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Advancements in Myocardial Infarction Care: Strategies and Outcomes
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Advancements in Myocardial Infarction Care: Strategies and Outcomes

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

Deadline for manuscript submissions: closed (20 September 2024) | Viewed by 2799

Special Issue Editor

Dr. Umberto Paradossi

E-Mail Website
Guest Editor
Cardiology Unit, Heart Centre, Fondazione Gabriele Monasterio—Regione Toscana, Massa, Italy
Interests: coronary artery disease; percutaneous interventions; myocardial infarction; acute coronary syndrome; STEMI

Special Issue Information

Dear Colleagues,

We are delighted to present this Special Issue titled “Advancements in Myocardial Infarction Care: Strategies and Outcomes”, a collection aimed at highlighting the strides made in the care strategies for myocardial infarction (MI) and their impact on patient outcomes.

MI remains a leading cause of morbidity and mortality worldwide, necessitating an ongoing effort to refine and innovate the ways in which we approach its management. From prevention to post-event rehabilitation, this Special Issue aims to explore the full spectrum of MI care, providing insights into the latest research, techniques, and technologies reshaping the field.

We aim to delve into advancements in diagnostics, where rapid detection and precise characterization of MI allow for timely and tailored treatment regimens. Breakthroughs in imaging and biomarkers offer practitioners new tools to enhance clinical decision-making.

Contributors are invited to share their experiences with novel antithrombotic agents, the evolution of percutaneous coronary intervention techniques, and cutting-edge interventional procedures to improve recovery times and outcomes. We, also, invite authors to emphasize in their papers the emerging trends in cardiac rehabilitation, secondary prevention programs, and long-term management of patients.

We hope that this Special Issue sparks dialogue, fosters collaboration, and encourages the continued pursuit of excellence in the care of those affected by MI.

We look forward to receiving your contributions.

Dr. Umberto Paradossi
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

  • myocardial infarction
  • antithrombotic agents
  • cardiovascular prevention
  • interventional cardiology
  • cardiac rehabilitation
  • percutaneous interventions
  • STEMI

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

Published Papers (3 papers)

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Research

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13 pages, 999 KiB  
Article
Advanced Lung Cancer Inflammation Index as Predictor of All-Cause Mortality in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention
by Giancarlo Trimarchi, Fausto Pizzino, Alessio Lilli, Alberto Ranieri De Caterina, Augusto Esposito, Stefano Dalmiani, Annamaria Mazzone, Gianluca Di Bella, Sergio Berti and Umberto Paradossi
J. Clin. Med. 2024, 13(20), 6059; https://doi.org/10.3390/jcm13206059 - 11 Oct 2024
Viewed by 477
Abstract
Background: The advanced lung cancer inflammation index (ALI) is an independent prognostic biomarker used to assess inflammation and nutritional status in various cancers, heart failure, and acute coronary syndromes. This study investigates the prognostic significance of ALI in patients experiencing ST-elevation myocardial infarction [...] Read more.
Background: The advanced lung cancer inflammation index (ALI) is an independent prognostic biomarker used to assess inflammation and nutritional status in various cancers, heart failure, and acute coronary syndromes. This study investigates the prognostic significance of ALI in patients experiencing ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), comparing its predictive abilities with the established Neutrophil-Lymphocyte Ratio (NLR). Methods: We conducted a retrospective analysis of 1171 patients from the Matrix Registry, encompassing demographic and clinical data for STEMI cases treated with pPCI, and ALI was determined using the formula [serum albumin (g/dL) × body mass index (kg/m2)]/NLR at the time of hospital admission. The primary outcome was all-cause mortality. Results: Of the 1171 patients, 86 died during the follow-up period. Univariate analysis identified age, female gender, smoking, hypertension, diabetes, prior myocardial infarction (PMI), lower left ventricular ejection fraction (LVEF), and reduced ALI as factors associated with mortality. Multivariate analysis confirmed age (HR: 1.1, 95% CI: 1.05–1.11, p < 0.001) and PMI (HR: 2.4, 95% CI: 1.4–4.3, p = 0.001) as prominent independent predictors, alongside ALI (HR: 0.95, 95% CI: 0.92–0.97, p < 0.001) and LVEF (HR: 0.98, 95% CI: 0.97–0.99, p = 0.04). An ALI cut-off of ≤10 indicated a higher mortality risk (HR: 2.3, 95% CI: 1.5–3.7, p < 0.001). The area under the curve for ALI (0.732) surpassed that for NLR (0.685), demonstrating ALI’s superior predictive capability. Conclusions: ALI is an independent prognostic factor for all-cause mortality in STEMI patients undergoing pPCI, showing greater discriminatory power than NLR, particularly in patients with ALI values ≤ 10, who face a 2.3-fold higher mortality risk. Full article
(This article belongs to the Special Issue Advancements in Myocardial Infarction Care: Strategies and Outcomes)
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Review

