Journal of Clinical Medicine

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Special Issue Editor

Dr. José Tuñón

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Guest Editor

1. Head of the Department of Cardiology, Fundación Jiménez Díaz, Madrid, Spain
2. Department of Cardiology, Autónoma University, Madrid, Spain
Interests: atherosclerosis; inflammation; biomarkers; lipids; prevention; mineral metabolism

Special Issue Information

Dear Colleagues,

Atherosclerosis is the leading cause of death in the Western world. The treatment of this disorder has evolved over the last few years due to both new therapies and improved risk stratification. Novel treatments, such as new lipid-lowering and antidiabetic drugs, modulators of the renin–angiotensin system, antiplatelet therapies and, more recently, anti-inflammatory drugs have been demonstrated to decrease the incidence of cardiovascular events. Furthermore, the evolution of imaging techniques has allowed for the non-invasive detection of preclinical atherosclerosis, increasing the possibility of detecting this disorder in early phases.

When patients develop acute coronary syndromes, new biomarkers, such as high-sensitivity troponin, and improved revascularization techniques may contribute to improving the outcomes of these patients. In addition, novel techniques may lead us to the discovery of new genetic and plasma biomarkers that may enhance our ability to identify populations at high risk of developing adverse outcomes. In this way, we will be able to use more intensive therapies in these subjects, in order to effectively decrease the incidence of future cardiovascular events.

In this Special Issue, we intend to review these topics in order to provide the reader with an update regarding the most recent improvements in the prevention and treatment of atherosclerosis.

Dr. José Tuñón
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

Atherosclerosis
Acute coronary syndromes
Lipids
Antiplatelet therapies
Biomarkers
Revascularization

Published Papers (2 papers)

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Research

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11 pages, 1486 KiB

Open AccessArticle

Association of GRACE Risk Score with Coronary Artery Disease Complexity in Patients with Acute Coronary Syndrome

by Georgios Sofidis, Nikolaos Otountzidis, Nikolaos Stalikas, Efstratios Karagiannidis, Andreas S. Papazoglou, Dimitrios V. Moysidis, Eleftherios Panteris, Olga Deda, Anastasios Kartas, Thomas Zegkos, Paraskevi Daskalaki, Niki Theodoridou, Leandros Stefanopoulos, Haralambos Karvounis, Helen Gika, Georgios Theodoridis and Georgios Sianos

J. Clin. Med. 2021, 10(10), 2210; https://doi.org/10.3390/jcm10102210 - 20 May 2021

Cited by 8 | Viewed by 4181

Abstract

The GRACE score constitutes a useful tool for risk stratification in patients with acute coronary syndrome (ACS), while the SYNTAX score determines the complexity of coronary artery disease (CAD). This study sought to correlate these scores and assess the accuracy of the GRACE score in predicting the extent of CAD. A total of 539 patients with ACS undergoing coronary angiography were included in this analysis. The patients were classified into those with a SYNTAX score < 33 and a SYNTAX score ≥ 33. Spearman’s correlation and receiver operator characteristic analysis were conducted to investigate the role of the GRACE score as a predictor of the SYNTAX score. There was a significantly positive correlation between the SYNTAX and the GRACE scores (r = 0.32, p < 0.001). The GRACE score predicted severe CAD (SYNTAX ≥ 33) moderately well (the area under the curve was 0.595 (0.522–0.667)). A GRACE score of 126 was documented as the optimal cut-off for the prediction of a SYNTAX score ≥ 33 (sensitivity = 53.5% and specificity = 66%). Therefore, our study reports a significantly positive correlation between the GRACE and the SYNTAX score in patients with ACS. Notably, NSTEMI patients with a high-risk coronary anatomy have higher calculated GRACE scores. A multidisciplinary approach by a heart team could possibly alter the therapeutic approach and management in patients presenting with ACS and a high calculated GRACE score. Full article

(This article belongs to the Special Issue Management of Acute Coronary Syndromes and Prevention of Atherosclerosis)

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Graphical abstract

Review

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15 pages, 1318 KiB

Open AccessReview

Anti-Inflammatory Drugs in Patients with Ischemic Heart Disease

by Ana María Pello Lázaro, Luis M. Blanco-Colio, Juan Antonio Franco Peláez and José Tuñón

J. Clin. Med. 2021, 10(13), 2835; https://doi.org/10.3390/jcm10132835 - 27 Jun 2021

Cited by 6 | Viewed by 4567

Abstract

Inflammation has long been known to play a role in atherogenesis and plaque complication, as well as in some drugs used in therapy for atherosclerotic disease, such as statins, acetylsalicylic acid, and modulators of the renin-angiotensin system, which also have anti-inflammatory effects. Furthermore, inflammatory biomarkers have been demonstrated to predict the incidence of cardiovascular events. In spite of this, and with the exception of acetylsalicylic acid, non-steroidal anti-inflammatory drugs are unable to decrease the incidence of cardiovascular events and may even be harmful to the cardiovascular system. In recent years, other anti-inflammatory drugs, such as canakinumab and colchicine, have shown an ability to reduce the incidence of cardiovascular events in secondary prevention. Colchicine could be a potential candidate for use in clinical practice given its safety and low price, although the results of temporary studies require confirmation in large randomized clinical trials. In this paper, we discuss the evidence linking inflammation with atherosclerosis and review the results from various clinical trials performed with anti-inflammatory drugs. We also discuss the potential use of these drugs in routine clinical settings. Full article

(This article belongs to the Special Issue Management of Acute Coronary Syndromes and Prevention of Atherosclerosis)

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