. The sex- and age-matched controls were 842 respondents from the Universitas Gadjah Mada Health and Health and Demographic Surveillance System Sleman who indicated no CAD presence on a questionnaire. The modifiable CAD risk factors compared between cases and controls were diabetes mellitus, hypertension, central obesity, smoking history, physical inactivity, and less fruit and vegetable intake. A multivariate regression model was applied to determine independent modifiable risk factors for CAD, expressed as adjusted odds ratios (AORs).
Results
A multivariate analysis model of 1,263 subjects including all modifiable risk factors indicated that diabetes mellitus (AOR, 3.32; 95% confidence interval [CI], 2.09–5.28), hypertension (AOR, 2.52; 95% CI, 1.76–3.60), former smoking (AOR, 4.18; 95% CI, 2.73–6.39), physical inactivity (AOR, 15.91; 95% CI, 10.13–24.99), and less fruit and vegetable intake (AOR, 5.42; 95% CI, 2.84–10.34) independently and significantly emerged as risk factors for CAD.
Conclusions
Hypertension, diabetes mellitus, former smoking, physical inactivity, and less fruit and vegetable intake were independent and significant modifiable risk factors for CAD in the Indonesian population.

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Metabolic Syndrome and Abnormal Electrocardiographic Frontal QRS-T Angle in Indonesian Patients
Effika Nurningtyas Putri, Erika Maharani, Jajah Fachiroh, Fatwa Sari Tetra Dewi, Anggoro Budi Hartopo
CardioMetabolic Syndrome Journal.2025;[Epub] CrossRef

Review Articles

Adverse reactions to antiarrhythmic drugs: Ungjeong Do; Cardiovasc Prev Pharmacother. 2023;5(1):1-14. Published online January 16, 2023; DOI: https://doi.org/10.36011/cpp.2023.5.e1

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There are various types of adverse reactions to antiarrhythmic drugs (AADs). Proarrhythmia, which refers to an exacerbation of the preexisting arrhythmia or occurrence of a new arrhythmia, may occur under the therapeutic concentration of an AAD. Bradyarrhythmia is the most common type of proarrhythmia due to AADs, and prior myocardial infarction and old age are known risk factors. Atrial flutter with 1:1 atrioventricular conduction usually occurs during rhythm control of atrial fibrillation with class IC AADs. QT prolongation due to AADs, mainly class III AADs, elevates the risk of torsade de pointes by triggered activity due to early afterdepolarization. The addition of clinical factors that promote QT prolongation, such as hypokalemia, hypomagnesemia, female sex, and bradycardia, increases the risk of developing torsade de pointes. Proarrhythmic monomorphic ventricular tachycardia usually occurs as a result of slow conduction and disparity of refractoriness due to class IC AADs. In patients with preexisting left ventricular systolic dysfunction or structural heart disease, the risk of hypotension or cardiogenic shock caused by negative inotropic effects due to AADs should be considered. To prevent these major adverse reactions to AADs, we need to understand the electrophysiologic properties of AADs in detail. Furthermore, the risk of proarrhythmia could be heightened by interplay with clinical factors, such as electrolyte unbalances, heart rate, and hepatic/renal or myocardial dysfunction. Sufficient awareness about drug-drug interactions, which may affect the metabolism of AADs, will improve patient safety during the management of arrhythmia.

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Catheter ablation vs antiarrhythmic therapy for atrial fibrillation in heart failure with preserved ejection fraction
Marisa R. DeLuca, Bilal Ali, Yasir Tarabichi, Beni R. Verma, Saima Karim
Heart Rhythm.2024;[Epub] CrossRef

The effects and side effects of liraglutide as a treatment for obesity: Jeonghoon Ha, Jin Yu, Joonyub Lee, Hun-Sung Kim; Cardiovasc Prev Pharmacother. 2022;4(4):142-148. Published online October 20, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e18

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The incidence of obesity is increasing throughout the world, including Korea. Liraglutide, the main purpose of which is glucose control, has recently gained significant attention due to its additional effect on weight loss. Liraglutide injections have been widely used as an important treatment for obese patients in Korea. In addition to weight loss, liraglutide has various other effects, such as prevention of cardiovascular disease. Despite its excellent effect on weight loss, notable side effects, such as nausea and vomiting, have also been associated with liraglutide. Despite these side effects, liraglutide has not been discontinued due to its beneficial effects on weight loss. Nonetheless, there are reports wherein patients did not experience weight loss upon taking the drug. As such, there is a possibility of liraglutide misuse and abuse. Therefore, physicians need to have a broad understanding of liraglutide and understand the advantages and disadvantages of liraglutide prescription.

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Natural product-based treatment potential for type 2 diabetes mellitus and cardiovascular disease
Dharmsheel Shrivastav, Satyam Kumar Kumbhakar, Shivangi Srivastava, Desh Deepak Singh
World Journal of Diabetes.2024; 15(7): 1603. CrossRef

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