Skip Navigation
Skip to contents

CPP : Cardiovascular Prevention and Pharmacotherapy

Sumissioin : submit your manuscript
SEARCH
Search

Most view

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

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

Special Article
Update on the Pharmacotherapy of Heart Failure with Reduced Ejection Fraction
Eui-Soon Kim, Jong-Chan Youn, Sang Hong Baek
Cardiovasc Prev Pharmacother. 2020;2(4):113-133.   Published online October 31, 2020
DOI: https://doi.org/10.36011/cpp.2020.2.e17
  • 1,673 View
  • 12 Download
  • 7 Citations
Abstract PDF
Heart failure (HF) is an important cardiovascular disease because of the increasing prevalence, high morbidity and mortality, and rapid expansion of health care costs. Over the past decades, efforts have been made to modify the prognosis of patients with HF. Regarding HF with reduced ejection fraction (HFrEF), several drugs have shown to improve mortality and morbidity, based on large-scale randomized controlled trials, leading to a critical paradigm shift in its pharmacological treatment. The paradigm of HFrEF pathophysiology has shifted from cardiorenal disease to hemodynamic changes, and neurohormonal activation is currently considered the prime pathophysiological mechanism of HFrEF. This review summarizes evidence on the pharmacological management of HFrEF derived from major randomized controlled trials, which have accomplished improvements in survival benefits.
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
  • 1,170 View
  • 83 Download
Abstract PDF
Statins are one of the most widely used drugs worldwide as first-line drugs for the treatment of hyperlipidemia and the prevention and treatment of cardiovascular diseases. Most of the side effects of statins are known to be mild, and mainly hepatotoxicity and various muscle symptoms are known. Recently, there have been studies on concerns about an increase in the incidence of diabetes after using statins, but it was found that the benefits sufficiently outweigh the risk of side effects. Therefore, the use of statins in the appropriate group should be actively performed, and it seems that the side effects can be prevented through close physical observation and appropriate examination.
Polygenic risk score: a useful clinical instrument for disease prediction and risk categorization
Jae-Seung Yun
Cardiovasc Prev Pharmacother. 2022;4(1):13-17.   Published online January 21, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e7
  • 824 View
  • 52 Download
Abstract PDF
Genetic information is one of the essential components of precision medicine. Over the past decade, substantial progress has been made, such as low-cost, high-throughput genotyping arrays, advances in statistical techniques, and progressively larger discovery datasets, enabling the discovery of alleles contributing to common diseases, such as coronary artery disease and type 2 diabetes. The polygenic risk score (PRS) represents the aggregate contribution of numerous common genetic variants, individually conferring small to moderate effects, and can be used as a marker of genetic risk for major chronic diseases. PRSs can be obtained from early childhood, and only one measurement is needed to determine the score. PRSs can potentially be used for triage of further investigations to confirm disease susceptibility and to optimize individualized preventive strategies for high-risk disease groups. We provide an overview and commentary on important advances in deriving and validating PRSs, as well as the implementation of PRSs for clinically useful purposes.
Original Article
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
  • 852 View
  • 20 Download
Abstract PDFSupplementary 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.
Review Article
Anti-inflammatory effects of colchicine on coronary artery disease
Hun-Jun Park
Cardiovasc Prev Pharmacother. 2022;4(1):7-12.   Published online January 20, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e5
  • 712 View
  • 37 Download
Abstract PDF
Inflammation plays a crucial role in the pathophysiology of coronary artery disease (CAD). Several types of sterile inflammation are mediated through the nucleotide-binding oligomerization domain-like receptor pyrin domain containing 3 (NLRP3) inflammasome. Colchicine has recently been shown to effectively block NLRP3 inflammasome assembly in addition to several other actions on inflammatory cells. Recent evidence also points to favorable effects of colchicine in patients with CAD, including lower levels of inflammatory markers, coronary plaque stabilization, and more favorable cardiac recovery after injury. This review focuses on the role of colchicine in the process of atherosclerosis and discusses its potential as a therapeutic option for the prevention and treatment of CAD.
