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Prevention of Cardiovascular Diseases
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Prevention of Cardiovascular Diseases

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 February 2023) | Viewed by 7376

Special Issue Editor

Dr. Simona Giubilato

E-Mail Website
Guest Editor
Cardiology Department, Cannizzaro Hospital, 95126 Catania, Italy
Interests: coronary artery disease; cardiovascular intensive care; anthitrombotic therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiovascular disease (CVD) is the leading cause of death worldwide. Prevention is an important strategy to reduce death and suffering caused by CVD. The recent 2021 ESC Guidelines on CVD prevention encourage management strategies at both an individual level and a population level, focusing mostly—although not exclusively—on risk factors, risk classification, and the prevention of clinical events. These guidelines include recommendations on disease prevention aimed at primary care and hospital care, as well as a personalized treatment approach that provides individual lifetime risk factors. An important feature of the 2021 ESC guidelines is the attention to disease prevention in older adults, including individuals of 70 years and older. These guidelines highlight the importance of assessing high-risk individuals by evaluating lifetime risk and gradually increasing treatment or lifestyle changes that reduce the risk of CVD. The approach of clinical management ‘stepwise intensification’ is recommended to involve healthcare professionals and patients. Moreover, and for the first time, the updated 2021 ESC Guidelines also address the impact of environmental factors, including water, air, and soil pollution, on the risk of CVD.

In this Special Issue, we encourage authors to submit papers on strategies for primary and secondary prevention of CVD.

Dr. Simona Giubilato
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

  • heart failure
  • acute coronary syndrome
  • dyslipidemia
  • cardiac imaging

Published Papers (4 papers)

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Research

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12 pages, 570 KiB  
Article
Blood Count-Derived Inflammatory Markers and Acute Complications of Ischemic Heart Disease in Elderly Women
by Ewelina A. Dziedzic, Jakub S. Gąsior, Agnieszka Tuzimek and Wacław Kochman
J. Clin. Med. 2023, 12(4), 1369; https://doi.org/10.3390/jcm12041369 - 08 Feb 2023
Cited by 10 | Viewed by 1610
Abstract
Coronary artery disease (CAD) in women occurs later than in men. Underlying atherosclerosis, a chronic process of lipoprotein deposition in arterial walls with a prominent inflammatory component, is influenced by several risk factors. In women, commonly used inflammatory markers are generally found to [...] Read more.
Coronary artery disease (CAD) in women occurs later than in men. Underlying atherosclerosis, a chronic process of lipoprotein deposition in arterial walls with a prominent inflammatory component, is influenced by several risk factors. In women, commonly used inflammatory markers are generally found to be related to the occurrence of acute coronary syndrome (ACS), as well as the development of other diseases that influence CAD. New inflammatory markers derived from total blood count—systemic inflammatory response index (SII), systemic inflammatory reaction index (SIRI), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR)—were analyzed in the group of 244 elderly, postmenopausal women with the diagnosis of ACS or stable CAD. SII, SIRI, MLR, and NLR were significantly higher in women with ACS compared to those with stable CAD (p < 0.05 for all)—the highest values were observed in women with NSTEMI. MLR from new inflammatory markers, HDL, and history of MI turned out to be significant factors associated with ACS. These results suggest that MLR as representative of blood count-derived inflammatory markers may be considered as additional CVD risk factors in women with suspected ACS. Full article
(This article belongs to the Special Issue Prevention of Cardiovascular Diseases)
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10 pages, 1470 KiB  
Article
Real-World Use of Alirocumab: Experience from a Large Healthcare Provider
by Avishay Elis, Cheli Melzer Cohen and Gabriel Chodick
J. Clin. Med. 2023, 12(3), 1084; https://doi.org/10.3390/jcm12031084 - 30 Jan 2023
Viewed by 1584
Abstract
With the emerging use of anti-PCSK9 monoclonal antibodies for lowering low-density lipoprotein cholesterol (LDL-C) levels, real-world evidence (RWE) is needed to evaluate drug effectiveness. This study aimed to characterize new users of alirocumab and evaluate its effectiveness in achieving LDL-C target levels. Included [...] Read more.
With the emerging use of anti-PCSK9 monoclonal antibodies for lowering low-density lipoprotein cholesterol (LDL-C) levels, real-world evidence (RWE) is needed to evaluate drug effectiveness. This study aimed to characterize new users of alirocumab and evaluate its effectiveness in achieving LDL-C target levels. Included were patients initiating treatment with alirocumab from 1 August 2016 to 1 May 2020, with blood lipids evaluations during baseline (180 days prior to therapy initiation) and after 120 (±60) days of follow-up. Patients with treatment intensification during the follow-up period were excluded. LDL-C change from baseline and reaching LDL-C target levels, according to 2019 ESC/EAS guidelines, were evaluated. Among 623 included patients, 50.2% were men, the mean age was 65 years (±9 y), 62% were classified as very-high risk, and 76% had statin intolerance. During the follow-up, 65% (n = 407) were treated only with alirocumab. In 90% the initiation dose was 75 mg, and 21% were up-titrated. Alirocumab was associated with a 31.7% reduction in LDL-C, with 20.5% of patients reaching target levels. In this RWE study, alirocumab was used primarily as a single agent for eligible patients. Suboptimal use and adherence to therapy may have led to a lower LDL-C reduction compared to previous RCTs and most reported real-world studies. Full article
(This article belongs to the Special Issue Prevention of Cardiovascular Diseases)
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14 pages, 1489 KiB  
Article
Clinical Evaluation of Patients with Genetically Confirmed Familial Hypercholesterolemia
by Andrea Aparicio, Francisco Villazón, Lorena Suárez-Gutiérrez, Juan Gómez, Ceferino Martínez-Faedo, Edelmiro Méndez-Torre, Pablo Avanzas, Rut Álvarez-Velasco, Elías Cuesta-Llavona, Claudia García-Lago, David Neuhalfen, Eliecer Coto and Rebeca Lorca
J. Clin. Med. 2023, 12(3), 1030; https://doi.org/10.3390/jcm12031030 - 29 Jan 2023
Cited by 2 | Viewed by 1758
Abstract
Familial hypercholesterolemia (FH) is the most common genetic disorder associated with premature atherosclerotic cardiovascular (CV) disease (ASCVD). However, it still is severely underdiagnosed. Initiating lipid-lowering therapy (LLT) in FH patients early in life can substantially reduce their ASCVD risk. As a result, identifying [...] Read more.
Familial hypercholesterolemia (FH) is the most common genetic disorder associated with premature atherosclerotic cardiovascular (CV) disease (ASCVD). However, it still is severely underdiagnosed. Initiating lipid-lowering therapy (LLT) in FH patients early in life can substantially reduce their ASCVD risk. As a result, identifying FH is of the utmost importance. The increasing availability of genetic testing may be useful in this regard. We aimed to evaluate the genetic profiles, clinical characteristics, and gender differences between the first consecutive patients referred for genetic testing with FH clinical suspicion in our institution (a Spanish cohort). Clinical information was reviewed, and all participants were sequenced for the main known genes related to FH: LDLR, APOB, PCSK9 (heterozygous FH), LDLRAP1 (autosomal recessive FH), and two other genes related to hyperlipidaemia (APOE and LIPA). The genetic yield was 32%. Their highest recorded LDLc levels were 294 ± 65 SD mg. However, most patients (79%) were under > 1 LLT medication, and their last mean LDLc levels were 135 ± 51 SD. LDLR c.2389+4A>G was one of the most frequent pathogenic/likely pathogenic variants and its carriers had significantly worse LDLc highest recorded levels (348 ± 61 SD vs. 282 ± 60 SD mg/dL, p = 0.002). Moreover, we identified an homozygous carrier of the pathogenic variant LDLRAP1 c.207delC (autosomal recessive FH). Both clinical and genetic hypercholesterolemia diagnosis was significantly established earlier in men than in women (25 years old ± 15 SD vs. 35 years old ± 19 SD, p = 0.02; and 43 ± 17 SD vs. 54 ± 19 SD, p = 0.02, respectively). Other important CV risk factors were found in 44% of the cohort. The prevalence of family history of premature ASCVD was high, whereas personal history was exceptional. Our finding reaffirms the importance of early detection of FH to initiate primary prevention strategies from a young age. Genetic testing can be very useful. As it enables familial cascade genetic testing, early prevention strategies can be extended to all available relatives at concealed high CV risk. Full article
(This article belongs to the Special Issue Prevention of Cardiovascular Diseases)
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Review

