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Acute Coronary Syndrome and Interventional Cardiology
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Acute Coronary Syndrome and Interventional Cardiology

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

Deadline for manuscript submissions: closed (15 July 2023) | Viewed by 4241

Special Issue Editor

Dr. Guus A. De Waard

E-Mail Website
Guest Editor
Department of Cardiology, Amsterdam Cardiovascular Sciences, VU University Medical Center, 1105 AZ Amsterdam, The Netherlands
Interests: acute coronary syndrome; coronary physiology; coronary revascularization; interventional cardiology

Special Issue Information

Dear Colleagues,

Prompt treatment of acute coronary syndromes with anticoagulants and antithrombotic drugs followed by revascularization has greatly improved patient outcomes by preserving ventricular function. However, the complications of acute coronary syndromes including ventricular arrhythmia, heart failure, repeat acute coronary syndromes and late complications of myocardial infarction still have an adverse influence on morbidity and life expectancy. With respect to the interventional side of acute coronary syndromes, significant strides towards improving outcomes after acute coronary syndromes are continuously made. Improved intracoronary diagnostics permit identification of vulnerable plaques and microvascular injury following reperfusion, optimalization of stent implantation reduces the risk of stent related complications and a broad spectrum of devices and pharmacological therapies are examined to reduce ischemia / reperfusion injury. The articles selected for this Special Issue show advances made in the field of Acute Coronary Syndromes and Interventional Cardiology.

Dr. Guus A. De Waard
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

  • acute coronary syndrome
  • myocardial infarction
  • percutaneous coronary interventions
  • microvascular injury
  • ischemia / reperfusion injury
  • vulnerable plaque
  • coronary physiology
  • intracoronary imaging

Published Papers (3 papers)

