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Clinical Advances in Diagnosis and Management of Atherosclerosis
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Clinical Advances in Diagnosis and Management of Atherosclerosis

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 June 2024) | Viewed by 5154

Special Issue Editors

Prof. Dr. Adrian Covic

E-Mail Website
Guest Editor
1. Nephrology Clinic, Dialysis and Renal Transplant Center, "C.I. Parhon" University Hospital, Iasi, Romania
2. Faculty of Medicine, University of Medicine and Pharmacy “Gr. T. Popa”, 700115 Iasi, Romania
3. Academy of Romanian Scientists (AOSR), Iasi, Romania
Interests: nephrology; dialysis; atherosclerosis; cardiovascular diseases; blood pressure; endothelial function; arrhythmia
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Cristian Stătescu

E-Mail Website
Guest Editor
Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
Interests: cardiac arrhythmias; pacemakers; atherosclerosis; cardiovascular disease; coronary artery disease; electrocardiography
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Despite all the efforts made by international health authorities in the treatment of cardiovascular diseases, they still remain the leading cause of morbidity and mortality worldwide.  Among cardiovascular illnesses, coronary artery disease is acknowledged as the most prevalent, and its incidence is expected to increase, as a result of the increasing prevalence of traditional atherosclerotic and non-traditional cardiovascular risk factors. The focus of this Special Issue is to bring together contributions from international researchers in the area of diagnosis and management of atherosclerosis. Early recognition and immediate treatment are essential to improve the prognosis of patients. Original research, reviews and mini-reviews are welcomed, in order to share our knowledge about the latest approaches in the diagnosis and treatment of atherosclerosis. In addition, we welcome contributions that advance in our understanding of molecular mechanisms of atherosclerosis, with a special focus on studies with potential human translation.

Prof. Dr. Adrian Covic
Prof. Dr. Cristian Stătescu
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

  • atherosclerosis
  • cardiovascular disease
  • coronary artery disease
  • endothelial function
  • acute coronary syndromes

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Published Papers (4 papers)

