Ayahuasca, a hallucinogenic brew used by Amazonian indigenous groups, contains β-carbolines that inhibit monoamine oxidase and dimethyltryptamine, a serotonin receptor agonist. Acute administration causes moderate cardiovascular effects in healthy volunteers, but long-term effects are unknown. In rats, ayahuasca (2-4 mL/kg) flattened and stretched vascular smooth muscle cells and altered collagen and elastic fiber arrangement. Chronic high-dose treatment increased media thickness and the ratio of media thickness to lumen diameter in the aorta. More research on cardiovascular function in long-term ayahuasca consumers is needed.
For patients undergoing transcatheter aortic valve replacement (TAVR), avoiding dual antiplatelet therapy (DAPT) before the procedure reduces minor bleeding events without raising the risk of stroke or heart attack. A meta-analysis of 5 studies involving 2,329 patients found that preoperative non-DAPT (single antiplatelet therapy or none) was linked to a lower rate of minor bleeding compared with DAPT. Preoperative single antiplatelet therapy also lowered major bleeding risk. No significant differences were observed for other bleeding events, transfusions, stroke, heart attack, or death from any cause.