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Research

12 pages, 902 KiB  
Article
Mortality in Patients with Acute Coronary Syndrome—A Prospective 5-Year Follow-Up Study
by Thuy Mi Nguyen, Daniela Melichova, Eivind W. Aabel, Øyvind H. Lie, Lars Gunnar Klæboe, Bjørnar Grenne, Benthe Sjøli, Harald Brunvand, Kristina Haugaa and Thor Edvardsen
J. Clin. Med. 2023, 12(20), 6598; https://doi.org/10.3390/jcm12206598 - 18 Oct 2023
Cited by 3 | Viewed by 2205
Abstract
Our objective was to compare long-term outcomes in patients with non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) between two time periods in Southern Norway. There are limited contemporary data comparing long-term follow-up after revascularization in the last decades. This prospective follow-up [...] Read more.
Our objective was to compare long-term outcomes in patients with non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) between two time periods in Southern Norway. There are limited contemporary data comparing long-term follow-up after revascularization in the last decades. This prospective follow-up study consecutively included both NSTEMI and STEMI patients during two time periods, 2014–2015 and 2004–2009. Patients were followed up for a period of 5 years. The primary outcome was all-cause mortality after 1 and 5 years. A total of 539 patients with acute myocardial infarction (AMI), 316 with NSTEMI (234 included in 2014 and 82 included in 2007) and 223 with STEMI (160 included in 2014 and 63 included in 2004). Mortality after NSTEMI was high and remained unchanged during the two time periods (mortality rate at 1 year: 3.5% versus 4.9%, p = 0.50; and 5 years: 11.4% versus 14.6%, p = 0.40). Among STEMI patients, all-cause mortality at 1 year was reduced in 2014 compared to 2004 (1.3% versus 11.1%, p < 0.001; and 5 years: 7.0% versus 22.2%, p = 0.004, respectively). Time to coronary angiography in NSTEMI patients remained unchanged between 2014 and 2007 (28.2 h [IQR 18.1–46.3] versus 30.3 h [IQR 18.0–48.3], p = 0.20), while time to coronary angiography in STEMI patients was improved in 2014 compared with 2004 (2.8 h [IQR 2.0–4.8] versus 21.7 h [IQR 5.4–27.1], p < 0.001), respectively. During one decade of AMI treatment, mortality in patients with NSTEMI remained unchanged while mortality in STEMI patients decreased, both at 1 and 5 years. Full article
(This article belongs to the Special Issue Acute Coronary Syndrome and Interventional Cardiology)
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10 pages, 629 KiB  
Article
Prognostic Implications of High-Degree Atrio-Ventricular Block in Patients with Acute Myocardial Infarction in the Contemporary Era
by Jesús Velásquez-Rodríguez, Lourdes Vicent, Felipe Díez-Delhoyo, María Jesús Valero Masa, Vanesa Bruña, Iago Sousa-Casasnovas, Miriam Juárez-Fernández, Francisco Fernández-Avilés and Manuel Martínez-Sellés
J. Clin. Med. 2023, 12(14), 4834; https://doi.org/10.3390/jcm12144834 - 22 Jul 2023
Cited by 1 | Viewed by 795
Abstract
Background: High-degree atrioventricular block (HAVB) is a known complication of ST-segment elevation myocardial infarction (STEMI). We aimed to determine the prevalence and prognostic impact of HAVB in a contemporary cohort of STEMI. Methods: Data were collected from the DIAMANTE registry that included STEMI [...] Read more.
Background: High-degree atrioventricular block (HAVB) is a known complication of ST-segment elevation myocardial infarction (STEMI). We aimed to determine the prevalence and prognostic impact of HAVB in a contemporary cohort of STEMI. Methods: Data were collected from the DIAMANTE registry that included STEMI patients admitted to our cardiac intensive care unit treated with urgent reperfusion. We studied the clinical characteristics and evolution in patients with and without HAVB at admission. Results: From 1109 consecutive patients, HAVB was documented in 95 (8.6%). The right coronary artery was the culprit vessel in 84 patients with HAVB (88.4%). The independent predictors of HAVB were: male sex (OR 1.9, 95% CI 1.2–2.9), age (OR 1.03, 95% CI 1.01–1.05), involvement of right coronary artery (OR 12.4, 95% CI 7.6–20.2), and creatinine value (OR 1.5, 95% CI 1.1–2.0). A transient percutaneous pacemaker was used in 37 patients with HAVB (38.9%). Patients with HAVB had higher mortality that patients without HAVB (15.8% vs. 4.1%, p < 0.001); however, in multivariate analysis, HAVB was not an independent predictor of in-hospital mortality. Conclusions: HAVB was seen in 9% of STEMI patients and was particularly frequent in elderly males with renal failure. Patients with HAVB had a poor prognosis during hospitalization, but HAVB was not an independent predictor of in-hospital mortality. Full article
(This article belongs to the Special Issue Acute Coronary Syndrome and Interventional Cardiology)
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11 pages, 1125 KiB  
Article
The Impact of Preclinical High Potent P2Y12 Inhibitors on Decision Making at Discharge and Clinical Outcomes in Patients with Acute Coronary Syndrome
by Andreas Hammer, Mario Krammel, Patrick Aigner, Georg Pfenneberger, Sebastian Schnaubelt, Felix Hofer, Niema Kazem, Lorenz Koller, Eva Steinacher, Ulrike Baumer, Christian Hengstenberg, Alexander Niessner and Patrick Sulzgruber
J. Clin. Med. 2023, 12(12), 4094; https://doi.org/10.3390/jcm12124094 - 16 Jun 2023
Cited by 1 | Viewed by 868
Abstract
Background: Purinergic signaling receptor Y12 (P2Y12) inhibitors are a fundamental part of pharmacological therapy in acute coronary syndrome (ACS) for preventing recurrent ischemic events. Current guidelines support the use of prasugrel over ticagrelor—however, ticagrelor is widely used for preclinical loading [...] Read more.
Background: Purinergic signaling receptor Y12 (P2Y12) inhibitors are a fundamental part of pharmacological therapy in acute coronary syndrome (ACS) for preventing recurrent ischemic events. Current guidelines support the use of prasugrel over ticagrelor—however, ticagrelor is widely used for preclinical loading during ACS due to its ease of administration. In this regard, it remains unknown whether the preclinical loading with P2Y12 inhibitors impacts decision-making for the long-term dual antiplatelet strategy, as well as cardiovascular outcomes, including re-percutaneous coronary intervention in real-world settings. Methods: Within this population-based prospective observational study, all patients with ACS who received medical care via the Emergency Medical Service (EMS) in the city of Vienna between January 2018 and October 2020 were enrolled. Patients were stratified according to their P2Y12 inhibitor loading regimen. Subsequently, the association of P2Y12 inhibitor loading on long-term prescription at discharge and outcome was assessed. Results: The entire study cohort consisted of 1176 individuals with ST-elevation myocardial infarction (STEMI), of whom 47.5% received prasugrel and 52.5% ticagrelor. The likelihood of adhering to the initial P2Y12 inhibitor strategy during the clinical stay was high for both ticagrelor (84%; OR: 10.00; p < 0.001) and prasugrel (77%; OR: 21.26; p < 0.001). During patient follow-up (median follow-up time three years), 84 (7.1%) patients died due to cardiovascular causes, and 82 (7.0%) patients required re-PCI. Notably, there was no difference in cardiovascular mortality (6.6% ticagrelor vs. 7.7% prasugrel) or re-PCI rates (6.6% ticagrelor vs. 7.3% prasugrel) addressing the P2Y12 inhibition strategy. Conclusion: We observed that, regardless of the initial antiplatelet inhibitor strategy, the in-hospital P2Y12 adherence was exceedingly high, and there was a minimal occurrence of switching to another P2Y12 inhibitor. Most importantly, no significant difference in cardiovascular death/re-PCI between ticagrelor and prasugrel-based preclinical loading has been observed. Consequently, the choice of high potent P2Y12 did not influence the cardiac outcome from a long-term perspective. Full article
(This article belongs to the Special Issue Acute Coronary Syndrome and Interventional Cardiology)
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