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Acute Coronary Syndrome: Recent Advances in Clinical Diagnosis and Treatment
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Acute Coronary Syndrome: Recent Advances in Clinical Diagnosis and Treatment

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

Deadline for manuscript submissions: 30 October 2024 | Viewed by 1983

Special Issue Editors

Dr. Gonzalo Luis Alonso Salinas

E-Mail Website
Guest Editor
Cardiology Department, Hospital Universitario de Navarra, 31006 Pamplona, Spain
Interests: eHealth; heart failure; acute coronary syndrome; frailty; comorbidity; revascularization
Dr. Pablo Díez-Villanueva

E-Mail Website
Guest Editor
Cardiology Service, Hospital Universitario La Princesa, 28006 Madrid, Spain
Interests: chronic heart failure; acute heart failure; acute coronary syndromes; atrial fibrillation; elderly

Special Issue Information

Dear Colleagues,

In recent years, we have seen significant advances in understanding and managing acute coronary syndrome, a condition that continues to be a major challenge in medical practice worldwide. This Special Issue aims to bring together experts and scientists from different countries to discover and share the latest developments in the diagnosis and treatment of acute coronary syndrome, as well as analyze their impact on clinical outcomes and quality of life for patients.

Technological advancements and innovative treatment modalities, pharmacological therapies and interventional procedures provide us with new insights and approaches to the treatment of this complex disease. We encourage you to submit your contributions in the form of review articles, original research and clinical studies that address key aspects of acute coronary syndrome and its clinical implications. This is a unique opportunity to spread knowledge, foster international dialogue and advance the fight against a disease that affects millions of people around the world. We look forward to your valuable participation in this Special Issue that is sure to enrich the field and help improve patient care. 

Dr. Gonzalo Luis Alonso Salinas
Dr. Pablo Díez-Villanueva
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

  • acute coronary syndrome
  • cardiogenic shock
  • electrocardiogram
  • eHealth
  • percutaneous coronary intervention
  • coronary bypass surgery
  • revascularization
  • diagnostics
  • myocardial injury
  • antithrombotic therapy

Published Papers (3 papers)