Special Article
Effects of Low-Carbohydrate, High-Fat Diets on Weight Loss, Cardiovascular Health and Mortality
Bo-Yeon Kim
Cardiovasc Prev Pharmacother. 2020;2(2):43-49.   Published online April 30, 2020
DOI: https://doi.org/10.36011/cpp.2020.2.e7
  • 665 View
  • 10 Download
  • 1 Citations
Abstract PDF
Obesity is a worldwide health challenge. The clinical consequences of obesity include nonalcoholic fatty liver disease, type 2 diabetes, and coronary heart disease. Numerous diets have been developed to reduce the incidence of cardiovascular diseases and induce weight loss. Low-carbohydrate, high-fat diets (LCHFDs) have become increasingly popular for weight loss. LCHFDs have led to weight loss in some clinical studies. However, the safety of LCHFDs and their long-term effects on the human body are still controversial. In this review, I will discuss the effects of LCHFDs on weight loss, cardiovascular health, and mortality.
Review Articles
Body Weight Change and Cardiovascular Disease: Effect of Weight Gain, Weight Loss, and Weight Cycling
Jung-Hwan Cho, Eun-Jung Rhee, Won-Young Lee
Cardiovasc Prev Pharmacother. 2021;3(4):73-81.   Published online October 31, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e12
  • 1,004 View
  • 43 Download
Abstract PDF
Obesity is an independent risk factor for the development and progression of cardiovascular disease (CVD). Various cardiovascular outcomes are related to the association between body weight change and CVD. Metabolically healthy obese individuals could have a better prognosis in terms of cardiovascular morbidity and mortality than metabolically unhealthy obese individuals. Smoking cessation causes significant weight gain and consequent deterioration of the metabolic profile despite not impairing the cardiovascular benefits. Intentional weight loss has a consistent cardiovascular protective effect, but unintentional weight loss due to progressive catabolism and loss of muscle mass could be associated with poor cardiovascular outcomes. Obese individuals who are successful in losing weight with subsequent regain (weight cycling) could have an unfavorable cardiometabolic profile and the risk of CVD. Further studies are needed to evaluate the impact of weight changes on CVD by identifying unknown pathophysiology and to decide appropriate management and interventions for various phenotypes of weight change.
Antiplatelet Therapy for Secondary Stroke Prevention in Patients with Ischemic Stroke or Transient Ischemic Attack
Kyung-Yul Lee
Cardiovasc Prev Pharmacother. 2021;3(4):86-94.   Published online October 31, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e10
  • 783 View
  • 22 Download
Abstract PDF
The risk of stroke recurrence is highest in the acute phase after transient ischemic attack (TIA) or ischemic stroke. Therefore, patients with TIA or ischemic stroke should be treated with antiplatelet medication for stroke prevention. The short-term use of dual antiplatelet therapy between 21 and 90 days may be considered in those with acute minor stroke or TIA and highrisk of recurrence. However, the long-term use of dual antiplatelet therapy is not recommended due to the risk of bleeding. The current stroke guideline does not specify the administration of an antiplatelet for the secondary prevention of ischemic stroke. However, as clinical studies progress, antiplatelet therapy may become a personalized treatment in the future.
Special Articles
Geriatric Considerations in the Management of Elderly Patients with Cardiovascular Diseases
Doo Soo Jeon
Cardiovasc Prev Pharmacother. 2021;3(2):38-46.   Published online April 30, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e6
  • 617 View
  • 13 Download
  • 1 Citations
Abstract PDF
Cardiovascular disease (CVD) is the most frequently diagnosed disease as well as the leading cause of death in the elderly. It usually results from long-term effects of cardiovascular risk factors as well as the aging process itself. Elderly people commonly have geriatric syndrome, which is an age-specific problem that is complicated by the presence of cardiovascular, cognitive, and physical dysfunction and is accompanied by many other chronic diseases. While caring for the elderly, in addition to CVD, various inherent problems must be considered. The patient-centered approach, instead of evidence-based guidelines that are designed for young adult patients, is the most important concept when it comes to elderly patients with CVD and multiple comorbidities. This approach should be used to maintain the functionality, independence, quality of life, and dignity of these patients.
Tafamidis for Cardiac Transthyretin Amyloidosis
