jcm-logo

Journal Browser

Journal Browser

Acute Coronary Syndrome(ACS): From Emergency Intervention to Long-Term Prevention

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 1768

Special Issue Editors


E-Mail Website
Guest Editor
Cardiothoracic Department, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, 54100 Massa, Italy
Interests: coronary artery disease; atherosclerosis; cardiac computed tomography; chronic total occlusion; intravascular imaging

E-Mail Website
Guest Editor
Division of Structural Interventional Cardiology, Cardiothoracovascular Department, Careggi University Hospital, 50134 Florence, Italy
Interests: coronary artery disease; atherosclerosis; chronic total occlusion; intravascular imaging; calcified lesions

Special Issue Information

Dear Colleagues,

Acute coronary syndrome (ACS) remains a leading cause of morbidity and mortality worldwide despite major advances in diagnosis and treatment. Rapid emergency intervention—including early recognition, primary percutaneous coronary intervention, and optimal antithrombotic therapy—has significantly improved short-term survival. However, challenges persist in optimizing in-hospital care, improving risk stratification, and ensuring effective secondary prevention to reduce recurrent events and long-term complications. This Special Issue aims to gather cutting-edge research, clinical studies, and comprehensive reviews addressing the entire spectrum of ACS management, from pre-hospital and emergency care to long-term rehabilitation and secondary prevention strategies. Particular attention will be given to novel diagnostic tools, individualized treatment algorithms, health systems optimization, and adherence to evidence-based secondary prevention therapies. By fostering multidisciplinary contributions, this Special Issue seeks to promote integrated care models that translate into improved patient outcomes and reduced cardiovascular burden.

Dr. Marco Ciardetti
Dr. Alessio Mattesini
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 250 words) can be sent to the Editorial Office for assessment.

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
  • primary percutaneous coronary intervention
  • antithrombotic therapy
  • secondary prevention
  • risk stratification

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Review

22 pages, 1103 KB  
Review
Redefining Dual Antiplatelet Strategies After Acute Coronary Syndrome: Insights from Recent RCTs
by Maggie He, Joseph Magdy, Maryam Aziz, Jun Tan, Arka Das, Stephen B. Wheatcroft and Heerajnarain Bulluck
J. Clin. Med. 2026, 15(7), 2472; https://doi.org/10.3390/jcm15072472 - 24 Mar 2026
Viewed by 1101
Abstract
For nearly two decades, 12 months of dual antiplatelet therapy (DAPT) after acute coronary syndrome (ACS) has been the standard recommendation. Recent evidence suggests that abbreviated DAPT durations may reduce bleeding without compromising ischemic protection in selected patients. This review synthesizes randomized controlled [...] Read more.
For nearly two decades, 12 months of dual antiplatelet therapy (DAPT) after acute coronary syndrome (ACS) has been the standard recommendation. Recent evidence suggests that abbreviated DAPT durations may reduce bleeding without compromising ischemic protection in selected patients. This review synthesizes randomized controlled trials, meta-analyses, and guideline updates published between 2023 and 2025, evaluating abbreviated DAPT strategies after ACS with percutaneous coronary intervention. Immediate aspirin withdrawal after PCI increased early stent thrombosis in NEO-MINDSET and STOPDAPT-3. One-month DAPT followed by ticagrelor monotherapy reduced bleeding without increasing ischemic events in ULTIMATE-DAPT and T-PASS. Three-month strategies demonstrated the most consistent safety profile, with TWILIGHT showing 50% bleeding reduction without increased death, myocardial infarction, or stroke (noting that TWILIGHT included 35% chronic coronary syndrome patients). Clopidogrel monotherapy after abbreviated DAPT increased myocardial infarction in STOPDAPT-2 ACS, highlighting the importance of potent P2Y12 inhibition. Meta-analyses confirmed bleeding reductions with early P2Y12 inhibitor monotherapy across broader populations, though benefits were more pronounced in East Asian cohorts. Abbreviated DAPT strategies offer personalized alternatives to standard 12-month therapy. Three-month DAPT followed by ticagrelor monotherapy represents a reasonable and evidence-supported strategy in selected patients with ACS. Risk stratification tools and individual patient factors should guide therapy duration decisions. Full article
Show Figures

Figure 1

17 pages, 306 KB  
Review
SGLT2 Inhibitors After Myocardial Infarction: Evidence, Mechanisms and Gaps in Knowledge
by Angela Buonpane, Marco Ciardetti, Giancarlo Trimarchi, Giancarla Scalone, Michele Alessandro Coceani, Luigi Emilio Pastormerlo, Federica Marchi, Umberto Paradossi, Sergio Berti, Claudio Passino and Alberto Ranieri De Caterina
J. Clin. Med. 2026, 15(6), 2260; https://doi.org/10.3390/jcm15062260 - 16 Mar 2026
Viewed by 382
Abstract
Sodium–glucose cotransporter 2 inhibitors (SGLT2is) have revolutionized the treatment of heart failure and are now established as disease-modifying therapies across the spectrum of left ventricular ejection fraction. More recently, these agents have been evaluated in the early post-acute myocardial infarction (AMI) setting, raising [...] Read more.
Sodium–glucose cotransporter 2 inhibitors (SGLT2is) have revolutionized the treatment of heart failure and are now established as disease-modifying therapies across the spectrum of left ventricular ejection fraction. More recently, these agents have been evaluated in the early post-acute myocardial infarction (AMI) setting, raising interest in their potential role beyond heart failure prevention. Evidence from post-AMI randomized trials and contemporary meta-analyses consistently shows neutral effects on ischemic coronary outcomes, despite favorable effects on heart failure-related endpoints, ventricular remodeling, and cardiometabolic parameters. At the same time, data from experimental and translational research provide a biological framework in which SGLT2i exert anti-atherogenic effects through multiple complementary mechanisms, including improvement of cardiometabolic risk factors, attenuation of vascular and systemic inflammation, modulation of endothelial function, regulation of vascular smooth muscle cell behavior, macrophage inflammatory polarization, inhibition of inflammasome signaling, and modulation of the perivascular adipose tissue–vascular interface. Taken together, the available evidence highlights a dissociation between clinical trial outcomes in the early post-AMI phase and the underlying vascular biology associated with SGLT2 inhibition. While the dominant early clinical effects of SGLT2i appear to relate to hemodynamic and heart failure-preventive mechanisms, their potential impact on atherosclerotic disease may be more gradual and context-dependent. This review summarizes current clinical and mechanistic evidence supporting this interpretation and discusses the implications for understanding the role of SGLT2i in patients after AMI. Full article
Show Figures

Graphical abstract

Back to TopTop