[Cardiovascular complications in malaria: a review]

Area of Science:

• Cardiology
• Infectious Diseases
• Pharmacology

Background:

• Malaria is a significant global health issue, primarily affecting tropical and subtropical regions, causing various complications.
• Cardiac involvement in malaria, though often overlooked, can lead to severe outcomes like acute coronary syndrome, heart failure, and malignant arrhythmias.
• Current antimalarial treatments carry risks of cardiovascular complications, necessitating careful drug selection.

Approach:

• This review systematically examines research on cardiovascular complications associated with malaria, including myocardial infarction, arrhythmia, hypertension, heart failure, and myocarditis.
• It explores potential mechanisms driving malaria-induced cardiovascular diseases, such as cell adhesion, inflammation, cytokine effects, myocardial apoptosis, and thrombosis.
• The review also summarizes the cardiac effects of various antimalarial drug classes, including quinolines, nucleoprotein synthesis inhibitors, and artemisinin derivatives.

Key Points:

• Cardiovascular complications are a serious, yet often underrecognized, consequence of malaria.
• Mechanisms include parasitic effects on cells, inflammation, and secondary organ damage.
• Antimalarial drugs, particularly quinolines, can exacerbate cardiac issues, while artemisinin derivatives show a favorable cardiac safety profile.

Conclusions:

• Artemisinin-derived drugs present a promising therapeutic option for malaria patients with cardiovascular comorbidities.
• Further research is needed to fully understand and manage malaria-related cardiac complications.
• Safe and effective antimalarial strategies are crucial for patients with co-existing heart conditions.