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Research Advances in Coronary Revascularization
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Research Advances in Coronary Revascularization

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 October 2024) | Viewed by 2336

Special Issue Editors

Prof. Dr. Irzal Hadžibegović

E-Mail Website
Guest Editor
Department of Cardiovascular Medicine, Dubrava University Hospital, Av. Gojka Suska 6, 10000 Zagreb, Croatia
Interests: interventional cardiology; coronary revascularization; coronary local drug delivery; transcatheter aortic valve im-plantation; structural heart disease interventions; thrombosis; resuscitation; medical statistics
Dr. Daniel Unić

E-Mail Website
Guest Editor
Department of Cardiac and Transplantation Medicine, Dubrava University Hospital, Av. Gojka Suska 6, 10000 Zagreb, Croatia
Interests: cardiac surgery; coronary artery by-pass grafting; mitral valve repair; transcatheter aortic valve implantation; heart transplantation; postoperative care; translational medicine
Dr. Vjekoslav Tomulić

E-Mail Website
Guest Editor
Head of Interventional Cardiology Clinic for Heart and Blood Diseases, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia
Interests: cardiac function; heart mitral valve; acute coronary syndrome; heart failure

Special Issue Information

Dear Colleagues,

In the dynamic world of contemporary cardiology, coronary revascularization has been constantly scrutinized and redefined, especially in the realm of chronic coronary syndromes. This Special Issue of the Journal of Clinical Medicine spotlights the transformative steps achieved, particularly in novel techniques in percutaneous coronary interventions (PCI) and optimization strategies in cardiac surgery. While PCI and cardiac surgery have somewhat distinct trajectories, the integration of new knowledge and advanced technologies bridge the gap between disciplines, underpinning a comprehensive approach to coronary revascularization. Recent insights into the role of coronary physiology in coronary revascularization planning and the concept of “leaving nothing behind” after PCI have emerged as new paths in the field and receive substantial scientific attention.

For this Special Issue, entitled “Research Advances in Coronary Revascularization”, we call for papers that highlight the quest for the optimization of coronary revascularization, from diagnosis to treatment, in order to achieve the best long-term results for patients treated in the modern era.

Prof. Dr. Irzal Hadžibegović
Dr. Daniel Unić
Dr. Vjekoslav Tomulić
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

  • coronary artery disease
  • chronic coronary syndrome
  • acute coronary syndrome
  • percutaneous coronary intervention
  • coronary artery bypass graft surgery
  • coronary plaque healing
  • drug eluting stents
  • drug coated balloons
  • intravascular imaging
  • coronary physiology

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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

