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Medicina
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Recent Advances in the Diagnosis and Treatment of Acute Myocardial...
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Recent Advances in the Diagnosis and Treatment of Acute Myocardial Infarction

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 8597

Special Issue Editor

Prof. Dr. Sung-Ho Her

E-Mail Website
Guest Editor
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
Interests: acute myocardial infarction; myocardial infarction; angiography; interventional cardiology; coronary angiography; atherosclerosis; vascular medicine; clinical cardiology; atrial fibrillation; hypertension
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The diagnosis and treatment of acute myocardial infarction in recent decades have been advanced with improvements in revascularization strategies (PCI or CABG), device technology and medications. Widespread use of intravascular imaging modalities can improve the prognosis of patients after PCI. Recently, several studies of de-escalation or short DAPT have been published and interpolated to our daily practice. Additionally, an intensive lipid-lowering treatment showed promising clinical outcomes for secondary prevention after patients experienced acute myocardial infarction.

We are faced with the need to propose new insights of diagnosis or treatment in our innovatively changing clinical practice, including new imaging modalities, possibilities of genetic and molecular diagnosis and new markers and tools for prognosis and revascularization strategies or medical treatments developed and successfully implemented in real-world practice.

Therefore, this Special Issue aims to collect a series of articles specifically related to recent advances in the diagnosis and treatment of acute myocardial infarction. We are interested in original research, pilot studies and systematic reviews or meta-analyses providing new insights into the diagnosis and treatment of acute myocardial infarction.

Prof. Dr. Sung-Ho Her
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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • new markers and tools
  • new device technology
  • imaging modalities
  • antiplatelet agents
  • lipid-lowering modalities

Published Papers (3 papers)

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Research

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12 pages, 935 KiB  
Article
Culprit versus Complete Revascularization during the Initial Intervention in Patients with Acute Coronary Syndrome Using a Virtual Treatment Planning Tool: Results of a Single-Center Pilot Study
by Deniss Vasiljevs, Natalja Kakurina, Natalja Pontaga, Baiba Kokina, Vladimirs Osipovs, Nikolajs Sorokins, Sergejs Pikta, Karlis Trusinskis and Aivars Lejnieks
Medicina 2023, 59(2), 270; https://doi.org/10.3390/medicina59020270 - 31 Jan 2023
Cited by 1 | Viewed by 3087
Abstract
Background and Objectives: The revascularization strategy for percutaneous coronary intervention (PCI) in patients with multivessel (MV) acute coronary syndrome (ACS) remains controversial. Certain gaps in the evidence are related to the optimal timing of non-culprit lesion revascularization and the utility of instantaneous wave-free [...] Read more.
Background and Objectives: The revascularization strategy for percutaneous coronary intervention (PCI) in patients with multivessel (MV) acute coronary syndrome (ACS) remains controversial. Certain gaps in the evidence are related to the optimal timing of non-culprit lesion revascularization and the utility of instantaneous wave-free ratio (iFR) in the management of MV ACS intervention. The major benefits of iFR utilization in MV ACS patients in one-stage complete revascularization are: (1) the possibility to virtually plan the PCI, both the location and the extension of the necessary stenting to achieve the prespecified final hemodynamic result; (2) the opportunity to validate the final hemodynamic result of the PCI, both in culprit artery and all non-culprit arteries and (3) the value of obliviating the uncomfortable, costly, time consuming and sometimes deleterious effects from Adenosine, as there is no requirement for administration. Thus, iFR use fosters the achievement of physiologically appropriate complete revascularization in MV ACS patients during acute hospitalization. Materials and Methods: This pilot study was aimed to test the feasibility of a randomized trial research protocol as well as to assess patient safety signals of co-registration iFR-guided one-stage complete revascularization compared with that of standard staged angiography-guided PCI in de novo patients with MV ACS. This was a single-center, prospective, randomized, open-label clinical trial consecutively screening patients with ACS for MV disease. The intervention strategy of interest was iFR-guided physiologically complete one-stage revascularization, in which the virtual PCI planning of non-culprit lesions and the intervention itself were performed in one stage directly following treatment of the culprit lesion and other critical stenosis of more than ninety percent. Seventeen patients were recruited and completed the 3-month follow-up. Results: Index PCI duration was significantly longer while the volume of contrast media delivered in index PCI was significantly greater in the iFR-guided group than in the angiography-guided group (119.4 ± 40.7 vs. 47 ± 15.5 min, p = 0.004; and 360 ± 97.9 vs. 192.5 ± 52.8 mL, p = 0.003). There were no significant differences in PCI-related major adverse cardiovascular events (MACE) between the groups during acute hospitalization and at 3-months follow-up. One-stage iFR-guided PCI requires fewer PCI attempts until complete revascularization than does angiography-guided staged PCI. Conclusions: Complete revascularization with the routine use of the virtual planning tool in one-stage iFR-guided PCI is a feasible practical strategy in an everyday Cath lab environment following the protocol designed for the study. No statistically significant safety signals were documented in the number of PCI related MACE during the 3-month follow-up. Full article
(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Acute Myocardial Infarction)
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Review

