Coronary Artery Disease from Pathogenetic Mechanisms to Postoperative Prognosis Research

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (25 August 2023) | Viewed by 9557

Special Issue Editors


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Guest Editor
Research Institute for Complex Issues of Cardiovascular Diseases, Sosnovy Blvd. 6, Kemerovo 650002, Russia
Interests: coronary artery disease and polyvascular disease; coronary artery bypass surgery; arterial stiffness; cardiac rehabilitation; psychosomatic medicine; distress; echocardiography; cardiooncology; cardiac risk; non-cardiac surgery; prognosis; comorbidity

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Guest Editor
Department of Internal Medicine, Samara State Medical University, Samara Regional Cardiology Centre, Samara 443095, Russia
Interests: coronary artery disease; acute coronary syndrome; pulmonary embolism, syncope; cardiooncology; non-cardiac surgery; prognosis

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Guest Editor
Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk 634009, Russia
Interests: cardiology

Special Issue Information

Dear Colleagues,

Cardiovascular disease (CVD) is currently the greatest threat to human health. Among them, coronary heart disease is still the main cause of death, research on this pathology is an important task. Not surprisingly, it is in this area that tremendous progress has been made regarding pathogenetic mechanisms, diagnostic, therapeutic and prophylactic methods, as well as coronary revascularization. A characteristic feature of these studies is a multidisciplinary approach; it is not for nothing that the very concept of "Heart team" arose to determine the optimal tactics for treating patients with coronary artery disease. Accordingly, to improve the quality and life expectancy of patients with coronary artery disease, research is needed in all of the above areas.

The purpose of this issue is to provide an opportunity to publish their research to different groups of researchers involved in the study of the problem of coronary artery disease. These may include both basic research and clinical research on the diagnosis, treatment, and rehabilitation of various forms of coronary artery disease, myocardial revascularization and predicting its outcomes. Also of interest is the problem of comorbidity in patients with coronary artery disease, which may affect the course and prognosis of the disease. Submission of all types of manuscripts including original research and reviews will be possible.

Dr. Aleksei N. Sumin
Prof. Dr. Dmitry V. Duplyakov
Prof. Dr. Alexey N. Repin
Guest Editors

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Keywords

  • coronary artery disease
  • pathogenetic mechanisms
  • risk factors
  • prognosis
  • diagnostics
  • myocardial revascularization
  • rehabilitation
  • comorbidity

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Published Papers (6 papers)

