Browsing by Autor "J. Ruiz"

Filter results by typing the first few letters
Now showing 1 - 2 of 2
  • Thumbnail Image
    Item type: Item ,
    Abstract 4339564: Evidence shows comparable efficacy of dual therapy with ticagrelor and aspirin versus monotherapy in peripheral arterial disease: A systematic review and meta-analysis of 1,702 patients
    (Lippincott Williams & Wilkins, 2025) Claudia Martinez‐Tapia; Luis E. Cueva; Karoly Pamela Zuñiga Montaño; J. Ruiz
    Peripheral artery disease (PAD) increases the risk of cardiovascular events, such as stroke and myocardial infarction. Antiplatelet therapy, particularly aspirin, has been essential in the management of PAD, although its effectiveness may be limited in high-risk patients. Recently, ticagrelor, a P2Y12 receptor inhibitor, has been shown to be an effective alternative or adjunctive treatment to aspirin. However, the optimal therapeutic strategy for PAD remains unclear, especially when comparing dual therapy with ticagrelor plus aspirin with monotherapy with either antiplatelet agent alone. While dual therapy has been shown to be effective in other cardiovascular diseases, its impact on PAD outcomes, particularly safety and efficacy, requires further investigation. A systematic search was performed in PubMed, Scopus, Embase, and Web of Science, following PRISMA guidelines, including studies up to March 19, 2025. We included only randomized controlled trials (RCTs) comparing the use of ticagrelor plus aspirin with monotherapy antiplatelet alone in patients with PAD. Our main outcomes were myocardial infarction, mortality, limb ischemia, and hemorrhagic events. Hazard Ratio (HR) with 95% Confidence Intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed with I2 statistics. Three RCTs were included from 280 studies obtained through the search. In 1,702 patients, no statistically significant differences were found in myocardial infarction (HR: 1.18; 95% CI: 0.70-1.96; p=0.54), mortality (HR: 0.73; 95% CI: 0.49-1.08; p=0.12), limb ischemia (HR: 0.64; 95% CI: 0.39-1.05; p=0.08), and hemorrhagic events (HR: 1.27; 95% CI: 0.32-4.99; p=0.74) between dual therapy and monotherapy.This meta-analysis is the first to evaluate the comparative effectiveness of dual treatment with ticagrelor plus aspirin versus monotherapy with either antiplatelet agent alone in patients with PAD. Although the results indicated no statistically significant differences between the two treatment strategies in terms of myocardial infarction, mortality, limb ischemia, or bleeding events, the absence of a clear benefit of dual therapy suggests that monotherapy may be a reasonable approach for the management of PAD in these patients. However, given the limitations of this analysis, including the number of studies, further RCTs are necessary to confirm these findings and provide more definitive guidance on the optimal treatment strategy for PAD.
  • Thumbnail Image
    Item type: Item ,
    Abstract 4341436: Semaglutide as an effective therapy for heart failure: Evidence from a meta-analysis of 6,479 patients
    (Lippincott Williams & Wilkins, 2025) J. Ruiz; Luis E. Cueva; Claudia Martinez‐Tapia; Carmen Chávez; Arianna Correa Siancas; Sergio Morales Acosta; Sol Juárez; Fátima Paico Bances; Adriana Robles; E Cubas
    Background: Heart failure (HF) remains a leading cause of morbidity and mortality worldwide, with limited therapeutic options for improving long-term cardiovascular outcomes. Semaglutide, a GLP-1 agonist, has shown promising effects in improving cardiovascular function and metabolic control. However, its overall efficacy in patients with heart failure has not yet been established. Methods: We conducted searches of PubMed, Embase, Scopus, and Web of Science through February 21, 2025, identifying randomized controlled trials (RCTs) and cohort studies comparing semaglutide with placebo in patients with HF. The main outcomes were variation from baseline in 6-minute walk distance traveled (6MWD), C-reactive protein (CRP) concentration, amino-terminal prohormone brain natriuretic peptide (NT-proBNP) concentration, body weight, waist circumference, adjudicated HF event (hospitalization or urgent visit), cardiac mortality, all-cause mortality, serious adverse events (SAEs), and cardiac events. Relative risks (RR), mean differences (MD), and hazard ratios (HR) with their 95% confidence intervals (CI) were calculated using a random-effects model. Heterogeneity was assessed with the I 2 statistic. Results: Four RCTs and two cohort studies were included, with a total population of 6,479 patients with HF, of whom 3,200 (49.39%) received semaglutide and 3,279 (50.61%) received placebo. Treatment with semaglutide was associated with a significant increase in 6MWD (RR: 16.60; 95%CI: 10.58 to 22.62; p < 0.00001), a reduction in CRP (RR:0.59; 95%CI: 0.49 to 0.70; p<0.00001) and NT-proBNP (RR:0.81; 95%CI: 0.74 to 0.89; p<0.00001), a decrease in body weight (MD:-6.11; 95%CI: -11.41 to -0.82; p=0.02) and waist circumference (MD:-7.43; 95%CI: -9.26 to -5.60; p<0.00001). In addition, lower adjudicated HF events (RR:0.69; 95%CI: 0.50 to 0.97; p=0.03), SAEs (RR:0.77; 95%CI: 0.66 to 0.91; p=0.001), cardiac events (RR:0.54; 95%CI: 0.32 to 0.92; p=0.02), all-cause mortality (RR:0.80; 95%CI: 0.67 to 0.95; p=0.01) and cardiac mortality (HR:0.72; 95%CI: 0.60 to 0.86; p=0.0003). Conclusion: This meta-analysis is one of the first to approach the potential of semaglutide in patients with HF. Semaglutide significantly improves functional capacity and metabolic parameters while reducing cardiac events, SAEs, and mortality. These findings suggest that semaglutide may represent a promising therapeutic option in this population and further research is warranted to confirm these results.