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Treatment and Outcome of Patients with Prior Cerebrovascular Accidents and...
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Treatment and Outcome of Patients with Prior Cerebrovascular Accidents and Coronary Artery Disease

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

Deadline for manuscript submissions: closed (20 January 2022) | Viewed by 8501

Special Issue Editor

Prof. Dr. Leonardo De Luca

E-Mail Website
Guest Editor
Division of Cardiology, Department of Cardiosciences, A.O. San Camillo-Forlanini, Circonvallazione Gianicolense, Rome, Italy
Interests: acute coronary syndromes; pharmacology and pharmacotherapy; interventional cardiology; acute heart failure

Special Issue Information

Dear Colleagues,

It is my great pleasure and honor to announce this Special Issue on “Treatment and Outcome of Patients with Prior Cerebrovascular Accidents and Coronary Artery Disease”. In recent decades, treatment and outcome of patients with a prior cerebrovascular accident and coronary artery disease have significantly changed. Antithrombotic strategies, using various combinations of antiplatelet and anticoagulant drugs, together with lipid lowering agents, are a cornerstone of the treatment of patients with coronary artery disease. However, in several recent trials conducted in patients with acute coronary syndromes, those with a history of cerebrovascular accidents have derived no benefit from novel therapies. To guide selection of treatments in this subset of patients, there is a need to further characterize the risk and type of ischemic and bleeding events associated with a history of cerebrovascular accidents, and the ideal timing and dosing for initiating such therapies in this subset of patients.

With this Special Issue, we aim to provide a glimpse on these topics and very much look forward to receiving your original research or review articles.

Dr. Leonardo De Luca
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

  • Stroke
  • TIA
  • Coronary artery disease
  • Acute coronary syndromes
  • Treatment

Published Papers (4 papers)

