Prostate cancer is recognized as one of the most common cancers affecting the male population. The prostate is revealed to be a hormone-dependent tissue as testosterone and dihydrotestosterone could bind to the androgen receptor, activate it, and initiate the nuclear translocation of this receptor which is followed by subsequent signaling cascades. Regarding this androgen dependency of the prostate, it is believed that androgen deprivation therapies are able to confront aggressive prostate cancer as first-line treatment. However, prostate cancer could overcome hormone deprivation strategies through a number of cellular mechanisms, such as intratumoral androgen production and the production of ligand-independent androgen receptor splice variants, which are known clinically as castration-resistant prostate cancer. Due to the limited efficacy of first-generation antiandrogens in complete blockage of androgen receptor activity, recently, four second-generation anti-androgens, including abiraterone acetate, enzalutamide, apalutamide, and darolutamide approved by the Food and Drug Administration, and considered standard of care for patients with advanced prostate cancer. Nevertheless, prostate cancer cells may acquire drug-resistance mechanisms to overcome these novel chemotherapeutics. Furthermore, potential adverse effects on nontargeted organs such as the cardiovascular system, are possible. Hence, the current study aimed to review the efficacy and cardio-safety of these novel therapeutical strategies.
Objectives: Numerous recent studies have emphasized the role of kidney failure in developing ischemic heart disease (IHD) and the resulting adverse consequences. The purpose of the present study was to quantitatively assess the effect of kidney failure based on glomerular filtration rate (GFR) in predicting clinical outcomes in patients with unstable angina (U/A). Methods: This retrospective cohort study included 129 patients with unstable angina with preserved left ventricular function. Serum creatinine levels were specified at the beginning of their admission. The GFR at admission time was determined based on the MDRD index. Based on the GFR value, patients were classified into two groups, i.e., normal GFR (>60) and decreased GFR (<60). Results: The frequency of one-month mortality in <60 GFR and >60 GFR was 3.2% and 0.0%, respectively. Furthermore, the prevalence of 6-month mortality in <60 GFR and >60 GFR was 8.1% and 0.0%, respectively. The frequency of readmission in <60 GFR and >60 GFR was 29% and 11%, respectively. Likewise, the frequency of revascularization through coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) in <60 GFR and >60 GFR was 25.8% and 8.9%, respectively. According to the multivariate logistic regression model, <60 GFR increased the risk of 6-month mortality up to 0.2 times (probability ratio of 2.081, P-value of 0.023). Regarding readmission, <60 GFR increased the need for readmission up to 2.4 times (probability ratio of 2.433, P-value of 0.049). On the other hand, the risk of CABG or PCI recurrence following initial intervention was 2.8 times higher in patients with <60 GFR than in the >60 GFR group (probability ratio 2.882, p-value .03. Conclusions: The study revealed that <60 GFR compared to higher values of GFR is associated with an increased risk of 6-month mortality, increased readmission, and increased revascularization in patients with unstable angina.
Cardiovascular diseases (CVDs) are considered the most common disorder and the leading cause of mortality globally. The etiology of CVDs depends on a variety of genetic and acquired parameters. Nowadays, a dramatic surge appeared in published reports to find the association between microRNAs (miRNAs) and CVDs in order to understand the cause of the disease, rapid diagnosis with the introduction of valid biomarkers, and target as a therapeutic approach. Apigenin is a novel nutraceutical flavonoid that cardioprotective properties are suggested. The current review aimed to evaluate the beneficial features of this phytochemical against CVDs with an emphasis on its ability to regulate the miRNAs. The findings demonstrated that Apigenin could regulate cardiac miRNAs, including miR-103, miR-122-5p, miR-15b, miR-155, and miR-33. Consequently, preventing CVDs is possible through different effects such as the promotion of cholesterol efflux, prevention of hyperlipidemia, alteration in ATP Binding Cassette Subfamily A Member 1 (ABCA1) levels, reducing of cardiocytes apoptosis, and retarding myocytes fibrosis. Also, it can regulate signaling pathways, protect against endothelial dysfunction, maintain oxidative balance, and decrease inflammatory factors and reactive oxygen species. Hence, apigenin regulatory characteristics affecting miRNAs expression could introduce this flavonoid as a novel cardioprotective phytochemical against different CVDs.
Objectives: Takotsubo cardiomyopathy (TCM) is a transient left ventricular wall motion abnormality commonly following physical and emotional stress that can be resolved entirely. Recent case reports and some case-control studies have suggested a likely close association between thyrotoxicosis and TCM. It was shown that resolving thyroid functional status led to resolving TCM symptoms leading to normal cardiac function without a significant sequela, emphasizing a triggering role of thyrotoxicosis for flaring TCM. Here, the literature on the association between thyroid dysfunction and the likelihood of TCM is reviewed to describe the likely pathophysiology of TCM associated with thyroid dysfunction.
Traumatic aortic dissection is most commonly caused following sudden deceleration injury. It most commonly involves descending thoracic aorta (DTA) and is associated with high mortality and morbidity if not treated urgently. Confirmation of diagnosis often requires contrast-enhanced computed tomography (CECT) or magnetic resonance imaging (MRI), which is time consuming, expensive, and often not available at many health-care facility. Transesophageal echocardiography (TEE) is equally efficient to CECT and MRI in diagnosing aortic dissection. It may also provide additional information that can be very useful for the management of the patient. In some cases, the likelihood of error in the diagnosis of such a critical condition with normal cardiovascular variations is expected. Herein, we describe a case with primary diagnosis of aortic dissection that led to final diagnosis of an aortic shelf that medically managed with a good long-term prognosis. In patients suspected to aortic dissection due to any cause, the specialized evaluation using the most accurate and sensitive tools is strongly recommended to discriminate normal vascular variations from major vascular defects requiring emergent surgical interventions.
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