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Diagnostics
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Diagnosis and Management of Cardiovascular Diseases
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Diagnosis and Management of Cardiovascular Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 July 2025 | Viewed by 1026

Special Issue Editors

Dr. Maria Nikolaou

E-Mail Website
Guest Editor
Department of Cardiology, Preventive Cardiology & Heart Failure Outpatient Clinic, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Street, 15127 Melissia, Greece
Interests: cardiometabolic medicine; cardiovascular endocrinology and metabolism; preventive cardiology and rehabilitation; heart failure; cardiogeriatrics; clinical epidemiology
Special Issues, Collections and Topics in MDPI journals
Dr. Nikolaos Theodorakis

E-Mail Website
Guest Editor Assistant
1. Department of Cardiology, Preventive Cardiology & Heart Failure Outpatient Clinic, Sismanogleio-Amalia Fleming General Hospital, 14 25is Martiou Street, 15127 Melissia, Greece
2. School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece
3. NT-CardioMetabolics, Clinic for Metabolism and Athletic Performance, 47 Tirteou Street, 17564 Palaio Faliro, Greece
Interests: cardiometabolic medicine; cardiovascular endocrinology and metabolism; preventive cardiology and rehabilitation; heart failure; cardiogeriatrics; clinical epidemiology

Special Issue Information

Dear Colleagues,

This Special Issue focuses on the evolving landscape of diagnosis in cardiovascular disease, showcasing groundbreaking advancements in diagnostic technologies. It spotlights novel imaging modalities, such as advanced echocardiography, computed tomography, and magnetic resonance imaging, which provide unprecedented detail and accuracy in visualizing cardiac structures and function. Additionally, it examines the latest developments in biomarker testing, genetic screening, and artificial intelligence-driven algorithms, enhancing early detection, risk assessment, and personalized treatment planning. This comprehensive exploration underscores the pivotal role of innovative diagnostic techniques in advancing the management of cardiovascular disease, ultimately aiming to improve patient care and outcomes.

Dr. Maria Nikolaou
Guest Editor
Dr. Nikolaos Theodorakis
Guest Editor Assistant

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. Diagnostics 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

  • cardiovascular disease
  • diagnostic techniques
  • imaging modalities
  • biomarker testing
  • genetic screening
  • artificial intelligence
  • risk stratification
  • personalized treatment

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Published Papers (2 papers)