Darae Kim, Jin-Oh Choi, Eun-Seok Jeon
Cardiovasc Prev Pharmacother. 2021;3(1):1-9.   Published online January 31, 2021
DOI: https://doi.org/10.36011/cpp.2021.3.e1
  • 544 View
  • 11 Download
  • 1 Citations
Abstract PDF
Transthyretin amyloid (ATTR) cardiomyopathy is a progressive disease caused by the infiltration of ATTR fibrils in the myocardium. Although it is a rare disease, ATTR cardiomyopathy is an important cause of heart failure with preserved ejection fraction, and its incidence is increasing due to improved diagnostic imaging tools. There has been a breakthrough in the field of transthyretin amyloidosis, which opens a new therapeutic door for the patients. In this review, an overview of tafamidis therapy in ATTR cardiomyopathy with recent results from clinical trials will be discussed.
Review Article
Dose Selection of Non-Vitamin K Antagonist Oral Anticoagulants in Korean Patients with Non-Valvular Atrial Fibrillation
So-Ryoung Lee, Young Keun On
Cardiovasc Prev Pharmacother. 2020;2(1):1-10.   Published online January 31, 2020
DOI: https://doi.org/10.36011/cpp.2020.2.e5
  • 512 View
  • 13 Download
Abstract PDF
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. In the Asian population, patients with AF have been shown to have increased risks of ischemic stroke and all-cause death compared to patients without AF by 3.34- and 2.61-fold, respectively. AF guidelines recommend oral anticoagulation (OAC) therapy in AF patients with a CHA2DS2-VASc score of ≥1 for men and ≥2 for women with non-valvular AF. After the introduction of non-vitamin K antagonist oral anticoagulants (NOACs) as a treatment for AF, their use has become widespread. Compared to warfarin, NOACs showed comparable efficacy for the prevention of thromboembolic events and superior safety in terms of bleeding complications, especially intracranial hemorrhage. Physicians should keep in mind considerations for optimal OAC therapy to achieve the best outcome. Furthermore, appropriate dose selection in order to achieve the best clinical outcome is an important issue in clinical practice. All NOACs do not have the same rules for dose reduction, and dose reduction of NOACs is primarily recommended according to the dose reduction criteria investigated in pivotal randomized control trials. In this review, we focus on the optimal dose of NOAC and summarize current guidelines and evidence for appropriate dosing of NOACs.
Special Article
Competing Risk Model in Survival Analysis
Yena Jeon, Won Kee Lee
Cardiovasc Prev Pharmacother. 2020;2(3):77-84.   Published online July 31, 2020
DOI: https://doi.org/10.36011/cpp.2020.2.e11
  • 515 View
  • 22 Download
Abstract PDF
Survival analysis is primarily used to identify the time-to-event for events of interest. However, there subjects may undergo several outcomes; competing risks occur when other events may affect the incidence rate of the event of interest. In the presence of competing risks, traditional survival analysis such as the Kaplan-Meier method or the Cox proportional hazard regression introduces biases into the estimation of survival probability. In this review, we discuss several methods that can be used to consider competing risks in survival analysis: the cumulative incidence function, the cause-specific hazard function, and Fine and Gray's Subdistribution hazard function. We also provide a guide for conducting competing risk analysis using SAS with the bone marrow transplantation dataset presented by Klein and Moeschberger (1997).
Original Articles
Association between reproductive aging and hypertension among Korean women
Eunji Kim, Youngrong Lee, Hyeon Chang Kim
Cardiovasc Prev Pharmacother. 2022;4(1):34-41.   Published online January 19, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e2
  • 589 View
  • 17 Download
Abstract PDFSupplementary Material
Background
Although postmenopausal women are well known to have a high prevalence of hypertension, it is unclear whether menopause itself increases blood pressure independently from the known risk factors of hypertension. This study sought to determine whether an association exists between reproductive aging, analyzed as a gradual transition, and an increased risk of hypertension among Korean women.
Methods
This cross-sectional study used baseline data from 5,456 women aged 30 to 64 years who participated in the Cardiovascular and Metabolic Diseases Etiology Research Center study in Korea from 2013 to 2018. The participants’ stage of reproductive aging was assessed by a questionnaire and categorized as premenopause, perimenopause, and postmenopause. Multiple logistic regression models were used to analyze the association between menopausal status and hypertension after adjusting for age, education level, marital status, employment, household income, smoking, drinking, physical activity, body mass index, and hormone replacement therapy use.
