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Diagnosis, Treatment and Prognosis of Coronary Heart Disease
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Diagnosis, Treatment and Prognosis of Coronary Heart Disease

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

Deadline for manuscript submissions: 31 January 2025 | Viewed by 5479

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,

Despite the advancements in diagnostic and therapeutic approaches over the past decades, coronary heart disease (CHD) remains the leading cause of morbidity and mortality worldwide. Current diagnosis and treatment emphasize the importance of a holistic approach that includes effective and timely preventive measures, early diagnosis preferably through non-invasive methods, the optimization of medical therapy based on current scientific evidence, and coronary revascularization through PCI or CABG where indicated. Emerging data regarding potential prognostic improvements in CHD are coming from new areas of intervention, such as precision medicine, minimally invasive procedures, stem cell therapy, and the clinical application of artificial intelligence.

We invite manuscripts regarding the latest information on coronary heart disease diagnosis, treatment and prognosis, including original clinical studies and reviews.

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

  • coronary heart disease
  • acute coronary syndrome
  • chronic coronary syndrome
  • ischemia with no obstructive coronary arteries (INOCA)
  • guideline-directed optimal medical therapy
  • precision medicine
  • artificial intelligence
  • interventional cardiology
  • percutaneous coronary intervention (PCI)

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Published Papers (5 papers)