12 pages, 566 KiB  
Article
Chronic Total Occlusions in Non-Infarct-Related Coronary Arteries and Long-Term Cardiovascular Mortality in Patients Receiving Percutaneous Coronary Intervention in Acute Coronary Syndromes
by Irzal Hadžibegović, Ivana Jurin, Mihajlo Kovačić, Tomislav Letilović, Ante Lisičić, Aleksandar Blivajs, Domagoj Mišković, Anđela Jurišić, Igor Rudež and Šime Manola
J. Clin. Med. 2024, 13(23), 7094; https://doi.org/10.3390/jcm13237094 (registering DOI) - 24 Nov 2024
Viewed by 180
Abstract
Background and aim: Patients with non-infarct-related artery chronic total occlusion (non-IRA CTO) found during percutaneous coronary intervention (PCI) in acute coronary syndromes (ACSs) are not rare and have worse clinical outcomes. We aimed to analyze their long-term clinical outcomes in regard to [...] Read more.
Background and aim: Patients with non-infarct-related artery chronic total occlusion (non-IRA CTO) found during percutaneous coronary intervention (PCI) in acute coronary syndromes (ACSs) are not rare and have worse clinical outcomes. We aimed to analyze their long-term clinical outcomes in regard to clinical characteristics, revascularization strategies, and adherence to medical therapy. Patients and methods: The dual-center ACS registry of patients treated from Jan 2017 to May 2023 was used to identify 1950 patients with timely PCI in ACS who survived to discharge with documented adequate demographic, clinical, and angiographic characteristics, treatment strategies, and medical therapy adherence during a median follow-up time of 49 months. Results: There were 171 (9%) patients with non-IRA CTO. In comparison to patients without non-IRA CTO, they were older, with more diabetes mellitus (DM), higher Syntax scores (median 27.5 vs. 11.5), and lower left ventricular ejection fraction (LVEF) at discharge (median LVEF 50% vs. 55%). There was also a lower proportion of patients with high adherence to medical therapy (32% vs. 46%). Patients with non-IRA CTO had significantly higher cardiovascular mortality during follow-up (18% vs. 8%, RR 1.87, 95% CI 1.27–2.75). After adjusting for relevant clinical and treatment characteristics in a multivariate Cox regression analysis, only lower LVEF, worse renal function, the presence of DM, and lower adherence to medical therapy were independently associated with higher cardiovascular mortality during follow-up, with low adherence to medical therapy as the strongest predictor (RR 3.18, 95% CI 1.76–5.75). Time to cardiovascular death was significantly lower in patients who did not receive non-IRA CTO revascularization, although CTO revascularization did not show independent association with survival in the multivariate analysis. Conclusions: Patients with non-IRA CTO found during ACS treatment have more unfavorable clinical characteristics, worse adherence to medical therapy, and higher cardiovascular mortality. They need a more scrutinized approach during follow-up to increase adherence to optimal medical therapy and to receive revascularization of the non-IRA CTO whenever it is clinically indicated and reasonably achievable without excess risks. Full article
(This article belongs to the Special Issue Research Advances in Coronary Revascularization)
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14 pages, 2181 KiB  
Article
Postoperative Atrial Fibrillation Prediction by Left Atrial Size in Coronary Artery Bypass Grafting and Five-Year Survival Outcome
by Mustafa Gerçek, Jochen Börgermann, Jan Gummert and Muhammed Gerçek
J. Clin. Med. 2024, 13(13), 3738; https://doi.org/10.3390/jcm13133738 - 26 Jun 2024
Cited by 1 | Viewed by 1095
Abstract
Background: Postoperative Atrial Fibrillation (POAF) is a common complication in cardiac surgery. Despite its multifactorial origin, the left atrial (LA) size is closely linked to POAF, raising the question of a valid cut-off value and its impact on the long-term outcome. Methods [...] Read more.
Background: Postoperative Atrial Fibrillation (POAF) is a common complication in cardiac surgery. Despite its multifactorial origin, the left atrial (LA) size is closely linked to POAF, raising the question of a valid cut-off value and its impact on the long-term outcome. Methods: Patients without a history of AF who underwent coronary artery bypass grafting between 2014 and 2016 were selected for this retrospective study. LA size was preoperatively assessed using the left atrial anterior–posterior diameter (LAAPd). Correlation and logistic regression analyses were performed, following a receiver-operating characteristic (ROC) analysis. Propensity score matching (PSM) was applied to ensure group comparability, followed by a comparison analysis regarding the primary endpoint of POAF and the secondary endpoints of all-cause mortality and stroke during a five-year follow-up. Results: A total of 933 patients were enrolled in the study eventually revealing a significant correlation between LAAPd and POAF (cor = 0.09, p < 0.01). A cut-off point of 38.5 mm was identified, resulting in groups with 366 patients each after PSM. Overall, patients with a dilated LA presented a significantly higher rate of POAF (22.3% vs. 30.4%, p = 0.02). In a five-year follow-up, a slightly higher rate of all-cause mortality (9.8% vs. 13.7%, HR 1.4 [0.92–2.29], p = 0.10) was observed, but there was no difference in the occurrence of strokes (3.6% vs. 3.3%, p = 0.87). Conclusions: An LAAPd of >38.5 mm was found to be an independent predictor of POAF after coronary artery bypass grafting and resulted in a non-significant tendency towards a worse outcome regarding all-cause mortality in a five-year follow-up. Full article
(This article belongs to the Special Issue Research Advances in Coronary Revascularization)
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16 pages, 2370 KiB  
Article
Ten-Year Outcomes in Patients Undergoing Simultaneous Coronary and Renal Angiography—Does Renal Artery Stenosis Matter?
by Adam Kern, Tomasz Stompór, Krystian Bojko, Ewa Sienkiewicz, Sebastian Pawlak, Dariusz Pawlak, Grzegorz Poskrobko, Ewa Andrasz, Leszek Gromadziński, Rakesh Jalali, Dariusz Onichimowski, Grażyna Piwko, Artur Zalewski and Jacek Bil
J. Clin. Med. 2024, 13(12), 3374; https://doi.org/10.3390/jcm13123374 - 7 Jun 2024
Cited by 1 | Viewed by 803
Abstract
Background: We aimed to characterize the population of consecutive patients undergoing coronary angiography with simultaneous renal artery angiography and assess prognostic factors at a 10 year follow-up. Methods: The KORONEF study was a prospective, single-center, observational, and descriptive study with 492 patients included. [...] Read more.
Background: We aimed to characterize the population of consecutive patients undergoing coronary angiography with simultaneous renal artery angiography and assess prognostic factors at a 10 year follow-up. Methods: The KORONEF study was a prospective, single-center, observational, and descriptive study with 492 patients included. We analyzed several baseline demographics, clinical and periprocedural characteristics, and laboratory data, and we assessed the results of coronary angiography and renal artery angiography. Results: The study population consisted of 37.2% women, and the mean age was 64.4 ± 9.9 years (min. 30 years, max. 89 years). Angiography revealed significant renal artery stenosis (RAS) in 35 (7.1%) patients. Among patients with significant RAS (≥50%), we observed more women (57.1% vs. 35.7%, p = 0.011), and patients were older (69.1 ± 10.4 years vs. 64.0 ± 9.7 years, p = 0.005). In the whole population, all-cause death was reported in 29.9% of patients, myocardial infarction (MI) rate—in 11.8%, and stroke—in 4.9%. In the multivariable analysis, independent predictors of death were age 65–75 years (HR 2.88), age > 75 years (HR 8.07), diabetes (HR 1.59), previous MI (HR 1.64), chronic kidney disease (HR 2.22), unstable angina (HR 0.37), and left ventricular ejection fraction > 60% (HR 0.43). Conclusions: Over a 10 year follow-up, the all-cause death rate was 29.9%, showing no statistically significant differences between patients with and without significant RAS. Full article
(This article belongs to the Special Issue Research Advances in Coronary Revascularization)
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