Publications by authors named "Hessam Kakavand"

3 Publications

  • Page 1 of 1

Pharmacologic Prevention of Myocardial Ischemia-Reperfusion Injury in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.

J Cardiovasc Pharmacol 2021 Jan 4;Publish Ahead of Print. Epub 2021 Jan 4.

Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran University of Pittsburgh School of Pharmacy, UPMC Presbyterian Hospital, Pittsburg, PA, US Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Abstract: Establishing efficient perfusion into the myocardium is the main purpose in patients with acute coronary syndrome, but the process of reperfusion is not without risk and can damage the myocardium paradoxically. Unfortunately, there is no effective treatment for reperfusion injury, and efforts to find an efficient preventive approach are still ongoing. In the last 3 decades, there have been many successful animal studies on how to prevent reperfusion injury; nonetheless, translation to the clinical setting has almost always proven disappointing. In this article, we review clinical studies on the prevention of reperfusion injury in patients with acute coronary syndrome undergoing primary percutaneous coronary intervention in a pharmacologic-based approach. We categorize all the agents which are evaluated for the prevention of myocardial reperfusion injury based on their mechanisms of action into five groups: drugs that can reduce oxidative stress, drugs that can affect cellular metabolism, rheological agents that target microvascular obstruction, anti-inflammatory agents, and agents with mixed mechanisms of action. Then, review all the clinical studies of these agents in the setting of primary percutaneous coronary intervention. Finally, we will discuss the possible reasons for the failure in translation of studies into practice and propose potential solutions to overcome this problem.
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http://dx.doi.org/10.1097/FJC.0000000000000980DOI Listing
January 2021

Cardiovascular Complications of COVID-19: Pharmacotherapy Perspective.

Cardiovasc Drugs Ther 2020 Jul 15. Epub 2020 Jul 15.

Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.

Coronavirus disease of 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly the world over. The disease was declared "pandemic" by the World Health Organization. An approved therapy for patients with COVID-19 has yet to emerge; however, there are some medications used in the treatment of SARS-CoV-2 infection globally including hydroxychloroquine, remdesivir, dexamethasone, protease inhibitors, and anti-inflammatory agents. Patients with underlying cardiovascular disease are at increased risk of mortality and morbidity from COVID-19. Moreover, patients with chronic stable states and even otherwise healthy individuals might sustain acute cardiovascular problems due to COVID-19 infection. This article seeks to review the latest evidence with a view to explaining possible pharmacotherapies for the cardiovascular complications of COVID-19 including acute coronary syndrome, heart failure, myocarditis, arrhythmias, and venous thromboembolism, as well as possible interactions between these medications and those currently administered (or under evaluation) in the treatment of COVID-19.
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http://dx.doi.org/10.1007/s10557-020-07037-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360896PMC
July 2020

Cardiovascular Considerations in Treating Patients With Coronavirus Disease 2019 (COVID-19).

J Cardiovasc Pharmacol 2020 05;75(5):359-367

Division of Cardiology, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA.

A novel betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly across the globe since December 2019. Coronavirus disease 2019 (COVID-19) has a significantly higher mortality rate than seasonal influenza and has disproportionately affected older adults, especially those with cardiovascular disease and related risk factors. Adverse cardiovascular sequelae, such as myocarditis, acute myocardial infarction, and heart failure, have been reported in patients with COVID-19. No established treatment is currently available; however, several therapies, including remdesivir, hydroxychloroquine and chloroquine, and interleukin (IL)-6 inhibitors, are being used off-label and evaluated in ongoing clinical trials. Considering these therapies are not familiar to cardiovascular clinicians managing these patients, this review describes the pharmacology of these therapies in the context of their use in patients with cardiovascular-related conditions.
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http://dx.doi.org/10.1097/FJC.0000000000000836DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219860PMC
May 2020