A recent study demonstrated that for patients at risk of renal injury undergoing coronary angiography for acute coronary syndromes (ACS), a short (5-day) regimen of once-daily inorganic nitrate resulted in decreased contrast-induced nephropathy (CIN), enhanced kidney outcomes at 3 months, and reduced major adverse cardiovascular events (MACE) at 1 year when compared with individuals who received a placebo. This study’s results were published in the European Heart Journal.

The NITRATE-CIN trial was a double-blind, randomized, placebo-controlled trial that included a total of 640 patients. These patients were randomized to receive either once daily potassium nitrate (n= 319; 12 mmol) or placebo (n= 321; potassium chloride) capsules for a period of 5 days. The primary endpoint of the trial was the incidence of CIN based on KDIGO criteria. Secondary outcomes measured included kidney function (eGFR) at 3 months, rates of procedural myocardial infarction, and MACE at 12 months.

Inorganic nitrate treatment led to a significant decrease in the rates of CIN compared to the placebo (9.1% vs 30.5%). This difference remained even after adjusting for baseline creatinine levels and diabetes status. Additionally, the use of inorganic nitrate exhibited positive outcomes in secondary outcomes, including a lower incidence of procedural myocardial infarction (2.7% vs 12.5%), improved renal function at 3 months (between-group change in estimated glomerular filtration rate of 5.17), and a reduced occurrence of MACE at 1 year (9.1% vs. 18.1%) compared to the placebo group.

Thus, it can be concluded that a 5-day regimen of once-daily inorganic nitrate may be beneficial for patients undergoing coronary angiography for ACS. This treatment resulted in a decrease in CIN, improved kidney outcomes at 3 months, and reduced MACE at 1 year compared to those who received a placebo.

A recent study demonstrated that the complete correction of post-transplant anemia in kidney transplant recipients resulted in improved cardiac indexes and quality of life, with no impact on cardiovascular comorbidity. The findings of the study were published in the journal, Experimental and Clinical Transplantation.

Two hundred forty-seven kidney recipients with stable graft function were enrolled in this study to evaluate anemia. Patients were randomly assigned to two groups: Group 1 (n = 183) aimed for a hemoglobin level of 11 to 12 g/dL, while Group 2 (n = 64) targeted a level of 13 to 15 g/dL using erythropoietin-stimulating agents. Monthly clinical and laboratory assessments of kidney graft function were conducted, along with evaluations of quality of life and echocardiography at baseline and twelve months.

Pretransplant characteristics were similar in both groups. Comparable posttransplant complications (P value > .05) but superior graft function at six months and improved cardiac indexes at one year of the study (P value < .05) were observed in Group 2. The quality of life showed improvement at the twelve-month mark following complete correction of post-transplant anemia in kidney transplant recipients treated with erythropoietin-stimulating agents.

Therefore, the complete correction of post-transplant anemia in kidney transplant recipients led to enhanced cardiac indexes and quality of life without an impact on cardiovascular comorbidity.

A recent study found that initial oral treprostinil improved survival while those who started treprostinil after a clinical worsening in the placebo group and tolerated the drug for up to 48 weeks, enjoyed substantial functional gains. This study was published in the journal, Advances in Therapy.

This trial was an open-label extension (OLE) of the FREEDOM-EV study which enrolled 470 patients who had experienced an investigator-assessed clinical worsening event. All OLE participants were kept on open-label oral treprostinil. Those participants who had previously been assigned to placebo or previously assigned treprostinil, continued with the dose titration. Assessments included measured N-terminal pro-brain natriuretic peptide (NT-proBNP) at week 48, functional class, and 6-min walk distance (6MWD) at 12-week intervals. Survival was studied using the Kaplan-Meier analysis while hazard ratio (HR) was measured using Cox proportional hazards.

At the end of the study, it was seen that initial administration of oral treprostinil reduced mortality. Those who were randomized to the placebo group and initiated on oral treprostinil after clinical worsening, showed a reduction in NT-proBNP of - 778 pg/mL, functional class shifts, and 6MWD improvements of + 84 m when compared to the OLE baseline. Modest trends were observed in those participants who were initially assigned placebo and did not show clinical worsening and also those participants who were on the study drug without clinical worsening but continued with the drug through week 48.

Based on the above results, it can be concluded that with initial treprostinil, improved survival in the entire data set may be observed while those participants in the placebo arm, who were kept on treprostinil after a clinical worsening and tolerated the drug at week 48, may exhibit substantial functional gains.

According to a recent study, the pulmonary hypertension (pH) due to left heart disease (LHD) noninvasive nomogram demonstrates exceptional diagnostic value and clinical applicability, enabling a more precise assessment of the risk of pH in individuals with LHD. This study’s results were published in the journal, Heart & Lung.

In this study, a total of 361 patients with left heart disease (LHD) who had undergone right heart catheterization were enrolled. These patients were then randomly divided into two groups: a training cohort consisting of 253 patients (70%) and a validation cohort consisting of 108 patients (30%). The presence of pH was determined by a resting mean pulmonary arterial pressure (mPAP) of ≥25 mmHg, as measured through the right heart catheterization (RHC) examination. To analyze the data, the Lasso regression model was used for dimension reduction and feature selection. Subsequently, a nomogram was constructed based on multivariable logistic regression analysis.

175 individuals with left heart disease were diagnosed with pulmonary hypertension during their hospitalization, accounting for 48.5% of the sample cohort. Factors such as elevated New York Heart Association functional class, excessive resting heart rate, increased red blood cell distribution width, pulmonary artery systolic pressure, and right ventricular end-diastolic diameter assessed via echocardiography were independently linked to the prevalence of pH-LHD. The incorporation of these 5 variables in the nomogram demonstrated optimal calibration (Hosmer-Lemeshow test, P = 0.791) and strong discrimination (AUC = 0.866 [95% CI, 0.820-0.911]) for the validation set.

The above study demonstrated that the noninvasive nomogram for pH-LHD exhibits excellent diagnostic efficacy and clinical applicability, facilitating a more accurate evaluation of the pH risk in individuals with LHD.