New pharmacological agents and novel cardiovascular pharmacotherapy strategies in 2022

Author:

Tamargo Juan1ORCID,Agewall Stefan2,Borghi Claudio3ORCID,Ceconi Claudio4,Cerbai Elisabetta5ORCID,Dan Gheorghe A6,Ferdinandy Péter78,Grove Erik Lerkevang910,Rocca Bianca11,Sulzgruber Patrick12ORCID,Semb Anne Grete13,Sossalla Samuel14,Niessner Alexander15,Kaski Juan Carlos16ORCID,Dobrev Dobromir171819ORCID

Affiliation:

1. Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón , Plaza de Ramón y Cajal s/n, Madrid 28040 , Spain

2. Department of Cardiology, Oslo University Hospital and Institute of Clinical Medicine, Oslo University , Oslo , Norvay

3. Department of Cardiovascular Medicine, University of Bologna-IRCCS AOU S. Orsola , Bologna , Italy

4. Unit of Cardiologia, ASST Garda , Desenzano del Garda , Italy

5. Department Neurofarba, Section of Pharmacology and Toxicology, University of Florence , Florence, Italy

6. “Carol Davila” University of Medicine, Colentina University Hospital , Bucharest , Romania

7. Department of Pharmacology and Pharmacotherapy, Semmelweis University , Budapest , Hungary

8. Pharmahungary Group , Szeged , Hungary

9. Department of Cardiology, Aarhus University Hospital , Aarhus , Denmark

10. Department of Clinical Medicine, Faculty of Health, Aarhus University , Aarhus , Denmark

11. Section of Pharmacology, Catholic University School of Medicine , Rome , Italy

12. Department of Medicine, Division of Cardiology, Medical University of Vienna , Vienna, Austria

13. Preventive Cario-Rheuma Clinic, Division of Research and Innovation, REMEDY Centre, Diakonhjemmet Hospital , Oslo , Norway

14. Department of Internal Medicine II, University Regensburg , Regensburg, Germany

15. Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna , Vienna, Austria

16. Molecular and Clinical Sciences Research Institute, St. George's, University of London , Cranmer Terrace, London SW17 0RE , UK

17. Institute of Pharmacology, West-German Heart and Vascular Centre, University Duisburg-Essen , Essen , Germany

18. Department of Medicine, Montreal Heart Institute and Université de Montréal , Montréal , Canada

19. Department of Molecular Physiology & Biophysics, Baylor College of Medicine , Houston, TX , USA

Abstract

Abstract Cardiovascular diseases (CVD) remain the leading cause of death worldwide, and pharmacotherapy of most of them is suboptimal. Thus, there is a clear unmet clinical need to develop new pharmacological strategies with greater efficacy and better safety profiles. In this review, we summarize the most relevant advances in cardiovascular pharmacology in 2022, including the approval of first-in-class drugs that open new avenues for the treatment of obstructive hypertrophic cardiomyopathy (mavacamten), type 2 diabetes mellitus (tirzepatide), and heart failure (HF) independent of left ventricular ejection fraction (sodium-glucose cotransporter 2 inhibitors). We also dealt with fixed dose combination therapies repurposing different formulations of ‘old’ drugs with well-known efficacy and safety for the treatment of patients with acute decompensated HF (acetazolamide plus loop diuretics), atherosclerotic cardiovascular disease (moderate-dose statin plus ezetimibe), Marfan syndrome (angiotensin receptor blockers plus β-blockers), and secondary cardiovascular prevention (i.e. low-dose aspirin, ramipril, and atorvastatin), thereby filling existing gaps in knowledge and opening new avenues for the treatment of CVD. Clinical trials confirming the role of dapagliflozin in patients with HF and mildly reduced or preserved ejection fraction, long-term evolocumab to reduce the risk of cardiovascular events, vitamin K antagonists for stroke prevention in patients with rheumatic heart disease-associated atrial fibrillation, antibiotic prophylaxis in patients at high risk for infective endocarditis before invasive dental procedures, and vutrisiran for the treatment of hereditary transthyretin-related amyloidosis with polyneuropathy were also reviewed. Finally, we briefly discuss recent clinical trials suggesting that FXIa inhibitors may have the potential to uncouple thrombosis from haemostasis and attenuate/prevent thromboembolic events with minimal disruption of haemostasis.

Funder

Comunidad de Madrid

National Research, Development and Innovation Office of Hungary

National Heart Laboratory

EU

COST

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Cardiology and Cardiovascular Medicine

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