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Research

13 pages, 933 KiB  
Article
Bisphosphonate Use and Cardiovascular Outcomes According to Kidney Function Status in Post-Menopausal Women: An Emulated Target Trial from the Multi-Ethnic Study of Atherosclerosis
by Elena Ghotbi, Nikhil Subhas, Michael P. Bancks, Sammy Elmariah, Jonathan L. Halperin, David A. Bluemke, Bryan R Kestenbaum, R. Graham Barr, Wendy S. Post, Matthew Budoff, João A. C. Lima and Shadpour Demehri
Diagnostics 2025, 15(13), 1727; https://doi.org/10.3390/diagnostics15131727 - 7 Jul 2025
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Abstract
Background/Objectives: Bisphosphonates may influence vascular calcification and atheroma formation via farnesyl pyrophosphate synthase inhibition in the mevalonate pathway regulating bone and lipid metabolism. However, the clinical impact of NCB use on cardiovascular outcomes remains uncertain, largely due to methodological heterogeneity in prior studies. [...] Read more.
Background/Objectives: Bisphosphonates may influence vascular calcification and atheroma formation via farnesyl pyrophosphate synthase inhibition in the mevalonate pathway regulating bone and lipid metabolism. However, the clinical impact of NCB use on cardiovascular outcomes remains uncertain, largely due to methodological heterogeneity in prior studies. We aimed to evaluate the association between nitrogen-containing bisphosphonate (NCB) therapy and coronary artery calcium (CAC) progression, as well as the incidence of cardiovascular disease (CVD) and coronary heart disease (CHD) events. Methods: From 6814 participants in MESA Exam 1, we excluded males (insufficient male NCB users in the MESA cohort), pre-menopausal women, baseline NCB users, and users of hormone replacement therapy, raloxifene, or calcitonin. Among 166 NCB initiators and 1571 non-users with available CAC measurements, propensity score matching was performed using the available components of FRAX, namely age, race, BMI, LDL cholesterol, alcohol, smoking, and steroid use, and baseline CAC yielded 165 NCB initiators matched to 473 non-users (1:3 ratio). Linear mixed-effects models evaluated CAC progression, and Cox models analyzed incident CVD and CHD events. Results: In the overall cohort, NCB use was not significantly associated with CAC progression (annual change: −0.01 log Agatston units; 95% CI: −0.05 to 0.01). However, among participants with a baseline estimated glomerular filtration rate (eGFR) < 65 mL/min/1.73 m2, NCB use was associated with attenuated CAC progression compared with non-users (−0.06 log Agatston units/year; 95% CI: −0.12 to −0.007). No significant association was observed between NCB use and incident CVD events in the overall cohort (HR: 0.90; 95% CI: 0.60−1.36) or within kidney function subgroups. Conclusions: Incident NCB use among postmenopausal women with mild or no CAC at baseline was associated with reduced CAC progression only in women with impaired kidney function. However, this association did not correspond to a decreased risk of subsequent cardiovascular events, suggesting that the observed imaging benefit may not translate into meaningful clinical association. Full article
(This article belongs to the Special Issue Diagnosis and Management of Cardiovascular Diseases)
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13 pages, 3170 KiB  
Article
Stent Failure Management in Contemporary Clinical Practice
by Iosif Xenogiannis, Charalampos Varlamos, Despoina-Rafailia Benetou, Vassiliki-Maria Dragona, Stefanos Vlachos, Christos Pappas, Fotios Kolokathis and Grigoris V. Karamasis
Diagnostics 2025, 15(13), 1709; https://doi.org/10.3390/diagnostics15131709 - 4 Jul 2025
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Abstract
Background: Although contemporary stent technology has significantly evolved, a substantial number of patients present with stent failure (SF), the clinical expression of which is either in-stent restenosis (ISR) or stent thrombosis (ST). Methods: In this observational, single-center study, we aimed to compare the [...] Read more.
Background: Although contemporary stent technology has significantly evolved, a substantial number of patients present with stent failure (SF), the clinical expression of which is either in-stent restenosis (ISR) or stent thrombosis (ST). Methods: In this observational, single-center study, we aimed to compare the clinical characteristics, clinical presentation, angiographic findings and subsequent management of patients who underwent percutaneous coronary intervention (PCI) for SF, either ISR or ST, with patients who had PCI for de novo lesions. Results: Over a period of two years (September 2022–October 2024), 1120 patients underwent PCI, of whom 9% had SF. Of the 101 SF cases, the majority (76 cases, 75%) had ISR, while the rest (25 cases, 25%) had ST. Regarding baseline characteristics, patients who underwent PCI for SF had a higher incidence of diabetes mellitus (53% vs. 29%; p < 0.001), dyslipidemia (88% vs. 50%; p < 0.001) as well as prior coronary artery bypass grafting surgery (7.9% vs. 3.7%; p = 0.043), while they were less likely to be current smokers (33% vs. 52%; p < 0.001). SF PCI patients presented more frequently with unstable angina (17% vs. 8.9%; p = 0.010). A new stent was implanted in less than half of SF cases (i.e., stent implantation, 44% vs. 91%; p < 0.001). On the other hand, in the clinical setting of SF, drug-coated balloons (44% vs. 5.3%; p < 0.001) and plain balloon angioplasty (8.9% vs. 0.7%; p < 0.001) was applied more frequently compared with de novo lesions. Furthermore, the usage of cutting/scoring balloons and lithotripsy was significantly higher in the SF group (8.9% vs. 0.4% and 12% vs. 3%, respectively; p < 0.001 for both). Intracoronary imaging guidance was more commonly used in the SF group (33% vs. 13%; p < 0.001). Stent malapposition (44%) and neoatherosclerosis (67%) were the most common mechanisms of ST and ISR, respectively, as identified by intravascular imaging modalities. Finally, the success rates were comparable (96% vs. 98%; p = 0.150) between the two groups. Conclusions: Approximately one of ten patients underwent PCI because of the failure of a previously implanted stent. Use of intracoronary imaging is significantly higher in the clinical context of SF. While DES implantation remains the standard of practice for de novo lesions, DCBs are a popular alternative, especially for ISR cases. Interventional cardiologists who are involved in the treatment of SF cases should be familiar with interpreting intravascular imaging to guide the use of the adjunctive device required to ensure that optimal procedural results in SF cases are obtained. Full article
(This article belongs to the Special Issue Diagnosis and Management of Cardiovascular Diseases)
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