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181. Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity.
作者: Milton Packer.;Michael R Zile.;Christopher M Kramer.;Seth J Baum.;Sheldon E Litwin.;Venu Menon.;Junbo Ge.;Govinda J Weerakkody.;Yang Ou.;Mathijs C Bunck.;Karla C Hurt.;Masahiro Murakami.;Barry A Borlaug.; .
来源: N Engl J Med. 2025年392卷5期427-437页
Obesity increases the risk of heart failure with preserved ejection fraction. Tirzepatide, a long-acting agonist of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors, causes considerable weight loss, but data are lacking with respect to its effects on cardiovascular outcomes.
182. Colchicine in Acute Myocardial Infarction.
作者: Sanjit S Jolly.;Marc-André d'Entremont.;Shun Fu Lee.;Rajibul Mian.;Jessica Tyrwhitt.;Sasko Kedev.;Gilles Montalescot.;Jan H Cornel.;Goran Stanković.;Raul Moreno.;Robert F Storey.;Timothy D Henry.;Shamir R Mehta.;Matthias Bossard.;Petr Kala.;Jamie Layland.;Biljana Zafirovska.;P J Devereaux.;John Eikelboom.;John A Cairns.;Binita Shah.;Tej Sheth.;Sanjib K Sharma.;Wadea Tarhuni.;David Conen.;Sarah Tawadros.;Shahar Lavi.;Salim Yusuf.; .
来源: N Engl J Med. 2025年392卷7期633-642页
Inflammation is associated with adverse cardiovascular events. Data from recent trials suggest that colchicine reduces the risk of cardiovascular events.
183. Left Atrial Appendage Closure after Ablation for Atrial Fibrillation.
作者: Oussama M Wazni.;Walid I Saliba.;Devi G Nair.;Eloi Marijon.;Boris Schmidt.;Troy Hounshell.;Henning Ebelt.;Carsten Skurk.;Saumil Oza.;Chinmay Patel.;Arvindh Kanagasundram.;Ashish Sadhu.;Sri Sundaram.;Jose Osorio.;George Mark.;Madhukar Gupta.;David B DeLurgio.;Jeffrey Olson.;Jens Erik Nielsen-Kudsk.;Lucas V A Boersma.;Jeff S Healey.;Karen P Phillips.;Federico M Asch.;Katherine Wolski.;Kristine Roy.;Thomas Christen.;Brad S Sutton.;Kenneth M Stein.;Vivek Y Reddy.; .
来源: N Engl J Med. 2025年392卷13期1277-1287页
Oral anticoagulation is recommended after ablation for atrial fibrillation among patients at high risk for stroke. Left atrial appendage closure is a mechanical alternative to anticoagulation, but data regarding its use after atrial fibrillation ablation are lacking.
184. Catheter Ablation or Antiarrhythmic Drugs for Ventricular Tachycardia.
作者: John L Sapp.;Anthony S L Tang.;Ratika Parkash.;William G Stevenson.;Jeff S Healey.;Lorne J Gula.;Girish M Nair.;Vidal Essebag.;Lena Rivard.;Jean-Francois Roux.;Pablo B Nery.;Jean-Francois Sarrazin.;Guy Amit.;Jean-Marc Raymond.;Marc Deyell.;Chris Lane.;Frederic Sacher.;Christian de Chillou.;Vikas Kuriachan.;Amir AbdelWahab.;Isabelle Nault.;Katia Dyrda.;Stephen Wilton.;Umjeet Jolly.;Arvindh Kanagasundram.;George A Wells.; .
来源: N Engl J Med. 2025年392卷8期737-747页
Patients with ventricular tachycardia and ischemic cardiomyopathy are at high risk for adverse outcomes. Catheter ablation is commonly used when antiarrhythmic drugs do not suppress ventricular tachycardia. Whether catheter ablation is more effective than antiarrhythmic drugs as a first-line therapy in patients with ventricular tachycardia is uncertain.
