Current Pharmaceutical Design - Volume 15, Issue 8, 2009

The theory of metabolic modulation has recently assumed clinical relevance in the treatment of various cardiovascular disease. It is now clear that chronic ischemic heart disease, heart failure and diabetic cardiomyopathy have in common several alterations of cardiac metabolism shifted towards a greater utilization of free fatty acids and a reduced efficiency of the Krebs cycle. Over the past years, several drugs have bee Read More

The morbidity and mortality of coronary heart disease and of heart failure remain unacceptably high despite major advances in their management. The main focus of treatment has been revascularisation for ischaemic heart disease and neuro-humoral modification for heart failure. There is an urgent need for new modalities of treatment to improve mortality and morbidity. Recently, there has been a great deal of interest in the Read More

Cardiovascular disease is a major health problem all over the world. The prevalence of type 2 diabetes mellitus has been rapidly increasing, together with the risk of cardiovascular events. Patients with diabetes, and/or with insulin resistance as well, have an impaired myocardial metabolism of glucose and free fatty acids (FFA) and accelerated and diffuse atherogenesis, with involvement of coronary artery tree. Si Read More

The effectiveness of drug therapy in controlling angina and the resulting improvement in exercise capacity were reviewed. We performed a Medline search of published reports on ranolazine, trimetazidine, and other medicines that act metabolically. Quality of life with regards to work capacity alone was analyzed. Most reports were about trimetazidine, with strong evidence of its efficacy and tolerability. Its effect on episodes of Read More

Metabolic modulation has been an attractive therapeutic approach to heart failure as scientific evidence for an altered metabolic state in the failing heart has been demonstrated for decades. However, the ability to safely alter the substrate metabolism in the myocardium without adverse effects while at the same time be able to provide long-term benefits have not been widely investigated. Meanwhile, the ability to alter long-term Read More

The pivotal therapeutic role of myocardial metabolic modulation in ischemic heart disease (IHD) is increasingly recognized. Among the others, inhibitors of free fatty acids (FFA) oxidation have been consistently shown to play an important role in the therapeutic strategy of IHD patients. Additionally, abnormalities of glucose homeostasis are consistently present in patients with IHD, definitely contributing to the progressio Read More

Coronary artery disease (CAD) is due to subintimal deposition of atheromatous plaques in large and mediumsized coronary arteries. Different risk factors have been identified such as hypertension, hypercholesterolemia, diabetes and smoking. Both hypertension and diabetes mellitus affect the same major target organs. The common hypertensive/ diabetic target is the vascular tree, hence renal function is particularly exposed i Read More

Progressions in acute cardiac care have improved survival after acute myocardial infarction, but in contraposition with this, there has been an increase in mortality because of heart failure. For this reason congestive heart failure is an increasingly widespread, costly and deadly disease, frequently named as epidemic of the XXI century. Despite advancement in modern treatment, mortality rate in heart failure patients re Read More

An urgent need of more effective and personalized treatments for cancer and other genetic diseases is becoming a generalized claim. This is pushing forward experimental alternative approaches based on targeted nanoconjugates, which are designed to be specifically directed against target cells. These constructs, although suitable to carry conventional chemical drugs, are specifically appropriate to deliver expressible Read More

Blood Brain Barrier (BBB) represents a major hurdle for the delivery of bioactives in the brain. It serves as a major constraint for the entry of hydrophilic drugs and the efflux pumps present on its surface restrain the intracellular accumulation of pharmacological moieties in the brain. Nanoparticles (NPs) in this regard can serve as a potential module for ferrying large doses of drugs across the BBB. These can be coate Read More