Early Diagnosis and Management of Coronary Artery Disease

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 4431

Special Issue Editors


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Guest Editor
Faculty of Public Health and Healthcare, Ruse University Angel Kanchev, 7017 Ruse, Bulgaria
Interests: coronary artery disease; coronary physiology; coronary bifurcation lesions; peripheral artery disease

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Guest Editor
1. Medical Faculty, Medical University of Sofia, 1431 Sofia, Bulgaria
2. Medica Cor Hospital, 7000 Ruse, Bulgaria
Interests: coronary artery disease; non-invasive cardiac imaging; cardiology

Special Issue Information

Dear Colleagues,

Coronary artery disease (CAD) remains a significant global health concern, with a substantial impact on morbidity and mortality. Timely and accurate diagnosis, as well as effective management strategies, are essential to mitigate the burden of CAD. The early diagnosis of CAD is hindered by the asymptomatic nature of the disease in its early stages. Left under-recognized and untreated, these cases have a worse prognosis than that of healthy counterparts. Patients may remain unaware of their condition until symptoms occur. Quite often they are late and nonspecific if present at all. Identifying individuals at a high risk of CAD and performing timely interventions are crucial to preventing adverse outcomes. Current methods for early CAD diagnosis are revolutionizing the concept of myocardial ischemia.

Advanced non-invasive imaging techniques, including coronary computed tomography angiography (CCTA), with or without functional assessment, cardiac magnetic resonance imaging (MRI), and perfusion scintigraphy, offer new and still underused diagnostic benefits for patients in the early stages of coronary artery disease. In addition to imaging biomarkers, new biochemical and molecular biomarkers become available, which makes possible the generation of multimodality early CAD scoring protocols for early detection and prognostication. On the other hand, invasive diagnostic procedures with the functional evaluation of epicardial and microvascular coronary artery disease play a pivotal role in the precise diagnosis and management of patients with CAD.

This Special Issue will delve into the latest approaches for the early identification of patients with CAD and their risk stratification. We will discuss the efficacy, cost-effectiveness, and challenges associated with new imaging modalities, as well as their possible combination with non-imaging (biochemical, molecular) and functional diagnostic methods. This Special Issue aspires to provide clinicians, researchers, and healthcare professionals with a comprehensive understanding of the evolving landscape of the early diagnosis and management of coronary artery disease. By addressing the gaps in the current methodology of early CAD detection, proper diagnosis, challenges to treatment, best practices, and innovations in this field, we aim to contribute to the improved care and outcomes of CAD patients worldwide.

Dr. Dobrin Iotkov Vassilev
Dr. Niya Boykova Mileva
Guest Editors

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Keywords

  • coronary artery disease
  • microvascular disease
  • ischemia

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Published Papers (3 papers)