185. Routine Spironolactone in Acute Myocardial Infarction.
作者: Sanjit S Jolly.;Marc-André d'Entremont.;Bertram Pitt.;Shun Fu Lee.;Rajibul Mian.;Jessica Tyrwhitt.;Sasko Kedev.;Gilles Montalescot.;Jan H Cornel.;Goran Stanković.;Raul Moreno.;Robert F Storey.;Timothy D Henry.;Shamir R Mehta.;Matthias Bossard.;Petr Kala.;Ravinay Bhindi.;Biljana Zafirovska.;P J Devereaux.;John Eikelboom.;John A Cairns.;Madhu K Natarajan.;J D Schwalm.;Sanjib K Sharma.;Wadea Tarhuni.;David Conen.;Sarah Tawadros.;Shahar Lavi.;Valon Asani.;Dragan Topic.;Warren J Cantor.;Olivier F Bertrand.;Ali Pourdjabbar.;Salim Yusuf.; .; .
来源: N Engl J Med. 2025年392卷7期643-652页
Mineralocorticoid receptor antagonists have been shown to reduce mortality in patients after myocardial infarction with congestive heart failure. Whether routine use of spironolactone is beneficial after myocardial infarction is uncertain.
186. Inebilizumab for Treatment of IgG4-Related Disease.
作者: John H Stone.;Arezou Khosroshahi.;Wen Zhang.;Emanuel Della Torre.;Kazuichi Okazaki.;Yoshiya Tanaka.;J Matthias Löhr.;Nicolas Schleinitz.;Lingli Dong.;Hisanori Umehara.;Marco Lanzillotta.;Zachary S Wallace.;Mikael Ebbo.;George J Webster.;Fernando Martinez Valle.;Manu K Nayar.;Cory A Perugino.;Vinciane Rebours.;Xinxin Dong.;Yanping Wu.;Qing Li.;Nishi Rampal.;Daniel Cimbora.;Emma L Culver.; .
来源: N Engl J Med. 2025年392卷12期1168-1177页
IgG4-related disease is a multiorgan, relapsing, fibroinflammatory, immune-mediated disorder with no approved therapy. Inebilizumab targets and depletes CD19+ B cells and may be effective for treating patients with IgG4-related disease.
187. Tirzepatide for Obesity Treatment and Diabetes Prevention.
作者: Ania M Jastreboff.;Carel W le Roux.;Adam Stefanski.;Louis J Aronne.;Bruno Halpern.;Sean Wharton.;John P H Wilding.;Leigh Perreault.;Shuyu Zhang.;Ramakrishna Battula.;Mathijs C Bunck.;Nadia N Ahmad.;Irina Jouravskaya.; .
来源: N Engl J Med. 2025年392卷10期958-971页
Obesity is a chronic disease and causal precursor to myriad other conditions, including type 2 diabetes. In an earlier analysis of the SURMOUNT-1 trial, tirzepatide was shown to provide substantial and sustained reductions in body weight in persons with obesity over a 72-week period. Here, we report the 3-year safety outcomes with tirzepatide and its efficacy in reducing weight and delaying progression to type 2 diabetes in persons with both obesity and prediabetes.
188. Randomized Trial of Very Early Medication Abortion.
作者: Karin Brandell.;Tagrid Jar-Allah.;John Reynolds-Wright.;Helena Kopp Kallner.;Helena Hognert.;Frida Gyllenberg.;Janina Kaislasuo.;Anand Tamang.;Heera Tuladhar.;Clare Boerma.;Karen Schimanski.;Gillian Gibson.;Mette Løkeland.;Pia Teleman.;Marie Bixo.;Mette Mandrup Kjaer.;Ervin Kallfa.;Johan Bring.;Oskari Heikinheimo.;Sharon Cameron.;Kristina Gemzell-Danielsson.; .
来源: N Engl J Med. 2024年391卷18期1685-1695页
Medication abortion, with a combination of mifepristone and misoprostol, is highly effective and safe. However, there is insufficient evidence on efficacy and safety at very early gestations before a pregnancy can be visualized with ultrasonography.