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Research

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10 pages, 640 KiB  
Article
Comprehensive Analysis of Factors Associated with New Episode of Postoperative Atrial Fibrillation after Coronary Artery Bypass Graft Surgery
by Olesya Rubanenko, Anatoly Rubanenko and Igor Davydkin
Life 2023, 13(10), 2035; https://doi.org/10.3390/life13102035 - 10 Oct 2023
Cited by 2 | Viewed by 1037
Abstract
The aim of the study was to perform a comprehensive fundamental analysis of the factors of inflammation, oxidative stress, fibrosis, myocardial dysfunction, ischemia and omega-3 index associated with postoperative atrial fibrillation (POAF) after coronary artery bypass graft (CABG) surgery in patients with coronary [...] Read more.
The aim of the study was to perform a comprehensive fundamental analysis of the factors of inflammation, oxidative stress, fibrosis, myocardial dysfunction, ischemia and omega-3 index associated with postoperative atrial fibrillation (POAF) after coronary artery bypass graft (CABG) surgery in patients with coronary artery disease. The study involved 158 patients who were admitted to the hospital to undergo CABG surgery. Patients were divided into two groups: group 1 comprised 111 patients without POAF (82% males, median age—62.0 (56.0; 66.0) years), and group 2 comprised 47 patients with POAF (84.4% males, median age—65.0 (61.0; 70.0) years). POAF occurred 5.2 (2.0; 7.0) days after CABG. In all the patients, we evaluated laboratory tests before and 3–4 days after CABG. All the patients also underwent echocardiography. According to results of multifactorial regression analysis, the odds ratio of POAF development for left atrial diameter >41 mm was 4.3 (95% confidence interval (CI) 2.0–9.7, p < 0.001), interleukin (IL)-6 postoperative levels >22.07 pg/mL—3.0 (95% CI 1.4–8.2, p = 0.006), IL-8 postoperative levels >9.67 pg/mL—2.3 (95% CI 1.2–7.3, p = 0.006), superoxide dismutase postoperative levels in plasma >1100.5 U/g—3.2 (95% CI 1.4–9.2, p = 0.03), glutathione postoperative levels ≤0.194 micromole/g of hemoglobin—1.9 (95% CI 1.2–6.3, p < 0.001), glutathione peroxidase postoperative levels ≤17.36 millimole/g of hemoglobin—2.2 (95% CI 1.1–8.2, p < 0.001), glutathione reductase postoperative levels ≤2.99 millimole/g of hemoglobin—2.3 (95% CI, 1.1–5.7, p < 0.001), malondialdehyde postoperative levels >1.25 micromole/g of hemoglobin—2.0 (95% CI, 1.2–7.9, p < 0.001), NO postoperative levels in plasma >36.4 micromole/L—1.5 (95% CI, 1.1–5.9, p < 0.001) and omega-3 index ≤1.59%—2.6 (95% CI 1.5–9.1, p < 0.001). Our study showed that increased left atrial diameter, high postoperative levels of inflammatory factors, oxidative stress, fibrosis indicators and omega-3 index were associated with POAF in patients who underwent CABG. Full article
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16 pages, 2417 KiB  
Article
The CHA2DS2-VASC Score Predicts Mortality in Patients Undergoing Coronary Angiography
by Nicholay Teodorovich, Gera Gandelman, Michael Jonas, Yakov Fabrikant, Michael Sraia Swissa, Sara Shimoni, Jacob George and Moshe Swissa
Life 2023, 13(10), 2026; https://doi.org/10.3390/life13102026 - 9 Oct 2023
Cited by 1 | Viewed by 1118
Abstract
Background: The CHA2DS2-VASC score is used to predict the risk of thromboembolic complications in patients with atrial fibrillation (AF). We hypothesized that the CHA2DS2-VASC score can be used to predict mortality in patients [...] Read more.
