Cardiovascular diseases (CVD) remain the leading cause of death worldwide and pharmacotherapy
of most of them is suboptimal. Thus, there is a clear unmet clinical need to develop
new pharmacological strategies with greater efficacy and better safety profiles. In
this review, we summarize the most relevant advances in cardiovascular pharmacology
in 2022 including the approval of first-in-class drugs that open new avenues for the
treatment of obstructive hypertrophic cardiomyopathy (mavacamten), type 2 diabetes
mellitus (tirzepatide), and heart failure (HF) independent of left ventricular ejection
fraction (sodium-glucose cotransporter 2 inhibitors). We also dealt with fixed dose
combination therapies repurposing different formulations of “old” drugs with well-known
efficacy and safety for the treatment of patients with acute decompensated HF (acetazolamide
plus loop diuretics), atherosclerotic cardiovascular disease (moderate-dose statin
plus ezetimibe), Marfan syndrome (angiotensin receptor blockers plus β-blockers),
and secondary cardiovascular prevention (i.e. low-dose aspirin, ramipril and atorvastatin),
thereby filling existing gaps in knowledge, and opening new avenues for the treatment
of CVD. Clinical trials confirming the role of dapagliflozin in patients with HF and
mildly reduced or preserved ejection fraction, long-term evolocumab to reduce the
risk of cardiovascular events, vitamin K antagonists for stroke prevention in patients
with rheumatic heart disease-associated atrial fibrillation, antibiotic prophylaxis
in patients at high risk for infective endocarditis before invasive dental procedures,
and vutrisiran for the treatment of hereditary transthyretin-related amyloidosis with
polyneuropathy were also reviewed. Finally, we briefly discuss recent clinical trials
suggesting that FXIa inhibitors may have the potential to uncouple thrombosis from
hemostasis and attenuate/prevent thromboembolic events with minimal disruption of
hemostasis.