189. Intraosseous or Intravenous Vascular Access for Out-of-Hospital Cardiac Arrest.
作者: Mikael F Vallentin.;Asger Granfeldt.;Thomas L Klitgaard.;Søren Mikkelsen.;Fredrik Folke.;Helle C Christensen.;Amalie L Povlsen.;Alberthe H Petersen.;Sofie Winther.;Lea W Frilund.;Carsten Meilandt.;Mathias J Holmberg.;Kristian B Winther.;Allan Bach.;Thomas H Dissing.;Christian J Terkelsen.;Steffen Christensen.;Line Kirkegaard Rasmussen.;Lone R Mortensen.;Mads L Loldrup.;Thomas Elkmann.;Anders G Nielsen.;Charlotte Runge.;Elise Klæstrup.;Jimmy H Holm.;Mikkel Bak.;Lars-Gustav R Nielsen.;Mette Pedersen.;Gunhild Kjærgaard-Andersen.;Peter M Hansen.;Anne C Brøchner.;Erika F Christensen.;Frederik M Nielsen.;Christian G Nissen.;Jeppe W Bjørn.;Peter Burholt.;Laust E R Obling.;Sarah L D Holle.;Lene Russell.;Henrik Alstrøm.;Søren Hestad.;Tanja H Fogtmann.;Jens U H Buciek.;Karina Jakobsen.;Mette Krag.;Michael Sandgaard.;Birthe Sindberg.;Lars W Andersen.
来源: N Engl J Med. 2025年392卷4期349-360页
Out-of-hospital cardiac arrest is a leading cause of death worldwide. Establishing vascular access is critical for administering guideline-recommended drugs during cardiopulmonary resuscitation. Both the intraosseous route and the intravenous route are used routinely, but their comparative effectiveness remains unclear.
190. A Randomized Trial of Drug Route in Out-of-Hospital Cardiac Arrest.
作者: Keith Couper.;Chen Ji.;Charles D Deakin.;Rachael T Fothergill.;Jerry P Nolan.;John B Long.;James M Mason.;Felix Michelet.;Chloe Norman.;Henry Nwankwo.;Tom Quinn.;Anne-Marie Slowther.;Michael A Smyth.;Kath R Starr.;Alison Walker.;Sara Wood.;Steve Bell.;Gemma Bradley.;Martina Brown.;Shona Brown.;Emma Burrow.;Karl Charlton.;Andrew Claxton Dip.;Victoria Dra'gon.;Christine Evans.;Jakob Falloon.;Theresa Foster.;Justin Kearney.;Nigel Lang.;Matthew Limmer.;Adam Mellett-Smith.;Joshua Miller.;Carla Mills.;Ria Osborne.;Nigel Rees.;Robert E S Spaight.;Gemma L Squires.;Belinda Tibbetts.;Michelle Waddington.;Gregory A Whitley.;Jason V Wiles.;Julia Williams.;Sarah Wiltshire.;Adam Wright.;Ranjit Lall.;Gavin D Perkins.; .
来源: N Engl J Med. 2025年392卷4期336-348页
In patients with out-of-hospital cardiac arrest, the effectiveness of drugs such as epinephrine is highly time-dependent. An intraosseous route of drug administration may enable more rapid drug administration than an intravenous route; however, its effect on clinical outcomes is uncertain.
191. Total Hip Replacement or Resistance Training for Severe Hip Osteoarthritis.
作者: Thomas Frydendal.;Robin Christensen.;Inger Mechlenburg.;Lone R Mikkelsen.;Claus Varnum.;Anders E Graversen.;Per Kjærsgaard-Andersen.;Peter H Revald.;Christian Hofbauer.;Manuel J Bieder.;Haidar Qassim.;Mohammad S Munir.;Stig S Jakobsen.;Sabrina M Nielsen.;Kim G Ingwersen.;Søren Overgaard.
来源: N Engl J Med. 2024年391卷17期1610-1620页
Total hip replacement is routinely recommended for severe hip osteoarthritis, but data from randomized trials are lacking regarding comparison of the effectiveness of this procedure with that of nonsurgical treatment such as resistance training.
192. Inavolisib-Based Therapy in PIK3CA-Mutated Advanced Breast Cancer.
作者: Nicholas C Turner.;Seock-Ah Im.;Cristina Saura.;Dejan Juric.;Sibylle Loibl.;Kevin Kalinsky.;Peter Schmid.;Sherene Loi.;Patrapim Sunpaweravong.;Antonino Musolino.;Huiping Li.;Qingyuan Zhang.;Zbigniew Nowecki.;Roland Leung.;Eirini Thanopoulou.;Noopur Shankar.;Guiyuan Lei.;Thomas J Stout.;Katherine E Hutchinson.;Jennifer L Schutzman.;Chunyan Song.;Komal L Jhaveri.