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Review

11 pages, 269 KiB  
Review
Management of Oral Anticoagulation and Antiplatelet Therapy in Post-Myocardial Infarction Patients with Acute Ischemic Stroke with and without Atrial Fibrillation
by Francesca Romana Pezzella, Marilena Mangiardi, Mario Ferrante, Sebastiano Fabiano, Sabrina Anticoli, Fabrizio Giorgio Pennacchi, Antonella Urso, Leonardo De Luca and Valeria Caso
J. Clin. Med. 2022, 11(13), 3894; https://doi.org/10.3390/jcm11133894 - 04 Jul 2022
Cited by 1 | Viewed by 1978
Abstract
The association between atrial fibrillation (AF), acute coronary syndrome (ACS), and stroke is a complex scenario in which the assessment of both thrombotic and hemorrhagic risk is necessary for scheduling an individually tailored therapeutic plan. Recent clinical trials investigating new antithrombotic drugs and [...] Read more.
The association between atrial fibrillation (AF), acute coronary syndrome (ACS), and stroke is a complex scenario in which the assessment of both thrombotic and hemorrhagic risk is necessary for scheduling an individually tailored therapeutic plan. Recent clinical trials investigating new antithrombotic drugs and dual and triple pathways in high-risk cardiovascular patients have revealed a new therapeutic scenario. In this paper, we review the burden of ischemic stroke (IS) in patients post-myocardial infarction with and without atrial fibrillation and the possible therapeutic strategies from a stroke point of view. Full article
(This article belongs to the Special Issue Treatment and Outcome of Patients with Prior Cerebrovascular Accidents and Coronary Artery Disease)
12 pages, 248 KiB  
Review
Antithrombotic Therapy in Patients with Coronary Artery Disease and Prior Stroke
by Elisa Bellettini and Leonardo De Luca
J. Clin. Med. 2021, 10(9), 1923; https://doi.org/10.3390/jcm10091923 - 29 Apr 2021
Cited by 4 | Viewed by 1809
Abstract
Patients with coronary artery disease (CAD) and prior cerebrovascular events (CVE) are frequently faced in clinical practice and present a high rate of both ischemic and bleeding events. For these reasons, the antithrombotic management is particularly challenging in this subgroup of patients. Recent [...] Read more.
Patients with coronary artery disease (CAD) and prior cerebrovascular events (CVE) are frequently faced in clinical practice and present a high rate of both ischemic and bleeding events. For these reasons, the antithrombotic management is particularly challenging in this subgroup of patients. Recent trials suggest that, although a potent antiplatelet strategy is safe in the acute phases of myocardial ischemia for these patients, the risk of major bleeding complications, including intracranial hemorrhage, is extremely high when the antithrombotic therapy is prolonged for a long period of time. Therefore, especially in patients with chronic CAD and history of CVE, the antithrombotic management should be carefully balanced between ischemic and bleeding risks. The present review is aimed at critically evaluating the available evidence to help make these crucial clinical decisions regarding the better antithrombotic therapy to use in this high-risk subgroup of patients. Full article
(This article belongs to the Special Issue Treatment and Outcome of Patients with Prior Cerebrovascular Accidents and Coronary Artery Disease)
9 pages, 250 KiB  
Review
Oral Antiplatelet Therapy for Secondary Prevention of Non-Cardioembolic Ischemic Cerebrovascular Events
by Leonardo De Luca, Elisa Bellettini, Dario Di Maio, Enrico Natale, Rita Lucia Putini, Sabrina Anticoli, Furio Colivicchi, Paolo Calabrò, Francesco Musumeci and Domenico Gabrielli
J. Clin. Med. 2021, 10(8), 1721; https://doi.org/10.3390/jcm10081721 - 16 Apr 2021
Cited by 3 | Viewed by 1694
Abstract
Stroke is the leading cause of disability and mortality worldwide. After an acute cerebrovascular ischemia, recurrent vascular events, including recurrent stroke or transient ischemic accidents (TIA), occur in around 20% of cases within the first 3 months. In order to minimize this percentage, [...] Read more.
Stroke is the leading cause of disability and mortality worldwide. After an acute cerebrovascular ischemia, recurrent vascular events, including recurrent stroke or transient ischemic accidents (TIA), occur in around 20% of cases within the first 3 months. In order to minimize this percentage, antiplatelet therapy may play a key role in the management of non-cardioembolic cerebrovascular events. This review will focus on the current evidence of antiplatelet therapies most commonly discussed in practice guidelines and used in clinical practice for the treatment of stroke/TIA complications. The antiplatelet therapies most commonly used and discussed are as follows: aspirin, clopidogrel, and ticagrelor. Full article
(This article belongs to the Special Issue Treatment and Outcome of Patients with Prior Cerebrovascular Accidents and Coronary Artery Disease)
14 pages, 285 KiB  
Review
Lipid-Lowering Therapy in Patients with Coronary Heart Disease and Prior Stroke: Mission Impossible?
by Pier Luigi Temporelli, Marcello Arca, Laura D’Erasmo and Raffaele De Caterina
J. Clin. Med. 2021, 10(4), 886; https://doi.org/10.3390/jcm10040886 - 22 Feb 2021
Cited by 4 | Viewed by 2270
Abstract
Hyperlipidemia is a powerful risk factor for coronary heart disease (CHD). It has been known for a long time that lipid-lowering drugs significantly reduce morbidity from CHD, thus proving a causal role for cholesterol in coronary events. Conversely, the relationship between low-density lipoprotein [...] Read more.
Hyperlipidemia is a powerful risk factor for coronary heart disease (CHD). It has been known for a long time that lipid-lowering drugs significantly reduce morbidity from CHD, thus proving a causal role for cholesterol in coronary events. Conversely, the relationship between low-density lipoprotein cholesterol (LDL-C) levels and stroke has been less clear and debated for many years. Recent data conclusively demonstrate not only the inverse epidemiological relationship of blood LDL-C with stroke, but also the efficacy of different strategies to attain cholesterol-lowering on stroke. They also dissipate lingering doubts about the possibility that lipid-lowering is linked to an increase in hemorrhagic stroke. However, despite current international lipid guidelines now strongly recommend aggressive lipid-lowering therapy in patients with atherosclerotic cardiovascular disease, including CHD and cerebrovascular disease (CeVD), secondary prevention patients are often undertreated with lipid-lowering therapies in routine clinical practice. This review highlights that patients with CHD and concomitant CeVD do not receive aggressive lipid-lowering therapy despite being at very high risk and with clear evidence of benefit from lowering LDL-C levels below current targets. Full article
(This article belongs to the Special Issue Treatment and Outcome of Patients with Prior Cerebrovascular Accidents and Coronary Artery Disease)
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