Background: The CHA2DS2-VASC score is used to predict the risk of thromboembolic complications in patients with atrial fibrillation (AF). We hypothesized that the CHA2DS2-VASC score can be used to predict mortality in patients undergoing coronary angiography. Methods and Results: This was a prospective study of 990 patients undergoing coronary angiography. The median follow-up was 2294 days. The patients were categorized into two groups according to their CHA2DS2-VASC score: group I had scores <4 and group II had scores ≥4 (527 (53.2%) and 463 (46.8%), respectively). A Kaplan–Meier analysis demonstrated a significant association between the CHA2DS2-VASC score and mortality (69/527 (13.1%) vs. 179/463 (38.7%) for group I vs. group II, respectively, p < 0.0001). The association remained significant in patients with and without AF, reduced and preserved LVEF, normal and reduced kidney function, and with and without ACS (p < 0.009 to p < 0.0001 for all). In the Cox regression model, which combined the CHA2DS2-VASC score, the presence of AF, LVEF, anemia, and renal insufficiency, an elevated CHA2DS2-VASC score of ≥4 was independently associated with higher mortality (HR 2.12, CI 1.29–3.25, p = 0.001). Conclusions: The CHA2DS2VASC score is a simple and reliable mortality predictor in patients undergoing coronary angiography and should be used for the initial screening for such patients. Full article
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14 pages, 1832 KiB  
Article
Impact of AfterAMI Mobile App on Quality of Life, Depression, Stress and Anxiety in Patients with Coronary Artery Disease: Open Label, Randomized Trial
by Maria Boszko, Bartosz Krzowski, Michał Peller, Paulina Hoffman, Natalia Żurawska, Kamila Skoczylas, Gabriela Osak, Łukasz Kołtowski, Marcin Grabowski, Grzegorz Opolski and Paweł Balsam
Life 2023, 13(10), 2015; https://doi.org/10.3390/life13102015 - 5 Oct 2023
Viewed by 1390
Abstract
mHealth solutions optimize cardiovascular risk factor control in coronary artery disease. The aim of this study was to investigate the influence of mobile app AfterAMI on quality of life in patients after myocardial infarction. 100 participants were randomized (1:1 ratio) into groups: (1) [...] Read more.
mHealth solutions optimize cardiovascular risk factor control in coronary artery disease. The aim of this study was to investigate the influence of mobile app AfterAMI on quality of life in patients after myocardial infarction. 100 participants were randomized (1:1 ratio) into groups: (1) with a rehabilitation program and access to afterAMI or (2) standard rehabilitation alone (control group, CG). 3 questionnaires (MacNew, DASS21 and EQ-5D-5L) were used at baseline, 1 month and 6 months after discharge. Median age was 61 years; 35% of patients were female. At 1 month follow up patients using AfterAMI had higher general quality of life scores both in MacNew [5.78 vs. 5.5 in CG, p = 0.037] and EQ-5D-5L [80 vs. 70 in CG, p = 0.007]. At 6 months, according to MacNew, the app group had significantly higher scores in emotional [6.09 vs. 5.45 in CG, p= 0.017] and physical [6.2 vs. 6 in CG, p = 0.027] aspects. The general MacNew quality of life score was also higher in the AfterAMI group [6.11 vs. 5.7 in CG, p = 0.015], but differences in EQ-5D-5L were not significant. There were no differences between groups in the DASS21 questionnaire. mHealth interventions may improve quality of care in secondary prevention, however further studies are warranted. Full article
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Review

