Diagnosis and Treatment of Acute Coronary Syndrome (ACS)

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 2105

Special Issue Editor


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Guest Editor
1. Department of Cardiology, UT MD Anderson Cancer Center, Houston, TX, USA
2. Center for Artificial Intelligence & Health Inequities, Global System Analytics & Structures, New Orleans, LA, USA
Interests: cardio-oncology; artificial intelligence; health equities; bioethics; policy

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic highlighted the need for healthcare systems globally to improve the clinical effectiveness, cost efficiency, and societal equity of value-based care while optimizing population health as regards scale, scope, and speed. Particularly, the pandemic also highlighted failures in appropriate preventive care for coronary artery disease (or CAD, the top medical mortality cause), acute treatment of its related complication of acute coronary syndrome (ACS), and long-term chronic disease management. Concurrently, there has been a growing number of large, randomized controlled trials challenging long-considered standards of analysis and care in CAD and ACS management while also demonstrating the research disparities on vulnerable populations and lower income communities and countries. 

We invite colleagues to submit their original research and review articles for this Special Issue, covering topics such as risk stratification, pharmacological versus invasive treatment, health inequities, cost effectiveness, and new innovative analytics methods such as artificial intelligence (including machine learning and deep learning) for CAD and ACS management especially on traditionally under-represented populations.

Dr. Dominique J Monlezun
Guest Editor

Manuscript Submission Information

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Keywords

  • acute coronary syndrome
  • coronary artery disease
  • cardiology
  • artificial intelligence

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Published Papers (1 paper)

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Review

13 pages, 315 KiB  
Review
Updated Strategies in Non-Culprit Stenosis Management of Multivessel Coronary Disease—A Contemporary Review
by Rares-Dumitru Manuca, Alexandra Maria Covic, Crischentian Brinza, Mariana Floria, Cristian Statescu, Adrian Covic and Alexandru Burlacu
Medicina 2024, 60(2), 263; https://doi.org/10.3390/medicina60020263 - 2 Feb 2024
Viewed by 1642
Abstract
The prevalence of multivessel coronary artery disease (CAD) in acute coronary syndrome (ACS) patients underscores the need for optimal revascularization strategies. The ongoing debate surrounding percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), hybrid interventions, or medical-only management adds complexity to decision-making, [...] Read more.
The prevalence of multivessel coronary artery disease (CAD) in acute coronary syndrome (ACS) patients underscores the need for optimal revascularization strategies. The ongoing debate surrounding percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), hybrid interventions, or medical-only management adds complexity to decision-making, particularly in specific angiographic scenarios. The article critically reviews existing literature, providing evidence-based perspectives on non-culprit lesion revascularization in ACS. Emphasis is placed on nuances such as the selection of revascularization methods, optimal timing for interventions, and the importance of achieving completeness in revascularization. The debate between culprit-only revascularization and complete revascularization is explored in detail, focusing on ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI), including patients with cardiogenic shock. Myocardial revascularization guidelines and recent clinical trials support complete revascularization strategies, either during the index primary PCI or within a short timeframe following the culprit lesion PCI (in both STEMI and NSTEMI). The article also addresses the complexities of decision-making in NSTEMI patients with multivessel CAD, advocating for immediate multivessel PCI unless complex coronary lesions require a staged revascularization approach. Finally, the article provided contemporary data on chronic total occlusion revascularization in ACS patients, highlighting the prognostic impact. In conclusion, the article addresses the evolving challenges of managing multivessel CAD in ACS patients, enhancing thoughtful integration into the clinical practice of recent data. We provided evidence-based, individualized approaches to optimize short- and long-term outcomes. The ongoing refinement of clinical and interventional strategies for non-culprit lesion management remains dynamic, necessitating careful consideration of patient characteristics, coronary stenosis complexity, and clinical context. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Acute Coronary Syndrome (ACS))
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