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Research

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9 pages, 1788 KiB  
Article
Heat Shock Protein 70 Constitutes a Promising Novel Biomarker in Differential Diagnosis between Takotsubo Syndrome and Non-ST-Segment Elevation Myocardial Infarction
by Ozan Demirel, Vera Paar, Philipp Tolnai, Albert Topf, Uta C. Hoppe, Michael Lichtenauer and Moritz Mirna
J. Clin. Med. 2024, 13(14), 4152; https://doi.org/10.3390/jcm13144152 - 16 Jul 2024
Viewed by 929
Abstract
(1) Background: Due to similar clinical presentation and a lack of specific biomarkers, initial differentiation between Takotsubo syndrome (TTS) and non-ST-segment elevation myocardial infarction (NSTEMI) remains challenging in daily practice. Heat Shock Protein 70 (HSP70) is a novel biomarker that is recognized [...] Read more.
(1) Background: Due to similar clinical presentation and a lack of specific biomarkers, initial differentiation between Takotsubo syndrome (TTS) and non-ST-segment elevation myocardial infarction (NSTEMI) remains challenging in daily practice. Heat Shock Protein 70 (HSP70) is a novel biomarker that is recognized for its potential in the diagnosis and differentiation of cardiovascular conditions. (2) Methods: Data from a total of 156 patients were analyzed (32.1% NSTEMI, 32.7% TTS, and 35.3% controls). Serum concentrations of HSP70 were determined using ELISA and compared between patients and controls. ROC curve analysis, logistic regression analysis and propensity-score-weighted logistic regression were conducted. (3) Results: Concentrations of HSP70 were highest in patients with TTS (median 1727 pg/mL vs. ACS: median 1545 pg/mL vs. controls: median 583 pg/mL, p < 0.0001). HSP70 was predictive for TTS in binary logistic regression analysis (B(SE) = 0.634(0.22), p = 0.004), which even remained significant after correction for possible confounders in propensity-score-weighted analysis. ROC curve analysis also revealed a significant association of HSP70 with TTS (AUC: 0.633, p = 0.008). (4) Conclusions: Based on our findings, HSP70 constitutes a promising biomarker for discrimination between TTS and NSTEMI, especially in combination with established cardiovascular biomarkers like pBNP or high-sensitivity cardiac troponin. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Coronary Heart Disease)
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11 pages, 1554 KiB  
Article
Prognostic Assessment of HLM Score in Heart Failure Due to Ischemic Heart Disease: A Pilot Study
by Andrea D’Amato, Paolo Severino, Massimo Mancone, Marco Valerio Mariani, Silvia Prosperi, Lorenzo Colombo, Vincenzo Myftari, Claudia Cestiè, Aurora Labbro Francia, Rosanna Germanò, Nicola Pierucci, Francesca Fanisio, Stefanie Marek-Iannucci, Andrea De Prisco, Gianmarco Scoccia, Lucia Ilaria Birtolo, Giovanna Manzi, Carlo Lavalle, Gennaro Sardella, Roberto Badagliacca, Francesco Fedele and Carmine Dario Vizzaadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(11), 3322; https://doi.org/10.3390/jcm13113322 - 4 Jun 2024
Cited by 1 | Viewed by 889
Abstract
Background: Ischemic heart disease (IHD) represents the main cause of heart failure (HF). A prognostic stratification of HF patients with ischemic etiology, particularly those with acute coronary syndrome (ACS), may be challenging due the variability in clinical and hemodynamic status. The aim of [...] Read more.
Background: Ischemic heart disease (IHD) represents the main cause of heart failure (HF). A prognostic stratification of HF patients with ischemic etiology, particularly those with acute coronary syndrome (ACS), may be challenging due the variability in clinical and hemodynamic status. The aim of this study is to assess the prognostic power of the HLM score in a population of patients with ischemic HF and in a subgroup who developed HF following ACS. Methods: This is an observational, prospective, single-center study, enrolling consecutive patients with a diagnosis of ischemic HF. Patients were stratified according to the four different HLM stages of severity, and the occurrence of CV death, HFH, and worsening HF events were evaluated at 6-month follow-up. A sub-analysis was performed on patients who developed HF following ACS at admission. Results: The study included 146 patients. HLM stage predicts the occurrence of CV death (p = 0.01) and CV death/HFH (p = 0.003). Cox regression analysis confirmed HLM stage as an independent predictor of CV death (OR: 3.07; 95% IC: 1.54–6.12; p = 0.001) and CV death/HFH (OR: 2.45; 95% IC: 1.43–4.21; p = 0.001) in the total population of patients with HF due to IHD. HLM stage potentially predicts the occurrence of CV death (p < 0.001) and CV death/HFH (p < 0.001) in patients with HF following ACS at admission. Conclusions: Pathophysiological-based prognostic assessment through HLM score is a potentially promising tool for the prediction of the occurrence of CV death and CV death/HFH in ischemic HF patients and in subgroups of patients with HF following ACS at admission. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Coronary Heart Disease)
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13 pages, 2393 KiB  
Article
The Value of a Coronary Computed Tomography Angiography plus Stress Cardiac Magnetic Resonance Imaging Strategy for the Evaluation of Patients with Chronic Coronary Syndrome
by Gherardo Busi, Mattia Alexis Amico, Matteo Vannini, Giacomo Virgili, Angela Migliorini, Giulia Pontecorboli, Silvia Pradella, Manlio Acquafresca, Mario Moroni, Carlo Di Mario, Renato Valenti and Nazario Carrabba
J. Clin. Med. 2024, 13(6), 1556; https://doi.org/10.3390/jcm13061556 - 8 Mar 2024
Viewed by 1092
Abstract
Background: Noninvasive imaging methods, either anatomical or functional tests, serve as essential instruments for the appropriate management of patients with established or suspected coronary artery disease (CAD). We sought to evaluate the safety and efficacy of a coronary computed tomography angiography (CCTA) plus [...] Read more.
Background: Noninvasive imaging methods, either anatomical or functional tests, serve as essential instruments for the appropriate management of patients with established or suspected coronary artery disease (CAD). We sought to evaluate the safety and efficacy of a coronary computed tomography angiography (CCTA) plus stress cardiac magnetic resonance imaging (S-CMR) strategy in patients with chronic coronary syndrome (CCS). Methods: Patients with suspected CCS showing intermediate coronary plaques (stenosis 30–70%) at CCTA underwent S-CMR. Patients with a positive S-CMR were referred to invasive coronary angiography (ICA) plus instantaneous wave-free ratio (iFR), and myocardial revascularization if recommended. All patients received guideline-directed medical therapy (GDMT), including high-dose statins, regardless of myocardial revascularization. The primary endpoint was a composite of death from cardiovascular causes, non-fatal myocardial infarction, and unplanned revascularization. Results: According to the results of CCTA, 62 patients showing intermediate coronary plaques underwent S-CMR, which was positive for a myocardial perfusion deficit in n = 17 (27%) and negative in n = 45 (73%) patients. According to the results of ICA plus iFR, revascularization was performed in 13 patients. No differences in the primary endpoint between the positive and negative S-CMR groups were observed at 1 year (1 [5.9%] vs. 1 [2.2%], p = 0.485) and after a median of 33.4 months (2 [11.8%] vs. 3 [6.7%]; p = 0.605). Conclusions: Our study suggests that a CCTA plus S-CMR strategy is effective for the evaluation of patients with suspicion of CCS at low–intermediate risk, and it may help to refine the selection of patients with intermediate coronary plaques at CCTA needing coronary revascularization. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Coronary Heart Disease)
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17 pages, 3195 KiB  
Article
Quantitative Association between Computed-Tomography-Based L1 Skeletal Muscle Indices and Major Adverse Clinical Events Following Percutaneous Coronary Intervention
by Eun Jin Park, So Yeon Park, Jaeho Kang, Wonsang Chu and Dong Oh Kang
J. Clin. Med. 2023, 12(23), 7483; https://doi.org/10.3390/jcm12237483 - 3 Dec 2023
Viewed by 1285
Abstract
Sarcopenia is as a non-traditional risk factor for atherosclerotic cardiovascular disease. Further investigation is required to elucidate the prognostic significance of computed tomography (CT)-based sarcopenia assessment in coronary artery disease (CAD). We prospectively enrolled 475 patients, who underwent coronary stent implantation and peri-procedural [...] Read more.
Sarcopenia is as a non-traditional risk factor for atherosclerotic cardiovascular disease. Further investigation is required to elucidate the prognostic significance of computed tomography (CT)-based sarcopenia assessment in coronary artery disease (CAD). We prospectively enrolled 475 patients, who underwent coronary stent implantation and peri-procedural CT scans within one month. Skeletal muscle index (SMI) was assessed cross-sectionally at the first lumbar vertebra (L1) level. The participants were grouped based on sex-specific L1 SMI quartiles. The primary endpoint was all-cause mortality, and the secondary composite endpoint was major adverse cardiovascular events (MACEs) over a 3-year follow-up period. Three-year all-cause mortality and MACE incidence increased significantly in patients in the lower L1 SMI quartiles compared to those of patients in the higher quartiles (p < 0.001). The individual composite endpoints consistently showed a higher incidence in the lower quartiles of L1 SMI (p < 0.001). In multivariable analysis, the lower L1 SMI quartiles independently predicted 3-year all-cause mortality and MACEs (lowest vs. highest quartiles, respectively: OR 4.90 (95% CI 1.54–15.5), p = 0.007; and OR 12.3 (95% CI 4.99–30.4), p < 0.001). In conclusion, CT-based L1 SMI demonstrated a distinct dose-dependent relationship with future MACEs in CAD patients undergoing percutaneous coronary intervention, thereby enhancing cardiovascular risk stratification. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Coronary Heart Disease)
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Review