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Review

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22 pages, 2740 KiB  
Review
Management of Coronary Artery Diseases in Systemic Vasculitides: Complications and Strategies
by Russka Shumnalieva, Niya Mileva, Ivan Padjen, Periklis Siliogkas, Lyubomir Chervenkov, Konstantina Bakopoulou, Issa El Kaouri, Anna Vasilska, Dimitrina Miteva, Dobrin Vassilev and Tsvetelina Velikova
Medicina 2024, 60(10), 1574; https://doi.org/10.3390/medicina60101574 - 25 Sep 2024
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Abstract
Coronary artery disease (CAD) presents a significant risk for patients with systemic vasculitides, a group of disorders characterized by the inflammation of blood vessels. In this review, we focus on the pathophysiological mechanisms, complications, and management strategies for CAD in systemic vasculitides. We [...] Read more.
Coronary artery disease (CAD) presents a significant risk for patients with systemic vasculitides, a group of disorders characterized by the inflammation of blood vessels. In this review, we focus on the pathophysiological mechanisms, complications, and management strategies for CAD in systemic vasculitides. We highlight how the inflammatory processes inherent in vasculitis contribute to accelerated atherosclerosis and myocardial ischemia. Key strategies in managing CAD in this patient population include using medicine treatments to mitigate vascular inflammation while balancing the risk of promoting cardiovascular events and lifestyle modifications. Understanding the nuanced relationship between systemic vasculitides and CAD is crucial for improving patient outcomes and guiding therapeutic approaches. Full article
(This article belongs to the Special Issue Early Diagnosis and Management of Coronary Artery Disease)
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16 pages, 1329 KiB  
Review
Current Challenges in Coronary Bifurcation Interventions
by Panayot Panayotov, Niya Mileva and Dobrin Vassilev
Medicina 2024, 60(9), 1439; https://doi.org/10.3390/medicina60091439 - 3 Sep 2024
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Abstract
Coronary bifurcation lesions account for a significant proportion of all percutaneous coronary interventions (PCIs). Interventional treatment of coronary bifurcations is related to significant technical challenges, high complication rates, and worse angiographic and long-term clinical outcomes. This review covers the specific features and structure [...] Read more.
Coronary bifurcation lesions account for a significant proportion of all percutaneous coronary interventions (PCIs). Interventional treatment of coronary bifurcations is related to significant technical challenges, high complication rates, and worse angiographic and long-term clinical outcomes. This review covers the specific features and structure of coronary bifurcation and explores the main challenges in the interventional treatment of these lesions. This review evaluates various methodologies designed to address these lesions, considering factors such as plaque distribution and bifurcation geometry. It also emphasizes the limitations associated with current techniques. A novel combined optimization approach applied in the interventional treatment of coronary bifurcation may offer superior procedural and long-term outcomes. This combined technique could potentially address the drawbacks of each method, providing a more effective solution for optimizing stent placement in bifurcation lesions. Refining and evaluating these combined techniques is essential for improving clinical outcomes in patients with bifurcation lesions. Full article
(This article belongs to the Special Issue Early Diagnosis and Management of Coronary Artery Disease)
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19 pages, 593 KiB  
Systematic Review
Current Trends in Biohumoral Screening for the Risk of Sudden Cardiac Death: A Systematic Review
by Oana-Maria Isailă, Lavinia-Alexandra Moroianu and Sorin Hostiuc
Medicina 2024, 60(3), 418; https://doi.org/10.3390/medicina60030418 - 29 Feb 2024
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Abstract
Background and Objectives: Sudden cardiac death (SCD) represents a challenge to health systems globally and is met with increased frequency in the population. Over time, multiple screening methods have been proposed, including the analysis of various plasma biomarkers. This article aims to [...] Read more.
Background and Objectives: Sudden cardiac death (SCD) represents a challenge to health systems globally and is met with increased frequency in the population. Over time, multiple screening methods have been proposed, including the analysis of various plasma biomarkers. This article aims to analyze for illustrative purposes the specialized literature in terms of current biomarkers and testing trends, in the case of cardiovascular diseases and implicitly sudden cardiac death. Materials and Methods: In this regard, we searched the PubMed database from 2010 to the present time using the keywords “sudden cardiac death” and “biomarkers”. The inclusion criteria were clinical trials that analyzed the effectiveness of screening methods in terms of biomarkers used in stratifying the risk of cardiac distress and/or sudden cardiac death. We excluded reviews, meta-analyses, and studies looking at the effectiveness of treatments. Results: An extended approach was found, through studies that brought to the forefront both classical markers analyzed by new, more performant methods, markers for other pathologies that also determined cardiovascular impact, non-specific molecules with effects on the cardiovascular system, and state-of-the-art markers, such as microRNA. Some molecules were analyzed simultaneously in certain groups of patients. Conclusion: The observed current trend revealed the tendency to define the clinical-biological particularities of the person to be screened. Full article
(This article belongs to the Special Issue Early Diagnosis and Management of Coronary Artery Disease)
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