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28 pages, 2625 KiB  
Review
Impact of Immunity on Coronary Artery Disease: An Updated Pathogenic Interplay and Potential Therapeutic Strategies
by Nicola Laera, Paolo Malerba, Gaetano Vacanti, Simone Nardin, Matteo Pagnesi and Matteo Nardin
Life 2023, 13(11), 2128; https://doi.org/10.3390/life13112128 - 27 Oct 2023
Cited by 6 | Viewed by 2454
Abstract
Coronary artery disease (CAD) is the leading cause of death worldwide. It is a result of the buildup of atherosclerosis within the coronary arteries. The role of the immune system in CAD is complex and multifaceted. The immune system responds to damage or [...] Read more.
Coronary artery disease (CAD) is the leading cause of death worldwide. It is a result of the buildup of atherosclerosis within the coronary arteries. The role of the immune system in CAD is complex and multifaceted. The immune system responds to damage or injury to the arterial walls by initiating an inflammatory response. However, this inflammatory response can become chronic and lead to plaque formation. Neutrophiles, macrophages, B lymphocytes, T lymphocytes, and NKT cells play a key role in immunity response, both with proatherogenic and antiatherogenic signaling pathways. Recent findings provide new roles and activities referring to endothelial cells and vascular smooth muscle cells, which help to clarify the intricate signaling crosstalk between the involved actors. Research is ongoing to explore immunomodulatory therapies that target the immune system to reduce inflammation and its contribution to atherosclerosis. This review aims to summarize the pathogenic interplay between immunity and CAD and the potential therapeutic strategies, and explore immunomodulatory therapies that target the immune system to reduce inflammation and its contribution to atherosclerosis. Full article
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14 pages, 1227 KiB  
Review
Revascularization and Left Ventricular Dysfunction for ICD Eligibility
by Letizia Rosa Romano, Carmen Anna Maria Spaccarotella, Ciro Indolfi and Antonio Curcio
Life 2023, 13(9), 1940; https://doi.org/10.3390/life13091940 - 21 Sep 2023
Viewed by 1360
Abstract
Common triggers for sudden cardiac death (SCD) are transient ischemia, hemodynamic fluctuations, neurocardiovascular influences, and environmental factors. SCD occurs rapidly when sinus rhythm degenerates into ventricular tachycardia (VT) and/or ventricular fibrillation (VF), followed by asystole. Such progressive worsening of the cardiac rhythm is [...] Read more.
Common triggers for sudden cardiac death (SCD) are transient ischemia, hemodynamic fluctuations, neurocardiovascular influences, and environmental factors. SCD occurs rapidly when sinus rhythm degenerates into ventricular tachycardia (VT) and/or ventricular fibrillation (VF), followed by asystole. Such progressive worsening of the cardiac rhythm is in most cases observed in the setting of ischemic heart disease and often associated with advanced left ventricular (LV) impairment. Revascularization prevents negative outcomes including SCD and heart failure (HF) due to LV dysfunction (LVD). The implantable cardioverter–defibrillator (ICD) on top of medical therapy is superior to antiarrhythmic drugs for patients with LVD and VT/VF. The beneficial effects of ICD have been demonstrated in primary prevention of SCD as well. However, yet debated is the temporal management for patients with LVD who are eligible to ICD prior to revascularization, either through percutaneous or surgical approach. Restoration of coronary blood flow has a dramatic impact on adverse LV remodeling, while it requires aggressive long-term antiplatelet therapy, which might increase complication for eventual ICD procedure when percutaneous strategy is pursued; on the other hand, when LV and/or multiorgan dysfunction is present and coronary artery bypass grafting is chosen, the overall risk is augmented, mostly in HF patients. The aims of this review are to describe the pathophysiologic benefits of revascularization, the studies addressing percutaneous, surgical or no revascularization and ICD implantation, as well as emerging defibrillation strategies for patients deemed at transient risk of SCD and/or at higher risk for transvenous ICD implantation. Full article
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13 pages, 976 KiB  
Review
Stable Coronary Artery Disease: Who Finally Benefits from Coronary Revascularization in the Modern Era? The ISCHEMIA and Interim ISCHEMIA-EXTEND Analysis
by Leonid Bershtein, Alexey Sumin, Elizaveta Zbyshevskaya, Victoria Gumerova, Darejan Tsurtsumia, Igor Kochanov, Alina Andreeva, Vartan Piltakian and Sergey Sayganov
Life 2023, 13(7), 1497; https://doi.org/10.3390/life13071497 - 1 Jul 2023
Cited by 4 | Viewed by 1567
Abstract
Coronary revascularization is one of the most studied treatment modalities in cardiology; however, there is no consensus among experts about its indications in patients with stable coronary artery disease (SCAD). Contemporary data regarding the role of revascularization in SCAD are in clear conflict [...] Read more.
Coronary revascularization is one of the most studied treatment modalities in cardiology; however, there is no consensus among experts about its indications in patients with stable coronary artery disease (SCAD). Contemporary data regarding the role of revascularization in SCAD are in clear conflict with the current European guidelines. This article discusses the main statements of the most significant American and European Guidelines on myocardial revascularization of the last decade and also analyzes the appropriateness of revascularization to improve the prognosis and symptoms in SCAD in the light of new research data, primarily the ISCHEMIA study (NCT01471522) and the ACC/AHA 2021 Revascularization Guidelines based on them. Data on the revascularization in SCAD obtained after the completion of ISCHEMIA (including the interim analysis of ISCHEMIA-EXTEND) and their potential significance are discussed. The results of ISCHEMIA sub-analyses in the most important “controversial” subgroups (3-vessel disease, proximal left anterior descending artery disease, strongly positive stress test, etc.) are reviewed, as are the results of the ISCHEMIA-CKD substudy in patients with severe chronic kidney disease (CKD). Full article
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