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The New Advances in Cardioprotection
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The New Advances in Cardioprotection

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Chronic Care".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 10913

Special Issue Editors

Dr. Rahul Gupta

E-Mail Website
Guest Editor
Lehigh Valley Heart Institute, Lehigh Valley Health Network, Allentown, PA 18103, USA
Interests: clinical outcomes research; meta-analysis; antithrombotic therapy; TAVR; acute coronary syndrome; percutaneous intervention
Special Issues, Collections and Topics in MDPI journals
Dr. Akshay Goel

E-Mail Website
Guest Editor
Westchester Medical Center, Valhalla, NY 10595, USA
Interests: valvular heart disease; mitral regurgitation; aortic stenosis; TAVR; coronary artery disease; acute coronary syndrome; unstable angina; NSTEMI; STEMI; heart failure; cardiomyopathy; myocarditis; pericarditis; arrhythmias; atrial fibrillation; statins; lipids; cardioprotective medications; ACEi; ARB; ARNI; SGLT-2 inhibitors

Special Issue Information

Dear Colleagues,

Cardiac disease remains the leading cause of death and disability worldwide. A number of molecular pathologic pathways, including excessive reactive oxygen species, calcium overload, inflammatory responses, cardiac fibrosis, apoptosis, cell death, and mitochondrial dysfunction, etc., have been identified, which induce cardiovascular risk factors, including ventricles hypertrophy, tissue ischemia, and arrhythmias, and result in sudden cardiac death and heart failure. Changes in patient demographics have meant that older and sicker patients with increasing co-morbidities, such as diabetes, left ventricular hypertrophy, renal failure etc., are undergoing coronary artery bypass graft surgery (CABG), often with concomitant valve and/or aortic surgery, thus increasing the risk of peri-operative myocardial injury and CABG-related myocardial infarction, and worsening clinical outcomes. As such, novel cardioprotective strategies are still required to attenuate the detrimental effects of acute myocardial ischemia and reperfusion injury, so as to prevent adverse LV remodeling, and reduce heart failure in patients with ischemic heart disease.  

This Special Issue of Healthcare seeks commentaries, original research, short reports, and reviews on recent advances in the field of cardioprotection with a focus on new drugs, targets, and approaches to treating cardiac ischemic/reperfusion injuries, and the use of mechanical devices in the treatment of heart failure, cardiogenic shock, or life-threatening arrhythmias. We would like to invite the authors’ views on the use of cardioprotective devices in patients undergoing percutaneous procedures and cardiac surgery. Additionally, we are looking for papers that can elucidate the cardioprotective effects of newer therapeutic measures in high-risk populations, such as those with diabetes, cancer, or multi-system disease.

Dr. Rahul Gupta
Dr. Akshay Goel
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. Healthcare 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 2700 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

  • Cardioprotection
  • Global health
  • Newer therapies
  • Pharmaceutical measures
  • Cardiogenic shock
  • Heart failure
  • Arrhythmias
  • Embolic devices
  • Percutaneous interventions
  • Cardiac Surgery
  • Mechanical devices