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19 pages, 1523 KiB  
Review
Takotsubo Syndrome and Gender Differences: Exploring Pathophysiological Mechanisms and Clinical Differences for a Personalized Approach in Patient Management
by Simona Giubilato, Giuseppina Maura Francese, Maria Teresa Manes, Roberta Rossini, Roberta Della Bona, Laura Gatto, Antonio Di Monaco, Filippo Zilio, Nicola Gasparetto, Carlotta Sorini Dini, Francesco Borrello, Antonia Mannarini, Angela Beatrice Scardovi, Daniela Pavan, Francesco Amico, Giovanna Geraci, Carmine Riccio, Furio Colivicchi, Massimo Grimaldi, Michele Massimo Gulizia and Fabrizio Olivaadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(16), 4925; https://doi.org/10.3390/jcm13164925 - 21 Aug 2024
Viewed by 800
Abstract
Takotsubo syndrome (TTS), also known as the broken-heart syndrome, is a reversible condition typically observed in female patients presenting for acute coronary syndromes (ACS). Despite its increasing incidence, TTS often remains undiagnosed due to its overlap with ACS. The pathophysiology of TTS is [...] Read more.
Takotsubo syndrome (TTS), also known as the broken-heart syndrome, is a reversible condition typically observed in female patients presenting for acute coronary syndromes (ACS). Despite its increasing incidence, TTS often remains undiagnosed due to its overlap with ACS. The pathophysiology of TTS is complex and involves factors such as coronary vasospasm, microcirculatory dysfunction, increased catecholamine levels, and overactivity of the sympathetic nervous system. Diagnosing TTS requires a comprehensive approach, starting with clinical suspicion and progressing to both non-invasive and invasive multimodal tests guided by a specific diagnostic algorithm. Management of TTS should be personalized, considering potential complications, the presence or absence of coronary artery disease (CAD), diagnostic test results, and the patient’s clinical course. The current data primarily derive from case series, retrospective analyses, prospective registries, and expert opinions. In recent years, there has been growing recognition of gender differences in the pathophysiology, presentation, and outcomes of TTS. This review provides an updated overview of gender disparities, highlighting the importance of tailored diagnostic and management strategies. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Coronary Heart Disease)
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