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17 pages, 765 KiB  
Review
Management of Acute Coronary Syndrome in Elderly Patients: A Narrative Review through Decisional Crossroads
by Roberto Verardi, Gianmarco Iannopollo, Giulia Casolari, Giampiero Nobile, Alessandro Capecchi, Matteo Bruno, Valerio Lanzilotti and Gianni Casella
J. Clin. Med. 2024, 13(20), 6034; https://doi.org/10.3390/jcm13206034 - 10 Oct 2024
Viewed by 784
Abstract
Diagnosis and treatment of acute coronary syndrome (ACS) pose particular challenges in elderly patients. When high troponin levels are detected, the distinction between non-ischemic myocardial injury (NIMI), type 1, and type 2 myocardial infarction (MI) is the necessary first step to guide further [...] Read more.
Diagnosis and treatment of acute coronary syndrome (ACS) pose particular challenges in elderly patients. When high troponin levels are detected, the distinction between non-ischemic myocardial injury (NIMI), type 1, and type 2 myocardial infarction (MI) is the necessary first step to guide further care. However, the assessment of signs of ischemia is hindered in older patients, and no simple clinical or laboratory tool proved useful in this discrimination task. Current evidence suggests a benefit of an invasive vs. conservative approach in terms of recurrence of MI, with no significant impact on mortality. In patients with multivessel disease in which the culprit lesion has been treated, a physiology-guided complete percutaneous revascularization significantly reduced major events. The management of ACS in elderly patients is an example of the actual need for a multimodal, thorough clinical approach, coupled with shared decision-making, in order to ensure the best treatment and avoid futility. Such a need will likely grow throughout the next decades, with the aging of the world population. In this narrative review, we address pivotal yet common questions arising in clinical practice while caring for elderly patients with ACS. Full article
(This article belongs to the Special Issue Advancements in Myocardial Infarction Care: Strategies and Outcomes)
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32 pages, 11062 KiB  
Review
Optical Coherence Tomography in Myocardial Infarction Management: Enhancing Precision in Percutaneous Coronary Intervention
by Angela Buonpane, Giancarlo Trimarchi, Marco Ciardetti, Michele Alessandro Coceani, Giulia Alagna, Giovanni Benedetti, Sergio Berti, Giuseppe Andò, Francesco Burzotta and Alberto Ranieri De Caterina
J. Clin. Med. 2024, 13(19), 5791; https://doi.org/10.3390/jcm13195791 - 28 Sep 2024
Viewed by 1267
Abstract
In acute myocardial infarction (AMI), the urgency of coronary revascularization through percutaneous coronary intervention (PCI) is paramount, offering notable advantages over pharmacologic treatment. However, the persistent risk of adverse events, including recurrent AMI and heart failure post-revascularization, underscores the necessity for enhanced strategies [...] Read more.
In acute myocardial infarction (AMI), the urgency of coronary revascularization through percutaneous coronary intervention (PCI) is paramount, offering notable advantages over pharmacologic treatment. However, the persistent risk of adverse events, including recurrent AMI and heart failure post-revascularization, underscores the necessity for enhanced strategies in managing coronary artery disease. Traditional angiography, while widely employed, presents significant limitations by providing only two-dimensional representations of complex three-dimensional vascular structures, hampering the accurate assessment of plaque characteristics and stenosis severity. Intravascular imaging, specifically optical coherence tomography (OCT), significantly addresses these limitations with superior spatial resolution compared to intravascular ultrasound (IVUS). Within the context of AMI, OCT serves dual purposes: as a diagnostic tool to accurately identify culprit lesions in ambiguous cases and as a guide for optimizing PCI procedures. Its capacity to differentiate between various mechanisms of acute coronary syndrome, such as plaque rupture and spontaneous coronary dissection, enhances its diagnostic potential. Furthermore, OCT facilitates precise lesion preparation, optimal stent sizing, and confirms stent deployment efficacy. Recent meta-analyses indicate that OCT-guided PCI markedly improves safety and efficacy in revascularization, subsequently decreasing the risks of mortality and complications. This review emphasizes the critical role of OCT in refining patient-specific therapeutic approaches, aligning with the principles of precision medicine to enhance clinical outcomes for individuals experiencing AMI. Full article
(This article belongs to the Special Issue Advancements in Myocardial Infarction Care: Strategies and Outcomes)
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