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The optimal duration and type of antiplatelet therapy after implantation of a drug-eluting stent (DES) remains uncertain. In this Review, Miyazaki et al. summarize the evidence on the duration of dual antiplatelet therapy and the risk of bleeding and adverse cardiac events after DES implantation, and describe the pitfalls of trial interpretation. Ongoing trials to test single antiplatelet therapy after DES implantation are also discussed.
Extracellular vesicles regulate the transfer of biological information, acting locally and remotely. Interest in extracellular vesicles, in particular exosomes, in the cardiovascular field emerged a decade ago, opening new research and therapeutic avenues. This Review summarizes current knowledge on the role of extracellular vesicles in coronary artery disease, and their emerging potential as biomarkers and therapeutic agents.
Innovations in noninvasive imaging have provided new insights in the pathophysiology and quantification of valvular heart disease. In this Review, Bax and Delgado discuss the novel imaging modalities used to assess the pathophysiology, dysfunction, and prognosis of aortic stenosis, mitral regurgitation, and aortic regurgitation.
Natural killer T (NKT) cells can be activated by both endogenous and exogenous lipid antigens. In this Review, Getz and Reardon provide an overview of NKT cells in the immune system, and propose mechanisms by which NKT cells can promote atherosclerosis.
In this Review, the authors discuss the pathological mechanisms involved in thoracic aortic aneurysms (TAAs), including extracellular matrix homeostasis, transforming growth factor-β signalling, and vascular smooth muscle cell contractility. The understanding of TAA genetics might not only help to characterize the aetiology of more complex forms of this disease, but can also lead to the development of new therapeutic strategies and patient management.
Left ventricular hypertrabeculation or noncompaction is a myocardial abnormality frequently associated with monogenic disorders, particularly neuromuscular disorders, or with chromosomal defects. The pathogenesis of this cardiomyopathy remains unknown, and the diagnostic criteria, prognosis, and optimal treatment are under debate. In this Review, Finsterer et al. provide an update on the aetiology, pathophysiology, diagnosis, treatment, and prognosis of left ventricular hypertrabeculation.
