Current Therapeutic Options for Cardiovascular Diseases: From Bench to Bedside

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

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

Special Issue Editor

Division of Neurology, Johns Hopkins University, Baltimore, MD 14110, USA
Interests: platelets; coagulation; clinical trials; vascular disease; antiplatelet agents; anticoagulants
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The area of vascular pharmacology is on the move and is rapidly evolving. New knowledge, however, suggests that sometimes data generated in clinical trials contradict real-life clinical scenarios. Numerous researchers and practitioners have discussed the clinical features of various cardiac diseases and optimal therapeutic options. In general, they have agreed that many patients require an individual approach to yield better outcomes. Furthermore, major outcomes may be different because of ethnicity, drug doses, and regiments challenging uniformed therapeutic recommendations. In summary, this Special Issue will focus on various approaches to national pharmaceutical management in vascular diseases, diabetes, stroke, and arrhythmias. We are expecting healthy friendly dialog debating these critical issues among top research groups.

Dr. Victor Serebruany
Guest Editor

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Keywords

  • antiplatelet therapy
  • anticoagulants
  • vascular disease
  • diabetes, stroke
  • arrhythmia
  • pharmacology

Published Papers (2 papers)

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Research

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13 pages, 767 KiB  
Article
The Effect of Circle of Willis Morphology on Retinal Blood Flow in Patients with Carotid Stenosis Measured by Optical Coherence Tomography Angiography
by Zsuzsanna Mihály, Lilla István, Cecilia Czakó, Fruzsina Benyó, Sarolta Borzsák, Andrea Varga, Rita Magyar-Stang, Péter Vince Banga, Ágnes Élő, Róbert Debreczeni, Illés Kovács and Péter Sótonyi
J. Clin. Med. 2023, 12(16), 5335; https://doi.org/10.3390/jcm12165335 - 16 Aug 2023
Cited by 1 | Viewed by 803
Abstract
The Circle of Willis (CoW) is the main collateral system, and its morphological variants are more common in patients who have severe carotid artery stenosis. Earlier data suggest that optical coherence tomography angiography (OCTA) may help to assess the changes in cerebral vascular [...] Read more.
The Circle of Willis (CoW) is the main collateral system, and its morphological variants are more common in patients who have severe carotid artery stenosis. Earlier data suggest that optical coherence tomography angiography (OCTA) may help to assess the changes in cerebral vascular perfusion by imaging the retinal blood flow. In this single-center prospective clinical study, patients scheduled for carotid endarterectomy (CEA) underwent preoperative computed tomography angiography (CTA) of the extra- and intracranial cerebral circulation. OCTA imaging was performed one week before surgery and postoperatively one month later. The patients were divided into two subgroups based on CTA evaluation of CoW: compromised CoW or non-compromised CoW (containing hypoplastic and normal segments). The effect of the patient’s age, OCTA scan quality (SQ), CoW morphology, laterality, and surgery on superficial capillary vessel density (VD) in the macula were assessed in multivariable regression models using linear mixed models. We found that VD significantly decreased with aging (−0.12%; 95%CI: −0.07–−0.15; p < 0.001) and was significantly higher in patients with non-compromised CoW morphology (by 0.87% 95%CI (0.26–1.50); p = 0.005). After CEA, retinal blood flow significantly improved by 0.71% (95%CI: 0.18–1.25; p = 0.01). These results suggest that in the case of carotid artery occlusion, patients with non-compromised CoW have more preserved ocular blood flow than subjects with compromised CoW due to remodeling of the intra-orbital blood flow. Measuring the retinal blood flow might be used as a relevant and sensitive indicator of collateral cerebrovascular circulation. Full article
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28 pages, 1038 KiB  
Review
Antiplatelet Therapy Aims and Strategies in Asian Patients with Acute Coronary Syndrome or Stable Coronary Artery Disease
by Chor-Cheung Tam and Hung-Fat Tse
J. Clin. Med. 2022, 11(24), 7440; https://doi.org/10.3390/jcm11247440 - 15 Dec 2022
Cited by 5 | Viewed by 3060
Abstract
Dual antiplatelet therapy (DAPT) has been the mainstay treatment to reduce ischemic events, such as myocardial infarction or stroke, in patients with coronary artery disease (CAD). The development of potent P2Y12 inhibitors (ticagrelor and prasugrel) has helped to further reduce ischemic events, [...] Read more.
Dual antiplatelet therapy (DAPT) has been the mainstay treatment to reduce ischemic events, such as myocardial infarction or stroke, in patients with coronary artery disease (CAD). The development of potent P2Y12 inhibitors (ticagrelor and prasugrel) has helped to further reduce ischemic events, particularly among high-risk patients. Meanwhile, the evolution of newer generations of drug-eluting stents are also improving outcomes of percutaneous coronary intervention. Research studies on antiplatelet therapy in recent years have focused on balancing ischemic and bleeding risks through different strategies, which include P2Y12 inhibitor monotherapy, escalation and de-escalation, and extended DAPT. Because results from the large number of clinical studies may sometimes appear conflicting, this review aims to summarize recent advances, and demonstrate that they are aligned by a general principle, namely, strategies may be adopted based on treatment aims for specific patients at several time points. Another aim of this review is to outline the important considerations for using antiplatelet therapy in Asian patients, in whom there is a greater prevalence of CYP2C19 loss-of-function mutations, and a common increased risk of bleeding, despite high platelet reactivity (the so-called “East Asian Paradox”). Full article
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