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15 pages, 1917 KiB  
Review
Effectiveness of Telemedicine for Reducing Cardiovascular Risk: A Systematic Review and Meta-Analysis
by Jesús Jaén-Extremera, Diego Fernando Afanador-Restrepo, Yulieth Rivas-Campo, Alejandro Gómez-Rodas, Agustín Aibar-Almazán, Fidel Hita-Contreras, María del Carmen Carcelén-Fraile, Yolanda Castellote-Caballero and Raúl Ortiz-Quesada
J. Clin. Med. 2023, 12(3), 841; https://doi.org/10.3390/jcm12030841 - 20 Jan 2023
Cited by 5 | Viewed by 1886
Abstract
Background: Cardiovascular diseases are the leading cause of death globally. There are six cardiovascular risk factors: diabetes, hypertension, hypercholesterolemia, overweight, sedentary lifestyle and smoking. Due to the low attendance of healthy people in the health system, the use of telemedicine can influence the [...] Read more.
Background: Cardiovascular diseases are the leading cause of death globally. There are six cardiovascular risk factors: diabetes, hypertension, hypercholesterolemia, overweight, sedentary lifestyle and smoking. Due to the low attendance of healthy people in the health system, the use of telemedicine can influence the acquisition of a heart-healthy lifestyle. Objective: this systematic review and meta-analysis aimed to determine the effectiveness of telemedicine and e-health in reducing cardiovascular risk. Methods: A systematic review and meta-analysis were carried out using the PubMed, Scopus, Cinhal and WOS databases. Randomized controlled studies between 2017 and 2022 in which telemedicine was used to reduce any of the risk factors were included. The methodological quality was assessed using the “PEDro” scale. Results: In total, 763 studies were obtained; after the review, 28 target articles were selected and finally grouped as follows: 13 studies on diabetes, six on hypertension, seven on obesity and two on physical activity. For all of the risk factors, a small effect of the intervention was seen. Conclusions: although the current evidence is heterogeneous regarding the statistically significant effects of telemedicine on various cardiovascular risk factors, its clinical relevance is undeniable; therefore, its use is recommended as long as the necessary infrastructure exists. Full article
(This article belongs to the Special Issue Prevention of Cardiovascular Diseases)
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