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12 pages, 844 KiB  
Article
The Evaluation of Lipid-Lowering Treatment in Patients with Acute Coronary Syndrome in a Hungarian Invasive Centre in 2015, 2017, and during the COVID-19 Pandemic—The Comparison of the Achieved LDL-Cholesterol Values Calculated with Friedewald and Martin–Hopkins Methods
by Laszlo Mark, Péter Fülöp, Hajnalka Lőrincz, Győző Dani, Krisztina Fazekas Tajtiné, Attila Thury and György Paragh
J. Clin. Med. 2024, 13(12), 3398; https://doi.org/10.3390/jcm13123398 - 11 Jun 2024
Viewed by 268
Abstract
Background/Objectives: Patients with acute coronary syndrome (ACS) represent a vulnerable population. We aimed to investigate serum lipid levels of patients with ACS upon admission and during one year of the COVID-19 pandemic in a rural county hospital, and compared these findings with the [...] Read more.
Background/Objectives: Patients with acute coronary syndrome (ACS) represent a vulnerable population. We aimed to investigate serum lipid levels of patients with ACS upon admission and during one year of the COVID-19 pandemic in a rural county hospital, and compared these findings with the data of patients with ACS in 2015 and 2017. The secondary aim of this paper was the comparison of the LDL-C values calculated with the Friedewald and Martin–Hopkins methods. Methods: A retrospective analysis of lipid-lowering data of patients treated with ACS in 2015, 2017 and in a COVID-19 year (1 April 2020–31 March 2021) was performed; the patient’s numbers were 454, 513 and 531, respectively. Results: In the COVID-19 period one year after the index event, only 42% of the patients had lipid values available, while these ratios were 54% and 73% in 2017 and in 2015, respectively. Using the Friedewald formula, in the COVID-19 era the median of LDL cholesterol (LDL-F) was 1.64 (1.09–2.30) mmol/L at six months and 1.60 (1.19–2.27) mmol/L at one year, respectively. These values were 1.92 (1.33–2.27) mmol/L and 1.73 (1.36–2.43) mmol/L using the Martin–Hopkins method (LDL-MH). The LDL-F yielded significantly lower values (15% lower at six months, p = 0.044; and 8% lower at one year, p = 0.014). The LDL-F reached the previous target of 1.8 mmol/L during the COVID-19 pandemic 36% at one year vs. 48% in 2017, and 37% in 2015. The recent target LDL-C level of 1.4 mmol/L was achieved in 22% of cases in the COVID-19 pandemic, 16% in 2015 and 19% in 2017. Conclusions: A significantly lower proportion of patients with ACS had available lipid tests during the COVID-19 pandemic. Besides the lower number of available samples, the proportion of achieved 1.4 mmol/L LDL-C target lipids was stable. More rigorous outpatient care in the follow-up period may help to improve the quality of lipid lowering treatments and subsequent secondary cardiovascular prevention. If direct LDL-C determination is not available, we prefer the LDL calculation with the Martin–Hopkins method. Full article
(This article belongs to the Special Issue Acute Coronary Syndrome: Recent Advances in Clinical Diagnosis and Treatment)
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8 pages, 446 KiB  
Article
Parenteral Anticoagulation at First Medical Contact Improves Infarct Related Artery Patency in STEMI
by Vlad Bataila, Nicoleta-Monica Popa-Fotea, Cosmin Cojocaru, Lucian Calmac, Cosmin Mihai, Marian-Bogdan Dragoescu, Vlad Ploscaru, Mugur Marinescu, Vasile Iliese, Anamaria-Georgiana Avram, Raluca-Elena Mitran and Radu-Gabriel Vatasescu
J. Clin. Med. 2024, 13(6), 1710; https://doi.org/10.3390/jcm13061710 - 16 Mar 2024
Viewed by 620
Abstract
(1) Background: Acute ST-segment elevation myocardial infarction (STEMI) remains one of the main morbidity and mortality contributors worldwide. Its main treatment, primary percutaneous coronary intervention (pPCI), can only be performed with a high anticoagulation regimen, usually with heparin. There is still not [...] Read more.
(1) Background: Acute ST-segment elevation myocardial infarction (STEMI) remains one of the main morbidity and mortality contributors worldwide. Its main treatment, primary percutaneous coronary intervention (pPCI), can only be performed with a high anticoagulation regimen, usually with heparin. There is still not enough evidence regarding the timing of heparin administration. (2) Methods: We conducted a multicenter observational study of 614 consecutive STEMI patients treated between 2017 and 2019. We split the population in two groups: one that received heparin at the first medical contact, as early as possible, and the second group that received heparin at the PCI capable center or in the cath lab. (3) Results: There was a significantly higher rate of infarct-related artery (IRA) patency at the time of the coronary angiogram in the pre-transfer heparin group than in the on-site heparin group, 44.7% vs. 37.3%, p = 0.042. Also, the early heparin group received shorter and wider stents. There was no difference in bleeding rates or in the in-hospital and two-year mortality rates. (4) Conclusions: Early administration of heparin leads to a higher rate of reperfusion in the IRA, before pPCI, with significant related benefits, such as better stent implantation parameters, without increased bleeding rates. Full article
(This article belongs to the Special Issue Acute Coronary Syndrome: Recent Advances in Clinical Diagnosis and Treatment)
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8 pages, 216 KiB  
Study Protocol
Accuracy of Smartwatch Electrocardiographic Recording in the Acute Coronary Syndrome Setting: Rationale and Design of the ACS WATCH II Study
by Mauro Buelga Suárez, Marina Pascual Izco, Jesús García Montalvo and Gonzalo Luis Alonso Salinas
J. Clin. Med. 2024, 13(2), 389; https://doi.org/10.3390/jcm13020389 - 10 Jan 2024
Viewed by 745
Abstract
Background: Acute Coronary Syndrome (ACS), with or without ST-segment elevation, is a major contributor to global mortality and morbidity. Swift diagnosis and treatment are vital for mitigating cardiac damage and improving long-term outcomes. The 12-lead electrocardiogram (ECG) currently serves as the gold [...] Read more.
Background: Acute Coronary Syndrome (ACS), with or without ST-segment elevation, is a major contributor to global mortality and morbidity. Swift diagnosis and treatment are vital for mitigating cardiac damage and improving long-term outcomes. The 12-lead electrocardiogram (ECG) currently serves as the gold standard for diagnosis in ACS with ST-segment elevation and may support the diagnosis in ACS without ST-segment elevation. However, the growing prevalence of smartwatches enables the acquisition of electrocardiographic data without traditional ECG equipment. While smaller studies support smartwatch ECG use, larger-scale validation within ACS remains lacking. The ACS WATCH II study aims to validate smartwatch ECG recordings for ACS. Methods: The primary objective is to validate smartwatch-obtained electrocardiographic data in patients presenting with ACS. Two cohorts of 120 patients each, presenting ACS with and without ST-segment elevation, will be assessed. Smartwatches will capture recordings of leads I, III, and V2 alongside standard ECGs. These leads, chosen due to a 97% ACS diagnosis sensitivity in previous studies, will undergo blind evaluation by two experienced external assessors against conventional ECG. Additionally, a control sample of 60 healthy individuals will be included. Conclusions: ACS WATCH II pioneers large-scale prospective validation of smartwatch ECG recordings in ACS patients. Additionally, it indirectly validates a swift diagnostic approach using three leads (I, III, and V2). This could expedite time-critical ACS diagnoses and simplify access through smartwatch-based diagnosis. Full article
(This article belongs to the Special Issue Acute Coronary Syndrome: Recent Advances in Clinical Diagnosis and Treatment)
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