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Research

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16 pages, 3300 KiB  
Article
Myocardial Expression of Pluripotency, Longevity, and Proinflammatory Genes in the Context of Hypercholesterolemia and Statin Treatment
by Konstantinos S. Mylonas, Michail Peroulis, Emmanouil I. Kapetanakis and Alkistis Kapelouzou
J. Clin. Med. 2024, 13(7), 1994; https://doi.org/10.3390/jcm13071994 - 29 Mar 2024
Cited by 1 | Viewed by 1022
Abstract
Background: This study sought to assess the effect of statin therapy on myocardial inflammation in a White New Zealand rabbit model of atherogenesis. Methods: The mRNA expression levels of pro-inflammatory, pluripotency, and aging-related markers were quantified following a controlled feeding protocol and statin [...] Read more.
Background: This study sought to assess the effect of statin therapy on myocardial inflammation in a White New Zealand rabbit model of atherogenesis. Methods: The mRNA expression levels of pro-inflammatory, pluripotency, and aging-related markers were quantified following a controlled feeding protocol and statin treatments. Results: Following high-cholesterol diet induction, we observed significant upregulation in the myocardial mRNA levels of MYD88, NF-κB, chemokines (CCL4, CCL20, and CCR2), IFN-γ, interleukins (IL-1β, IL-2, IL-4, IL-8, IL-10, and IL-18), and novel markers (klotho, KFL4, NANOG, and HIF1α). In contrast, HOXA5 expression was diminished following a hyperlipidemic diet. Both statin treatments significantly influenced the markers studied. Nevertheless, rosuvastatin administration resulted in a greater reduction in MYD88, NF-kB, chemokines (CCL4, CCL20, and CCR2), and interleukins IL-1β, IL-8, KLF4, NANOG, and HIF1α than fluvastatin. Fluvastatin, on the other hand, led to a stronger decrease in IL-4. Downregulation of IL-2 and IL-18 and upregulation of IFNβ and HOXA5 were comparable between the two statins. Notably, rosuvastatin had a stronger effect on the upregulation of klotho and IL-10. Conclusion: Overall, statin therapy significantly attenuated inflammatory, pluripotency, and klotho expression in myocardial tissue under atherogenic conditions. Our findings also highlight the differential efficacy of rosuvastatin over fluvastatin in curtailing proatherogenic inflammation, which could have profound implications for the clinical management of cardiovascular disease. Full article
(This article belongs to the Special Issue Clinical Advances in Diagnosis and Management of Atherosclerosis)
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10 pages, 1415 KiB  
Article
Impact of Pemafibrate Therapy on Reducing Small Dense Low-Density-Lipoprotein-Cholesterol Levels in Patients with Hypertriglyceridemia
by Yuki Hida, Teruhiko Imamura and Koichiro Kinugawa
J. Clin. Med. 2023, 12(21), 6915; https://doi.org/10.3390/jcm12216915 - 3 Nov 2023
Cited by 1 | Viewed by 1224
Abstract
Background: Small dense LDL-cholesterol is a recently discovered cardiovascular risk factor beyond LDL-cholesterol. Pemafibrate is a novel selective peroxisome proliferator-activated receptor-α modulator that reduces triglyceride levels. Given the significant association between triglycerides and small dense LDL-cholesterol levels, pemafibrate may reduce the levels of [...] Read more.
Background: Small dense LDL-cholesterol is a recently discovered cardiovascular risk factor beyond LDL-cholesterol. Pemafibrate is a novel selective peroxisome proliferator-activated receptor-α modulator that reduces triglyceride levels. Given the significant association between triglycerides and small dense LDL-cholesterol levels, pemafibrate may reduce the levels of small dense LDL-cholesterol. Methods: Patients with hypertriglyceridemia who started pemafibrate therapy and continued it for >3 months between 2018 and 2022 were included in this retrospective study. The levels of small dense LDL-cholesterol, which was estimated using Sampson’s equation, consisting of the LDL-cholesterol and triglyceride levels, were compared between baseline and 3-month follow-up. Results: A total of 98 patients receiving pemafibrate therapy (median age: 63 years, 69 male) were eligible, including 33 patients (34%) who received concomitant statins. Small dense LDL-cholesterol levels decreased significantly during the course of 3-month pemafibrate therapy from 48.9 (IQR: 35.7, 57.9) mg/dL to 38.8 (IQR: 30.0, 45.1) mg/dL, regardless of the concomitant administration of statins (p < 0.001). The rate of cardiovascular events decreased significantly from the pre-treatment 1-year period to the treatment 1-year period (from 13 to 2 events, from 0.133 to 0.021 events per year, incidence rate ratio: 0.16, 95% confidence interval: 0.14–0.17, p < 0.001). Conclusions: Pemafibrate therapy may mitigate the concentrations of small dense LDL-cholesterol autonomously in patients manifesting hypertriglyceridemia within the authentic clinical milieu. The clinical importance of the diminishment in small dense LDL-cholesterol instigated via pemafibrate merits further scrutiny. Full article
(This article belongs to the Special Issue Clinical Advances in Diagnosis and Management of Atherosclerosis)
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Review