来源: N Engl J Med. 2024年391卷17期1584-1596页
Inavolisib is a highly potent and selective inhibitor of the alpha isoform of the p110 catalytic subunit of the phosphatidylinositol 3-kinase complex (encoded by PIK3CA) that also promotes the degradation of mutated p110α. Inavolisib plus palbociclib-fulvestrant has shown synergistic activity in preclinical models and promising antitumor activity in early-phase trials.
193. Once-Weekly Semaglutide in Persons with Obesity and Knee Osteoarthritis.
作者: Henning Bliddal.;Harold Bays.;Sébastien Czernichow.;Joanna Uddén Hemmingsson.;Jøran Hjelmesæth.;Thomas Hoffmann Morville.;Anna Koroleva.;Jesper Skov Neergaard.;Patricia Vélez Sánchez.;Sean Wharton.;Alicja Wizert.;Lars E Kristensen.; .
来源: N Engl J Med. 2024年391卷17期1573-1583页
Weight reduction has been shown to alleviate symptoms of osteoarthritis of the knee, including pain. The effect of glucagon-like peptide-1 receptor agonists on outcomes in knee osteoarthritis among persons with obesity has not been well studied.
194. Transcatheter Valve Replacement in Severe Tricuspid Regurgitation.
作者: Rebecca T Hahn.;Raj Makkar.;Vinod H Thourani.;Moody Makar.;Rahul P Sharma.;Christiane Haeffele.;Charles J Davidson.;Akhil Narang.;Brian O'Neill.;James Lee.;Pradeep Yadav.;Firas Zahr.;Scott Chadderdon.;Mackram Eleid.;Sorin Pislaru.;Robert Smith.;Molly Szerlip.;Brian Whisenant.;Nishant K Sekaran.;Santiago Garcia.;Terri Stewart-Dehner.;Holger Thiele.;Robert Kipperman.;Konstantinos Koulogiannis.;D Scott Lim.;Dale Fowler.;Samir Kapadia.;Serge C Harb.;Paul A Grayburn.;Anna Sannino.;Michael J Mack.;Martin B Leon.;Philipp Lurz.;Susheel K Kodali.; .
来源: N Engl J Med. 2025年392卷2期115-126页
Severe tricuspid regurgitation is associated with disabling symptoms and an increased risk of death. Data regarding outcomes after percutaneous transcatheter tricuspid-valve replacement are needed.
195. Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis.
作者: Philippe Généreux.;Allan Schwartz.;J Bradley Oldemeyer.;Philippe Pibarot.;David J Cohen.;Philipp Blanke.;Brian R Lindman.;Vasilis Babaliaros.;William F Fearon.;David V Daniels.;Adnan K Chhatriwalla.;Clifford Kavinsky.;Hemal Gada.;Pinak Shah.;Molly Szerlip.;Thom Dahle.;Kashish Goel.;William O'Neill.;Tej Sheth.;Charles J Davidson.;Raj R Makkar.;Heather Prince.;Yanglu Zhao.;Rebecca T Hahn.;Jonathon Leipsic.;Björn Redfors.;Stuart J Pocock.;Michael Mack.;Martin B Leon.; .
来源: N Engl J Med. 2025年392卷3期217-227页
For patients with asymptomatic severe aortic stenosis and preserved left ventricular ejection fraction, current guidelines recommend routine clinical surveillance every 6 to 12 months. Data from randomized trials examining whether early intervention with transcatheter aortic-valve replacement (TAVR) will improve outcomes in these patients are lacking.
196. Atrasentan in Patients with IgA Nephropathy.
作者: Hiddo J L Heerspink.;Meg Jardine.;Donald E Kohan.;Richard A Lafayette.;Adeera Levin.;Adrian Liew.;Hong Zhang.;Amit Lodha.;Todd Gray.;Yi Wang.;Ronny Renfurm.;Jonathan Barratt.; .
来源: N Engl J Med. 2025年392卷6期544-554页
Patients with IgA nephropathy and severe proteinuria have a high lifetime risk of kidney failure. The efficacy and safety of the selective endothelin type A receptor antagonist atrasentan in reducing proteinuria in patients with IgA nephropathy are incompletely understood.
