The overall objective of the Stroke Minimization through Additive Anti-atherosclerotic Agents in Routine Treatment II (SMAART-II) is to deploy a hybrid study design to firstly, demonstrate the efficacy of a polypill (Polycap ®) containing fixed doses of antihypertensives, a statin, and antiplatelet therapy taken as two capsules, once daily orally in reducing composite vascular risk over 24 months vs. usual care among 500 recent stroke patients encountered at 12 hospitals in Ghana. Secondly, SMAART II seeks to develop an implementation strategy for routine integration and policy adoption of this polypill for post-stroke cardiovascular risk reduction in an under-resourced system burdened by suboptimal care and outcomes.

Start Date01 Jun 2025

Sponsor / Collaborator

Northern California Institute for Research & Education

NCT06930885

/ Not yet recruitingPhase 3IIT

Evaluation of a POlypill and Colchicine for Risk Reduction in Patients With Established Atherosclerotic Cardiovascular Disease: The EPOCA Randomized Clinical Trial

The EPOCA study (Evaluation of a POlypill and Colchicine for risk reduction in patients with established Atherosclerotic cardiovascular disease) will be a randomized, superiority, parallel, 2x2 factorial, multicenter clinical trial which will include at least 7713 and up to a maximum of 10797 participants with established atherosclerotic cardiovascular disease.

Start Date01 May 2025

Sponsor / Collaborator-

100 Clinical Results associated with ACE x HMGCR

100 Translational Medicine associated with ACE x HMGCR

0 Patents (Medical) associated with ACE x HMGCR

Literatures (Medical) associated with ACE x HMGCR

01 Mar 2025·Food Science and Biotechnology

Fermentation characteristics and anti-hypolipidemic effect of barley wine from co-fermentation with yeast and lactic acid bacteria

Article

Author: Song, Geun-Seoup ; Oh, Hyeon Hwa ; Jeong, Do-Youn ; Jang, So-Won

In this study, the variations in ingredients (organic acid, free sugar, free amino acid, β-glucan, γ-aminobutyric acid (GABA), total phenolic content (TPC)) of single yeast fermentation (SYF0d, SYF5d, SYF10d) and simultaneous cultured fermentation (SCF0d, SCF5d, SCF10d) were analyzed. The contents of β-glucan, GABA, and TPC in SCF10d were higher compared to those in SYF10d (417.28, 596.77, and 495.66 μg/mL), at 1158.92, 818.57, and 605.48 μg/mL, respectively. DPPH radical activity, ABTS radical activity, and oxygen radical absorbance capacity were greater in SCF10d than in SYF10d (187.60, 885.58, and 1.98 mg/mL), at 506.05, 1674.90, and 2.73 mg/mL, respectively. Anti-hypolipidemic (ACE1 inhibitory activity) and anti-cholesterol (HMG-CoA reductase inhibitory activity) of SCF10d were 59.66% (1/5 dilution factor, DF) and 37.16% (1/10 DF), respectively. These results suggest that SCF had higher antioxidant and anti-hypolipidemic activities.

01 Feb 2025·Naunyn-Schmiedeberg's Archives of Pharmacology

An investigation on the cardioprotective potential of lichen compound protocetraric acid by H2O2-induced toxicity in H9c2 rat heart cells through in vitro and in silico analysis

Article

Author: Sutar, Ruchira R. ; Behera, Bhaskar C. ; Khare, Roshni ; Sutar, Ruchira R ; Gaikwad, Subhash B. ; Mapari, Sachin V ; Behera, Bhaskar C ; Mapari, Sachin V. ; Gaikwad, Subhash B

Worldwide, cardiovascular diseases (CVDs) are the leading cause of death and require treatment and prevention. Lichens are symbiotic organisms that are known to produce unique secondary metabolites and have been used as folk medicines. The aim of the study is to emphasize the importance of lichens in improving heart health, with the objective of investigating protocetraric acid, a lichen metabolite, for its antioxidant and cardioprotective potential by using in vitro and in silico techniques. Protocetraric acid (PRC) was isolated, characterized, and tested for antioxidant properties using six assays. In cardiovascular investigations, hydroxymethylglutaryl-coenzymeA reductase (HMGCR), angiotensin-converting enzyme inhibitory, and fibrinolytic capacities, along with enzyme inhibitory kinetics studies, were carried out. In silico toxicology and molecular docking analysis were done to determine the binding sites on target proteins. The cytoprotective ability of PRC was evaluated by H₂O₂-induced toxicity in H9c2 rat heart cells. Out of six lichens, the extract of F. caperata showed comparatively stronger antioxidant activity in terms of 1,1-diphenyl-2-picryl hydrazil (DPPH), scavenging of nitric oxide (SNO), and ferric reducing potential (FRAP) equivalent values. PRC showed significant antioxidant properties, and with respect to cardiovascular studies, PRC exhibited 86% HMGCR and 82% ACE inhibition, while 57% fibrinolysis at 320 µM concentration. Inhibitory kinetic tests of PRC showed competitive and uncompetitive HMGCR and ACE inhibition types respectively. PRC showed minimum binding energies of - 7.9, - 8.9, and - 9.0 kcal/mol with 1HWK, 1O8A, and 4BZS. The H9c2 cell line pre-treated with PRC was found to reduce H₂O₂ toxicity as well as increase cell viability. Protocetraric acid is a potent compound that has been experimentally shown to have hypocholesterolemic, hypotensive, and cardioprotective properties for treating cardiovascular diseases.

01 Jan 2025·Giornale italiano di cardiologia (2006)

[Clinical pharmacology of combination therapies for the prevention and treatment of cardiovascular diseases].

Review

Author: Ferri, Nicola ; Corsini, Alberto

Hypertension and hypercholesterolemia represent two causal factors of atherosclerotic cardiovascular disease and are modulated by different molecular mediators. These mediators represent the pharmacological targets on which oral therapies have been developed for the control of hypertension and hypercholesterolemia. Pharmacological therapy aimed at modulating cardiovascular risk factors has demonstrated clinical efficacy with the results of several phase 3 clinical trials. In particular, the HMG-CoA reductase inhibitors, including rosuvastatin, and the inhibitor of the cholesterol transporter NPC1L1 ezetimibe are effective drugs in reducing levels of low-density lipoprotein cholesterol. On the other side, antihypertensive drugs include renin-angiotensin-aldosterone system inhibitors, such as angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers, calcium channel blockers, beta-blockers and thiazide diuretics. Combination therapy, therefore, represents the most effective and tolerated approach for controlling both risk factors. Based on this evidence, fixed combination therapies have been developed which are useful in simplifying the treatment of patients at high cardiovascular risk. An essential condition for the development of fixed formulations is represented by the complementarity of the pharmacological action of the two or three associated drugs, and similar pharmacokinetic profile allowing the same frequency of administration. Furthermore, the pharmacokinetic profile of the two drugs given in fixed combination must not differ significantly from that observed with the two drugs administered individually. In this review the following fixed combination therapies are examined: rosuvastatin/ezetimibe, ramipril/amlodipine, candesartan/amlodipine, ramipril/amlodipine/hydrochlorothiazide and amlodipine/rosuvastatin, describing their pharmacodynamic and pharmacokinetic characteristics and their bioequivalence with respect to single therapies. This analysis provides essential information for the evaluation of their clinical effectiveness in the control of hypertension and hypercholesterolemia in patients at high cardiovascular risk.

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