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13 pages, 1530 KiB  
Review
Diagnostic Accuracy of Ischemia-Modified Albumin for Acute Coronary Syndrome: A Systematic Review and Meta-Analysis
by Hyungoo Shin, Jae-Guk Kim, Bo-Hyoung Jang, Tae-Ho Lim, Wonhee Kim, Youngsuk Cho, Kyu-Sun Choi, Min-Kyun Na, Chiwon Ahn and Juncheol Lee
Medicina 2022, 58(5), 614; https://doi.org/10.3390/medicina58050614 - 28 Apr 2022
Cited by 6 | Viewed by 2587
Abstract
The diagnostic usefulness of ischemia-modified albumin in acute coronary syndrome (ACS) has been questioned. The goal of this systematic review and meta-analysis was to see how accurate ischemia-modified albumin (IMA) was in diagnosing ACS in patients admitted to emergency departments (EDs). We searched [...] Read more.
The diagnostic usefulness of ischemia-modified albumin in acute coronary syndrome (ACS) has been questioned. The goal of this systematic review and meta-analysis was to see how accurate ischemia-modified albumin (IMA) was in diagnosing ACS in patients admitted to emergency departments (EDs). We searched for relevant literature in databases such as MEDLINE, EMBASE, and the Cochrane Library. Primary studies that reliably reported on patients with symptoms suggestive of ACS and evaluated IMA on admission to emergency departments were included. The QUADAS-2 tool was used to assess the risk of bias in the included research. A total of 4,761 patients from 19 studies were included in this systematic review. The sensitivity and specificity were 0.74 and 0.40, respectively, when the data were pooled. The area under the curve value for IMA for the diagnosis of ACS was 0.75, and the pooled diagnostic odds ratio value was 3.72. Furthermore, ACS patients with unstable angina had greater serum IMA levels than those with non-ischemic chest pain. In contrast to prior meta-analyses, our findings suggest that determining whether serum IMA levels are effective for diagnosing ACS in the emergency department is difficult. However, the accuracy of these findings cannot be ascertained due to high heterogeneity between studies. Full article
(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Acute Myocardial Infarction)
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Other

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10 pages, 1193 KiB  
Systematic Review
Beta-Blocker Use after Discharge in Patients with Acute Myocardial Infarction in the Contemporary Reperfusion Era
by Mengjin Hu, Song Hu, Xiaojin Gao and Yuejin Yang
Medicina 2022, 58(9), 1177; https://doi.org/10.3390/medicina58091177 - 30 Aug 2022
Viewed by 2289
Abstract
Background and objectives: The effect of beta-blocker use after discharge on patients with acute myocardial infarction (AMI) in the contemporary reperfusion era remains ambiguous. By applying meta-analysis, we sought to assess the role of beta-blockers in the contemporary reperfusion era. Materials and Methods: [...] Read more.
Background and objectives: The effect of beta-blocker use after discharge on patients with acute myocardial infarction (AMI) in the contemporary reperfusion era remains ambiguous. By applying meta-analysis, we sought to assess the role of beta-blockers in the contemporary reperfusion era. Materials and Methods: Randomized controlled trials (RCT) and observational studies using propensity score matching, comparing use of beta-blockers with non-use of beta-blockers, in patients with AMI after discharge. The primary outcome was all-cause mortality. Odds ratios (OR) and associated 95% confidence intervals (CI) were calculated. Results: One RCT and eight observational studies, containing 47,339 patients with AMI, were included. Compared with non-use of beta-blockers, beta-blocker use after discharge may have reduced the risk of all-cause mortality (OR: 0.70, 95% CI: 0.61 to 0.80, I2 = 14.4%), cardiac death (OR: 0.63, 95% CI: 0.44 to 0.91, I2 = 22.8%), myocardial infarction (OR: 0.73, 95% CI: 0.62 to 0.86, I2 = 0), and revascularization (OR: 0.92, 95% CI: 0.85 to 0.99, I2 = 0). No significant differences were found in major adverse cardiovascular events (MACE, OR: 0.88, 95% CI: 0.66 to 1.17, I2 = 78.4%), heart failure (OR: 0.56, 95% CI: 0.29 to 1.08, I2 = 0) or stroke (OR: 1.13, 95% CI: 0.92 to 1.39, I2 = 0). For patients with preserved left ventricular function, beta-blocker use after discharge may have also reduced the risk of all-cause mortality (OR: 0.61, 95% CI: 0.44 to 0.84, I2 = 0). Conclusions: Use of beta-blockers after discharge may still be beneficial for AMI patients in the contemporary reperfusion era, with or without preserved left ventricular function. Full article
(This article belongs to the Special Issue Recent Advances in the Diagnosis and Treatment of Acute Myocardial Infarction)
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