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Update on the Diagnosis, Treatment, and Prognosis of Acute Coronary...
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Update on the Diagnosis, Treatment, and Prognosis of Acute Coronary Syndromes

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 April 2024) | Viewed by 2998

Special Issue Editors

Prof. Dr. Holger Thiele

grade E-Mail Website
Guest Editor
Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, 04289 Leipzig, Germany
Interests: acute myocardial infarction; cardiogenic shock; interventional cardiology; structural heart disease; cardiac imaging
Special Issues, Collections and Topics in MDPI journals
Dr. Hans-Josef Feistritzer

E-Mail Website
Guest Editor
Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, 04289 Leipzig, Germany
Interests: acute myocardial infarction; structural heart disease; interventional cardiology; cardiac imaging

Special Issue Information

Dear Colleagues,

Implementation of high-sensitivity cardiac troponin assays revolutionized diagnostic algorithms, in particular for patients with non-ST-elevation acute coronary syndromes (ACS). However, diagnosis may be challenging, especially in patients with inconclusive electrocardiograms and those without detectable stenosis in invasive coronary angiography. In these cases, further diagnostic approaches are needed. Besides primary percutaneous coronary intervention, the implementation of systems of care, modern antiplatelet and antithrombotic therapy as well as high intense lipid lowering therapy substantially improved the treatment and prognosis of ACS patients. Nevertheless, further efforts are needed to improve the treatment and prognosis, especially for patients with non-obstructive coronary arteries and those with high-risk ACS including cardiogenic shock.

This Special Issue focuses on innovative diagnostic and therapeutic strategies as well as comprehensive prognostic evaluation of patients with ACS. Among others, this comprises the management of patients with myocardial infarction with non-obstructive coronary arteries (MINOCA). What is the use of optical coherence tomography (OCT) in these patients? What is the value of cardiac magnetic resonance (CMR) imaging for diagnosis and prognostic assessment? Are there any upcoming invasive and non-invasive therapeutic strategies in patients with high-risk ACS? These and other topics should be addressed in this Special Issue. The present Special Issue aims to deepen the latest evidence in the field of ACS focusing on both diagnostic and therapeutic advances.

Therefore, we welcome the submission of “state-of-the-art” review articles as well as “cutting-edge” original research papers dealing with the topics of diagnostic and therapeutic advances in patients with ACS.

Prof. Dr. Holger Thiele
Dr. Hans-Josef Feistritzer
Guest Editors

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
  • acute myocardial infarction
  • interventional cardiology
  • cardiac imaging
  • intravascular imaging
  • cardiac magnetic resonance imaging
  • biomarkers
  • secondary prevention

Published Papers (2 papers)

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Review

18 pages, 940 KiB  
Review
Optimal Antithrombotic Strategies in Cardiogenic Shock
by Michal Droppa and Tobias Geisler
J. Clin. Med. 2024, 13(1), 277; https://doi.org/10.3390/jcm13010277 - 03 Jan 2024
Viewed by 1624
Abstract
Cardiogenic shock (CS) represents a critical condition with a high mortality rate. The most common cause of CS is coronary artery disease, and patients typically present with myocardial infarction, necessitating immediate treatment through percutaneous coronary intervention (PCI) and often requiring mechanical circulatory support. [...] Read more.
Cardiogenic shock (CS) represents a critical condition with a high mortality rate. The most common cause of CS is coronary artery disease, and patients typically present with myocardial infarction, necessitating immediate treatment through percutaneous coronary intervention (PCI) and often requiring mechanical circulatory support. CS is associated with a prothrombotic situation, while on the other hand, there is often a significant risk of bleeding. This dual challenge complicates the selection of an optimal antithrombotic strategy. The choice of antithrombotic agents must be personalized, taking into consideration all relevant conditions. Repeated risk assessment, therapeutic monitoring, and adjusting antithrombotic therapy are mandatory in these patients. This review article aims to provide an overview of the current evidence and practical guidance on antithrombotic strategies in the context of CS. Full article
(This article belongs to the Special Issue Update on the Diagnosis, Treatment, and Prognosis of Acute Coronary Syndromes)
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Graphical abstract

15 pages, 667 KiB  
Review
Reperfusion Injury: How Can We Reduce It by Pre-, Per-, and Postconditioning
by Maria Buske, Steffen Desch, Gerd Heusch, Tienush Rassaf, Ingo Eitel, Holger Thiele and Hans-Josef Feistritzer
J. Clin. Med. 2024, 13(1), 159; https://doi.org/10.3390/jcm13010159 - 27 Dec 2023
Viewed by 1102
Abstract
While early coronary reperfusion via primary percutaneous coronary intervention (pPCI) is established as the most efficacious therapy for minimizing infarct size (IS) in acute ST-elevation myocardial infarction (STEMI), the restoration of blood flow also introduces myocardial ischemia-reperfusion injury (IRI), leading to cardiomyocyte death. [...] Read more.
While early coronary reperfusion via primary percutaneous coronary intervention (pPCI) is established as the most efficacious therapy for minimizing infarct size (IS) in acute ST-elevation myocardial infarction (STEMI), the restoration of blood flow also introduces myocardial ischemia-reperfusion injury (IRI), leading to cardiomyocyte death. Among diverse methods, ischemic conditioning (IC), achieved through repetitive cycles of ischemia and reperfusion, has emerged as the most promising method to mitigate IRI. IC can be performed by applying the protective stimulus directly to the affected myocardium or indirectly to non-affected tissue, which is known as remote ischemic conditioning (RIC). In clinical practice, RIC is often applied by serial inflations and deflations of a blood pressure cuff on a limb. Despite encouraging preclinical studies, as well as clinical studies demonstrating reductions in enzymatic IS and myocardial injury on imaging, the observed impact on clinical outcome has been disappointing so far. Nevertheless, previous studies indicate a potential benefit of IC in high-risk STEMI patients. Additional research is needed to evaluate the impact of IC in such high-risk cohorts. The objective of this review is to summarize the pathophysiological background and preclinical and clinical data of IRI reduction by IC. Full article
(This article belongs to the Special Issue Update on the Diagnosis, Treatment, and Prognosis of Acute Coronary Syndromes)
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