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14 pages, 6649 KiB  
Review
Beyond Stress Ischemia: Unveiling the Multifaceted Nature of Coronary Vulnerable Plaques Using Cardiac Computed Tomography
by Gianluigi Napoli, Saima Mushtaq, Paolo Basile, Maria Cristina Carella, Daniele De Feo, Michele Davide Latorre, Andrea Baggiano, Marco Matteo Ciccone, Gianluca Pontone and Andrea Igoren Guaricci
J. Clin. Med. 2024, 13(14), 4277; https://doi.org/10.3390/jcm13144277 - 22 Jul 2024
Viewed by 637
Abstract
Historically, cardiovascular prevention has been predominantly focused on stress-induced ischemia, but recent trials have challenged this paradigm, highlighting the emerging role of vulnerable, non-flow-limiting coronary plaques, leading to a shift towards integrating plaque morphology with functional data into risk prediction models. Coronary computed [...] Read more.
Historically, cardiovascular prevention has been predominantly focused on stress-induced ischemia, but recent trials have challenged this paradigm, highlighting the emerging role of vulnerable, non-flow-limiting coronary plaques, leading to a shift towards integrating plaque morphology with functional data into risk prediction models. Coronary computed tomography angiography (CCTA) represents a high-resolution, low-risk, and largely available non-invasive modality for the precise delineation of plaque composition, morphology, and inflammatory activity, further enhancing our ability to stratify high-risk plaque and predict adverse cardiovascular outcomes. Coronary artery calcium (CAC) scoring, derived from CCTA, has emerged as a promising tool for predicting future cardiovascular events in asymptomatic individuals, demonstrating incremental prognostic value beyond traditional cardiovascular risk factors in terms of myocardial infarction, stroke, and all-cause mortality. Additionally, CCTA-derived information on adverse plaque characteristics, geometric characteristics, and hemodynamic forces provides valuable insights into plaque vulnerability and seems promising in guiding revascularization strategies. Additionally, non-invasive assessments of epicardial and pericoronary adipose tissue (PCAT) further refine risk stratification, adding prognostic significance to coronary artery disease (CAD), correlating with plaque development, vulnerability, and rupture. Moreover, CT imaging not only aids in risk stratification but is now emerging as a screening tool able to monitor CAD progression and treatment efficacy over time. Thus, the integration of CAC scoring and PCAT evaluation into risk stratification algorithms, as well as the identification of high-risk plaque morphology and adverse geometric and hemodynamic characteristics, holds promising results for guiding personalized preventive interventions, helping physicians in identifying high-risk individuals earlier, tailoring lifestyle and pharmacological interventions, and improving clinical outcomes in their patients. Full article
(This article belongs to the Special Issue Clinical Advances in Diagnosis and Management of Atherosclerosis)
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21 pages, 664 KiB  
Review
Patient-Related Factors Predicting Stent Thrombosis in Percutaneous Coronary Interventions
by Larisa Anghel, Bogdan-Sorin Tudurachi, Andreea Tudurachi, Alexandra Zăvoi, Alexandra Clement, Alexandros Roungos, Laura-Cătălina Benchea, Ioana Mădălina Zota, Cristina Prisacariu, Radu Andy Sascău and Cristian Stătescu
J. Clin. Med. 2023, 12(23), 7367; https://doi.org/10.3390/jcm12237367 - 28 Nov 2023
Cited by 3 | Viewed by 1706
Abstract
Over the past four decades, percutaneous coronary intervention (PCI) safety and efficacy have significantly improved, particularly with the advent of the drug-eluting stent (DES). First-generation DESs reduced in-stent restenosis rates and targeted lesion revascularization; however, safety issues emerged, due to high incidences of [...] Read more.
Over the past four decades, percutaneous coronary intervention (PCI) safety and efficacy have significantly improved, particularly with the advent of the drug-eluting stent (DES). First-generation DESs reduced in-stent restenosis rates and targeted lesion revascularization; however, safety issues emerged, due to high incidences of stent thrombosis (ST) linked to death, myocardial infarction, and repeat revascularization. Second-generation DESs were developed to overcome these issues, reducing late-thrombotic-event risk while maintaining anti-restenosis efficacy. Nevertheless, ST still occurs with second-generation DES use. Stent thrombosis etiology is multifaceted, encompassing lesion-, patient-, procedural-, and stent-related factors. Overall, most early-stent-thrombosis cases are linked to procedural and patient-related aspects. Factors like premature discontinuation of dual antiplatelet therapy, resistance to clopidogrel, smoking, diabetes mellitus, malignancy, reduced ejection fraction or undertaking coronary angioplasty for an acute coronary syndrome can increase the risk of stent thrombosis. The aim of this study is to assess patient-related factors that potentially heighten the risk of stent thrombosis, with the objective of pinpointing and addressing modifiable contributors to this risk. By focusing on both patient- and procedure-related factors, a multifaceted approach to coronary revascularization can help minimize complications and maximize long-term benefits in managing ST. Full article
(This article belongs to the Special Issue Clinical Advances in Diagnosis and Management of Atherosclerosis)
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