197. Long-Term Effects of Empagliflozin in Patients with Chronic Kidney Disease.
作者: .;William G Herrington.;Natalie Staplin.;Nikita Agrawal.;Christoph Wanner.;Jennifer B Green.;Sibylle J Hauske.;Jonathan R Emberson.;David Preiss.;Parminder Judge.;Doreen Zhu.;Rejive Dayanandan.;Ryoki Arimoto.;Kaitlin J Mayne.;Sarah Y A Ng.;Emily Sammons.;Michael Hill.;Will Stevens.;Karl Wallendszus.;Susanne Brenner.;Alfred K Cheung.;Zhi-Hong Liu.;Jing Li.;Lai Seong Hooi.;Wen Liu.;Takashi Kadowaki.;Masaomi Nangaku.;Adeer Levin.;David Z I Cherney.;Aldo P Maggioni.;Roberto Pontremoli.;Rajat Deo.;Shinya Goto.;Xavier Rossello.;Katherine R Tuttle.;Dominik Steubl.;Dan Massey.;Martina Brueckmann.;Martin J Landray.;Colin Baigent.;Richard Haynes.; .
来源: N Engl J Med. 2025年392卷8期777-787页
In the EMPA-KIDNEY trial, empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, had positive cardiorenal effects in patients with chronic kidney disease who were at risk for disease progression. Post-trial follow-up was designed to assess how the effects of empagliflozin would evolve after the discontinuation of the trial drug.
198. Alternative Complement Pathway Inhibition with Iptacopan in IgA Nephropathy.
作者: Vlado Perkovic.;Jonathan Barratt.;Brad Rovin.;Naoki Kashihara.;Bart Maes.;Hong Zhang.;Hernán Trimarchi.;Dmitrij Kollins.;Olympia Papachristofi.;Severina Jacinto-Sanders.;Tobias Merkel.;Nicolas Guerard.;Ronny Renfurm.;Thomas Hach.;Dana V Rizk.; .
来源: N Engl J Med. 2025年392卷6期531-543页
The alternative complement pathway plays a key role in the pathogenesis of IgA nephropathy. Iptacopan specifically binds to factor B and inhibits the alternative pathway.
199. CRISPR-Based Therapy for Hereditary Angioedema.
作者: Danny M Cohn.;Padmalal Gurugama.;Markus Magerl.;Constance H Katelaris.;David Launay.;Laurence Bouillet.;Remy S Petersen.;Karen Lindsay.;Emel Aygören-Pürsün.;David Maag.;James S Butler.;Mrinal Y Shah.;Adele Golden.;Yuanxin Xu.;Ahmed M Abdelhady.;David Lebwohl.;Hilary J Longhurst.
来源: N Engl J Med. 2025年392卷5期458-467页
Hereditary angioedema is a rare genetic disease characterized by severe and unpredictable swelling attacks. NTLA-2002 is an in vivo gene-editing therapy that is based on clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein 9. NTLA-2002 targets the gene encoding kallikrein B1 (KLKB1). A single dose of NTLA-2002 may provide lifelong control of angioedema attacks.
200. Phase 3 Trial of Stereotactic Body Radiotherapy in Localized Prostate Cancer.
作者: Nicholas van As.;Clare Griffin.;Alison Tree.;Jaymini Patel.;Peter Ostler.;Hans van der Voet.;Andrew Loblaw.;William Chu.;Daniel Ford.;Shaun Tolan.;Suneil Jain.;Philip Camilleri.;Kiran Kancherla.;John Frew.;Andrew Chan.;Olivia Naismith.;John Armstrong.;John Staffurth.;Alexander Martin.;Ian Dayes.;Paula Wells.;Derek Price.;Emily Williamson.;Julia Pugh.;Georgina Manning.;Stephanie Brown.;Stephanie Burnett.;Emma Hall.
来源: N Engl J Med. 2024年391卷15期1413-1425页
Whether stereotactic body radiotherapy (SBRT) is noninferior to conventionally or moderately hypofractionated regimens with respect to biochemical or clinical failure in patients with localized prostate cancer is unclear.
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