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Acute Coronary Syndromes: Focus on Precision Medicine
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Acute Coronary Syndromes: Focus on Precision Medicine

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 15 July 2024 | Viewed by 8444

Special Issue Editor

Prof. Dr. Rossella Marcucci

E-Mail Website
Guest Editor
Department of Clinical and Experimental Medicine, University of Florence, 50132 Florence, Italy
Interests: interventional cardiology; myocardial infarction; acute myocardial infarction; atherosclerosis; hypertension; heart failure; flow cytometry; cardiovascular medicine; atrial fibrillation; clinical hematology

Special Issue Information

Dear Colleagues,

Despite all the advances in clinical and pharmacological interventions, cardiovascular disease is still a leading cause of morbidity and mortality. In the wide range of therapeutic options that have been proved to modify the disease history so far, one of the purposes of contemporary medicine is to identify the best strategy for each patient, opening the way for so-called ‘precision medicine’. This is particularly true in the setting of acute coronary syndromes, where the high cardiovascular risk of the index event and potential recurrences produce the need to adopt the most effective treatment, starting from the cath lab until the therapy at discharge. The choice of the antithrombotic pattern in patients with concomitant anticoagulant indication or the research of possible sources of residual risk in patients treated with current evidence-based recommended care are just some possible fields where a tailored approach may find application. The future of cardiovascular therapy will probably rely on pharmacogenomics, the measurement of individual drug responses, and the identification of markers that may influence it.

Prof. Dr. Rossella Marcucci
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • tailored therapy
  • acute coronary syndrome
  • antithrombotic therapy
  • platelet reactivity
  • pharmacogenomics

Published Papers (2 papers)

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Research

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11 pages, 2087 KiB  
Article
Effect of Body Mass Index on the Prognostic Value of Atherogenic Index of Plasma in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
by Yi Kan, Yan Sun, Hua Shen, Xiaoli Liu, Yuyang Liu, Dongmei Shi, Xiaoteng Ma and Yujie Zhou
J. Clin. Med. 2023, 12(20), 6543; https://doi.org/10.3390/jcm12206543 - 16 Oct 2023
Cited by 1 | Viewed by 910
Abstract
(1) Background: The aim of this study was to investigate whether the prognostic value of the atherogenic index of plasma (AIP) for adverse cardiovascular events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) varied across different BMI groups. (2) Methods: [...] Read more.
(1) Background: The aim of this study was to investigate whether the prognostic value of the atherogenic index of plasma (AIP) for adverse cardiovascular events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) varied across different BMI groups. (2) Methods: This study was a retrospective analysis of a prospective registry involving 1725 ACS patients undergoing PCI. The primary endpoint was a composite of all-cause death, non-fatal ischemic stroke, non-fatal spontaneous myocardial infarction (MI), and unplanned repeat revascularization. (3) Results: The study population finally consisted of 526 patients with BMI < 24 kg/m2 (age 62 ± 10 years; male 64.3%), 827 patients with 24 kg/m2 ≤ BMI < 28 kg/m2 (age 60 ± 10 years; male 81.8%), and 372 patients with BMI ≥ 28 kg/m2 (age 57 ± 11 years; male 81.2%). The AIP as a continuous variable increased the risk for the primary endpoint in ACS patients undergoing PCI with BMI < 24 kg/m2 (HR 2.506; 95% CI 1.285–4.885; p = 0.007), while it did not increase the risk in patients with BMI ≥ 24 kg/m2 (hazard ratio [HR]: 1.747; 95% CI 0.921–3.316; p = 0.088 for patients with 24 kg/m2 ≤ BMI < 28 kg/m2; and HR: 2.096; 95% CI 0.835–5.261; p = 0.115 for patients with BMI ≥ 28 kg/m2, respectively). Compared with the lowest AIP tertile, the top AIP tertile was associated with a significantly increased risk of the primary endpoint in BMI < 24 kg/m2 group (HR: 1.772, 95% CI: 1.110 to 2.828, p = 0.016). (4) Conclusions: The AIP was significantly associated with an increased risk of adverse cardiovascular events in ACS patients undergoing PCI with BMI < 24 kg/m2, but not in the patients with BMI ≥ 24 kg/m2. Full article
(This article belongs to the Special Issue Acute Coronary Syndromes: Focus on Precision Medicine)
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Review

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31 pages, 2609 KiB  
Review
Precision Medicine and the future of Cardiovascular Diseases: A Clinically Oriented Comprehensive Review
by Yashendra Sethi, Neil Patel, Nirja Kaka, Oroshay Kaiwan, Jill Kar, Arsalan Moinuddin, Ashish Goel, Hitesh Chopra and Simona Cavalu
J. Clin. Med. 2023, 12(5), 1799; https://doi.org/10.3390/jcm12051799 - 23 Feb 2023
Cited by 14 | Viewed by 7137
Abstract
Cardiac diseases form the lion’s share of the global disease burden, owing to the paradigm shift to non-infectious diseases from infectious ones. The prevalence of CVDs has nearly doubled, increasing from 271 million in 1990 to 523 million in 2019. Additionally, the global [...] Read more.
Cardiac diseases form the lion’s share of the global disease burden, owing to the paradigm shift to non-infectious diseases from infectious ones. The prevalence of CVDs has nearly doubled, increasing from 271 million in 1990 to 523 million in 2019. Additionally, the global trend for the years lived with disability has doubled, increasing from 17.7 million to 34.4 million over the same period. The advent of precision medicine in cardiology has ignited new possibilities for individually personalized, integrative, and patient-centric approaches to disease prevention and treatment, incorporating the standard clinical data with advanced “omics”. These data help with the phenotypically adjudicated individualization of treatment. The major objective of this review was to compile the evolving clinically relevant tools of precision medicine that can help with the evidence-based precise individualized management of cardiac diseases with the highest DALY. The field of cardiology is evolving to provide targeted therapy, which is crafted as per the “omics”, involving genomics, transcriptomics, epigenomics, proteomics, metabolomics, and microbiomics, for deep phenotyping. Research for individualizing therapy in heart diseases with the highest DALY has helped identify novel genes, biomarkers, proteins, and technologies to aid early diagnosis and treatment. Precision medicine has helped in targeted management, allowing early diagnosis, timely precise intervention, and exposure to minimal side effects. Despite these great impacts, overcoming the barriers to implementing precision medicine requires addressing the economic, cultural, technical, and socio-political issues. Precision medicine is proposed to be the future of cardiovascular medicine and holds the potential for a more efficient and personalized approach to the management of cardiovascular diseases, contrary to the standardized blanket approach. Full article
(This article belongs to the Special Issue Acute Coronary Syndromes: Focus on Precision Medicine)
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