Results
The prevalence of hypertension increased with reproductive aging: 9.8% in premenopause, 25.2% in perimenopause, and 27.7% in postmenopause. The adjusted odds ratio (95% confidence interval) for having hypertension was 1.70 (1.07–2.72) for perimenopausal women and 1.14 (0.88–1.48) for postmenopausal women, compared to premenopausal women.
Conclusions
Our study shows that perimenopausal women are at high risk of developing hypertension. Since the menopausal transition may last months or years, blood pressure monitoring and early interventions are crucial for not only postmenopausal women, but also those in the transition.
Safety and efficacy of low-dose aspirin in patients with coronary artery spasm: long-term clinical follow-up
Byoung Geol Choi, Kyung-Hee Kim, Seung-Woon Rha
Cardiovasc Prev Pharmacother. 2022;4(1):26-33.   Published online January 21, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e6
  • 673 View
  • 24 Download
Abstract PDF
Background
Aspirin is known to aggravate coronary artery spasm (CAS) regardless of the dose (100–325 mg/day). However, it is unclear whether low-dose aspirin (LDA; 100 mg) has deleterious impacts on the clinical course of CAS patients in the long-term. Thus, we investigated the impact of LDA on the long-term clinical outcomes of CAS patients.
Methods
A total of 5,697 consecutive patients without significant coronary artery disease who underwent an acetylcholine provocation test from November 2004 to May 2015 were enrolled. Of these patients, 3,072 CAS patients were enrolled in the study and divided into two groups based on whether they took LDA: the LDA group (n=338) and the non-LDA group (n=2,734). All CAS patients were prescribed anti-anginal medication as appropriate. To adjust for any potential confounders that could cause bias, a propensity score matching analysis was performed using a logistic regression model.
Results
After propensity score matching, two propensity-matched groups (524 pairs, 1,048 patients, C-statistic=0.827) were generated, and the baseline characteristics of the two groups were balanced. The two groups were showed no significant differences in any follow-up events, such as major adverse cardiac events and recurrent angina.
Conclusions
The main finding of the present study is that the use of LDA did not affect cardiovascular events up to 5 years in CAS patients. Therefore, the prescription of LDA in these patients should be individualized considering their clinical status.
Indirect comparison of nonvitamin K oral anticoagulants and left atrial appendage occlusion
Sung-Hwan Kim, So-Yoon Park, Seung-Sik Hwang
Cardiovasc Prev Pharmacother. 2022;4(1):18-25.   Published online January 18, 2022
DOI: https://doi.org/10.36011/cpp.2022.4.e1
  • 644 View
  • 22 Download
Abstract PDFSupplementary Material
Background
Anticoagulation is important in atrial fibrillation (AF) patients to reduce the occurrence of thrombotic events. We evaluated the efficacy and safety of percutaneous left atrial appendage occlusion (LAAO) as an alternative to systemic anticoagulation through an indirect comparative analysis.
Methods
An indirect comparative analysis of nonvitamin K oral anticoagulants (NOACs) and LAAO was conducted. Comparisons were made using data from four landmark randomized clinical trials (RE-LY, ROCKET-AF, ARISTOTLE, and PROTECT AF). Using warfarin as the common comparator, an indirect comparison was performed using data from each trial, and the relative risk was calculated between NOACs and LAAO.
Results
NOACs and LAAO showed similar results for the reduction of stroke and systemic embolism, with a non-statistically significant trend favoring NOACs (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.37–1.46 for dabigatran; HR, 0.99; 95% CI, 0.50–1.92 for rivaroxaban; HR, 0.89; 95% CI, 0.45–1.74 for apixaban). Significantly fewer major bleeding and procedure-related complications were found in patients treated with apixaban compared with LAAO (HR, 0.45; 95% CI, 0.26–0.75). Cardiovascular death occurred more frequently in patients administered NOACs than in patients with LAAO (HR, 2.28; 95% CI, 1.03–5.10 for dabigatran; HR, 2.41; 95% CI, 1.09–5.42 for rivaroxaban; HR, 2.40; 95% CI, 1.10–5.36 for apixaban).
Conclusions
The rate of all-cause death was similar between NOACs and LAAO. Compared with LAAO, NOACs led to a nonsignificant numerical decrease in stroke and embolism in AF patients. Significantly fewer safety events occurred in patients treated with apixaban. LAAO significantly reduced cardiovascular death.

CPP : Cardiovascular Prevention and Pharmacotherapy