Coronary Artery Disease: From Pathophysiology to Therapeutic Strategies

Dear Colleagues,

This Special Issue, “Coronary Artery Disease: From Pathophysiology to Therapeutic Strategies”, will focus on aspects of the development of coronary artery disease (CAD) and the role of new technologies and therapies in the prevention of myocardial infarction.

Coronary artery disease is one of the most frequent causes of morbidity and mortality in the modern world, classically defined as clinically manifest myocardial ischemia and ischemic chest pain due to a pathological process characterized by non-stenotic and/or stenotic atherosclerotic plaque accumulation in the epicardial arteries.

Based on recent pathophysiological functional and structural insights, more comprehensive concepts and definitions of chronic coronary syndromes (CCSs) have been defined. Consequently, these novel approaches to the clinical presentation and therapies of cardiovascular diseases have resulted in improved guidelines [1]. As is, the cardiovascular model changed from a more static into a more dynamic alteration in macro and microvascular compartments.

Specifically of great interest is coronary microvascular dysfunction, as it is increasingly recognized as a cause of angina and ischemia in non-obstructive coronary arteries (INOCA and ANOCA). Also, there are identified risk factors predisposing the development of coronary atherosclerosis that may also result in impaired vasomotion and/or endothelial function. Different mechanisms of ischemia can act together, and patients may experience unpredictable courses throughout their lifetime.

As a result, improved clinical management strategies have been implemented. These strategies include awareness of the need for primary and secondary prevention by means of close attention being paid to lifestyle factors and guideline-directed medical therapy implementation with newly developed drugs.

Ultimately, treatment of CAD is always aimed at alleviating angina symptoms and preventing acute myocardial infarction or premature death. Clinicians therefore benefit from concise updates on diagnostic and prognostic tools and therapeutic models.

In our Special Issue, we will therefore address the newest insights in clinical diagnostic tools that assess coronary microvascular function. For the issue, we suggest that questions regarding the following be addressed:

• The role of coronary angiography, or noninvasive approach with the use of stress positron emission tomography or stress magnetic resonance imaging in diagnosis.
• Can patients with obstructive CAD still benefit from early revascularization or during long-term follow-up?
• Is the still a place for Heart Team work in decision-making strategies?

The goal is to stimulate research and clinical interest in this exciting field of CAD. The hope is to develop strategies and technologies that can help us address the challenges presented by coronary artery disease.

We cordially invite authors to submit original research and review articles that focus on these exciting pathophysiologic and therapeutic challenges to improving cardiovascular health.

Reference

1. Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024 Sep 29;45(36):3415-3537

Dr. Pawel Nadziakiewicz
Guest Editor

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• pathophysiological concept of coronary artery disease
• coronary microvascular dysfunction
• chronic coronary syndrome
• acute coronary syndrome
• post-acute coronary syndrome with heart failure
• diagnostics in coronary artery disease
• therapeutic strategies in CAD
• revascularization