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.

中文翻译：

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2022年新药物和新心血管药物治疗策略。

心血管疾病（CVD）仍然是全世界死亡的主要原因，其中大多数疾病的药物治疗效果不佳。因此，开发具有更高功效和更好安全性的新药理学策略显然存在未满足的临床需求。在这篇综述中，我们总结了 2022 年心血管药理学最相关的进展，包括批准首创药物，这些药物为治疗阻塞性肥厚性心肌病 (mavacamten)、2 型糖尿病 (tirzepatide) 和心脏病开辟了新途径心力衰竭 (HF) 与左心室射血分数无关（钠-葡萄糖协同转运蛋白 2 抑制剂）。我们还涉及固定剂量联合疗法，重新利用具有众所周知的功效和安全性的“旧”药物的不同配方来治疗急性失代偿性心力衰竭（乙酰唑胺加袢利尿剂）、动脉粥样硬化性心血管疾病（中等剂量他汀类药物加依折麦布） 、马凡综合征（血管紧张素受体阻滞剂加β受体阻滞剂）和心血管二级预防（即小剂量阿司匹林、雷米普利和阿托伐他汀），从而填补了现有的知识空白，并为CVD的治疗开辟了新途径。临床试验证实了达格列净对射血分数轻度降低或保留的心力衰竭患者的作用、长期使用 evolocumab 降低心血管事件风险、维生素 K 拮抗剂用于预防风湿性心脏病相关心房颤动患者中风、抗生素预防还审查了在侵入性牙科手术前感染性心内膜炎高危患者中的疗效，以及 vutrisiran 用于治疗遗传性转甲状腺素蛋白相关淀粉样变性伴多发性神经病的疗效。最后，我们简要讨论最近的临床试验，这些试验表明 FXIa 抑制剂可能具有将血栓形成与止血分离的潜力，并在对止血的破坏最小的情况下减轻/预防血栓栓塞事件。