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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18 pages, 6366 KiB  
Article
SGLT2 Inhibitors in Acute Heart Failure: A Meta-Analysis of Randomized Controlled Trials
by Noor Ul Amin, Faiza Sabir, Talal Amin, Zouina Sarfraz, Azza Sarfraz, Karla Robles-Velasco and Ivan Cherrez-Ojeda
Healthcare 2022, 10(12), 2356; https://doi.org/10.3390/healthcare10122356 - 23 Nov 2022
Cited by 15 | Viewed by 6112
Abstract
Acute heart failure (AHF) is a major public health concern, affecting 26 million worldwide. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of glucose-lowering drugs, comprising canagliflozin, dapagliflozin, and empagliflozin that are being explored for AHF. We aim to meta-analyze the effectiveness of [...] Read more.
Acute heart failure (AHF) is a major public health concern, affecting 26 million worldwide. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a class of glucose-lowering drugs, comprising canagliflozin, dapagliflozin, and empagliflozin that are being explored for AHF. We aim to meta-analyze the effectiveness of SGLT2 inhibitors compared to placebo for primary outcomes including all-cause and cardiovascular mortality, heart failure events, symptomatic improvement, and readmissions. Our secondary outcome is the risk of serious adverse events. This meta-analysis has been designed in accordance with the PRISMA Statement 2020. A systematic search across PubMed, Scopus, and Cochrane Library was conducted through August 13, 2022. The following keywords were utilized: sglt2, sodium-glucose transporter 2 inhibitors, sglt2 inhibitors, decompensated heart failure, de-novo heart failure, and/or acute heart failure. Only randomized controlled trials (RCTs) with adult patients (>18 years), hospitalized with de-novo AHF, acutely decompensated chronic heart failure with reduced, borderline, or preserved ejection, and receiving SGLT2 inhibitors were included. A quantitative analytical methodology was applied where the standardized mean difference (SMD) applying 95% confidence intervals (CI) for continuous outcomes and risk ratio (RR) with 95% CI was yielded. All tests were carried out on Review Manager 5.4 (Cochrane). In total, three RCTs were included pooling in a total of 1831 patients where 49.9% received SGLT2 inhibitors. The mean age was 72.9 years in the interventional group compared to 70.6 years in the placebo. Only 33.7% of the sample was female. The follow-up spanned 2–9 months. Heart failure events were reduced by 62% in the interventional group (RR = 0.66, p < 0.0001). readmissions had a reduced risk of 24% with SGLT2 inhibitors (RR = 0.76, p = 0.03). We assessed the efficacy and safety of SGLT2 inhibitors in preventing complications post-AHF. The odds of all-cause mortality, cardiovascular mortality, heart failure events, and re-admissions rates were substantially reduced within the first 1–9 months of hospitalization. Full article
(This article belongs to the Special Issue The New Advances in Cardioprotection)
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Review

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20 pages, 1280 KiB  
Review
The Use of Cardioprotective Devices and Strategies in Patients Undergoing Percutaneous Procedures and Cardiac Surgery
by Toufik Abdul-Rahman, Ileana Lizano-Jubert, Neil Garg, Emilio Tejerina-Marion, Syed Muhammad Awais Bukhari, Ana Luisa Ek, Andrew Awuah Wireko, Adriana C. Mares, Vladyslav Sikora and Rahul Gupta
Healthcare 2023, 11(8), 1094; https://doi.org/10.3390/healthcare11081094 - 11 Apr 2023
Cited by 1 | Viewed by 4113
Abstract
In the United States, about one million people are seen to visit the operating theater for cardiac surgery annually. However, nearly half of these visits result in complications such as renal, neurological, and cardiac injury of varying degrees. Historically, many mechanisms and approaches [...] Read more.
In the United States, about one million people are seen to visit the operating theater for cardiac surgery annually. However, nearly half of these visits result in complications such as renal, neurological, and cardiac injury of varying degrees. Historically, many mechanisms and approaches have been explored in attempts to reduce injuries associated with cardiac surgery and percutaneous procedures. Devices such as cardioplegia, mechanical circulatory support, and other methods have shown promising results in managing and preventing life-threatening cardiac-surgery-related outcomes such as heart failure and cardiogenic shock. Comparably, cardioprotective devices such as TandemHeart, Impella family devices, and venoarterial extracorporeal membrane oxygenation (VA-ECMO) have also been proven to show significant cardioprotection through mechanical support. However, their use as interventional agents in the prevention of hemodynamic changes due to cardiac surgery or percutaneous interventions has been correlated with adverse effects. This can lead to a rebound increased risk of mortality in high-risk patients who undergo cardiac surgery. Further research is necessary to delineate and stratify patients into appropriate cardioprotective device groups. Furthermore, the use of one device over another in terms of efficacy remains controversial and further research is necessary to assess device potential in different settings. Clinical research is also needed regarding novel strategies and targets, such as transcutaneous vagus stimulation and supersaturated oxygen therapy, aimed at reducing mortality among high-risk cardiac surgery patients. This review explores the recent advances regarding the use of cardioprotective devices in patients undergoing percutaneous procedures and cardiac surgery. Full article
(This article belongs to the Special Issue The New Advances in Cardioprotection)
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