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Advances in Clinical Practice and Personalized Approaches in Cardiovascular Disease
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Advances in Clinical Practice and Personalized Approaches in Cardiovascular Disease

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

Deadline for manuscript submissions: 31 May 2025 | Viewed by 1494

Special Issue Editors

Prof. Dr. Joseph B. Selvanayagam

E-Mail Website
Guest Editor
Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, SA 5042, Australia
Interests: heart failure; cardiomyopathies; cardiac magnetic resonance imaging; coronary artery disease; arrhythmia disorders
Dr. Sivabaskari Pasupathy

E-Mail Website
Guest Editor
School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia
Interests: myocardial infarction with non obstructive coronary arteries (MINOCA); angina with non obstructive coronary arteries (ANOCA); cardiac magnetic resonance imaging; coronary artery disease; heart failure; cardiomyopathies
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue aims to address the emerging challenges and innovations in the management of cardiovascular disease, with a focus on advancing clinical practice through personalized approaches. As cardiovascular disease remains a leading cause of mortality worldwide, there is an urgent need for tailored interventions that account for individual patient variability. Recent advances in imaging technologies and data-driven predictive models have opened new pathways for precision medicine. However, the translation of these innovations into clinical practice faces hurdles such as heterogeneous patient populations and the integration of multi-modal data.

This Special Issue invites original research and reviews that explore personalized diagnostics, therapeutic strategies, and preventive measures in cardiovascular care. The scope includes novel biomarkers, cutting-edge imaging techniques, patient stratification methods, and advancements in pharmacotherapy that enhance treatment plans. The goal is to bring together leading experts in the field to share knowledge and mobilize future efforts in bridging the gap between research and clinical application, ultimately improving patient outcomes.

Prof. Dr. Joseph B. Selvanayagam
Dr. Sivabaskari Pasupathy
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

  • personalized medicine
  • cardiovascular innovations
  • cardiac imaging
  • risk assessment
  • multimodal imaging
  • therapeutic strategies
  • data-driven decision making
  • clinical outcomes
  • translational research

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Published Papers (6 papers)

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Research

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12 pages, 452 KiB  
Article
Coping Strategies and Health-Related Quality of Life in Individuals with Heart Failure
by Mohammed Owayrif Alanazi, Pallav Deka, Charles W. Given, Rebecca Lehto and Gwen Wyatt
J. Clin. Med. 2025, 14(9), 3073; https://doi.org/10.3390/jcm14093073 - 29 Apr 2025
Abstract
Background: Heart failure (HF) contributes to a poor physical and emotional health-related Quality of Life (HRQoL) and poor health outcomes. Coping strategies have been identified as essential in enhancing HRQoL. The study’s purpose was to examine the relationships between the factors that influence [...] Read more.
Background: Heart failure (HF) contributes to a poor physical and emotional health-related Quality of Life (HRQoL) and poor health outcomes. Coping strategies have been identified as essential in enhancing HRQoL. The study’s purpose was to examine the relationships between the factors that influence coping (i.e., age, sex, education, income, HF duration), HF severity, coping strategies (i.e., problem-focused, active emotion-focused, avoidant emotion-focused), and physical and emotional HRQoL. Methods: A cross-sectional study was conducted using online surveys. Descriptives, Pearson’s correlation, and one-way ANOVA analyses were used to analyze the data. Results: A total of 108 participants completed the study, with the majority being Black men. The result showed significant negative relationships (p < 0.05) between problem-focused and active emotion-focused coping and HF severity. Lower age was significantly related to the use of problem-focused and active emotion-focused coping (p < 0.05); females showed higher use of all coping strategies as compared with males (p < 0.05). A better physical HRQoL was significantly associated with active emotion-focused coping (r = −0.283, p = 0.005), whereas a better emotional HRQoL was significantly associated with problem-focused coping (r = −0.265, p = 0.005) and active emotion-focused coping (r = −0.373, p < 0.001). Conclusions: Findings showed that individuals with a lower HF severity, a younger age, and a higher income and education tended to predominantly utilize adaptive coping strategies. Individuals with HF who use problem-focused and active emotion-focused coping may experience better physical and emotional HRQoL, whereas those using primarily avoidant emotional-focused coping may need guidance in their coping strategies. Healthcare professionals may take factors such as HF severity into account to tailor interventions that promote adaptive coping and enhance HRQoL outcomes. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Personalized Approaches in Cardiovascular Disease)
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11 pages, 957 KiB  
Article
Clinical Outcomes of Transradial Versus Transfemoral Approach in Rotational Atherectomy: Results from the Rotational Atherectomy in Calcified Lesions in Korea (ROCK) Registry
by Kyunyeon Kim, Jin Jung, Sung-Ho Her, Kyusup Lee, Ji-Hoon Jung, Ki-Dong Yoo, Keon-Woong Moon, Donggyu Moon, Su-Nam Lee, Won-Young Jang, Ik-Jun Choi, Jea-Hwan Lee, Jang-Hoon Lee, Sang-Rok Lee, Seung-Whan Lee, Kyeong-Ho Yun and Hyun-Jong Lee
J. Clin. Med. 2025, 14(9), 3066; https://doi.org/10.3390/jcm14093066 - 29 Apr 2025
Abstract
Background and Objectives: Rotational atherectomy (RA) is a crucial method for percutaneous coronary intervention (PCI) of heavily calcified coronary lesions. The aim of this study was to compare the clinical outcomes in patients undergoing RA via the radial versus femoral approach. Methods: The [...] Read more.
Background and Objectives: Rotational atherectomy (RA) is a crucial method for percutaneous coronary intervention (PCI) of heavily calcified coronary lesions. The aim of this study was to compare the clinical outcomes in patients undergoing RA via the radial versus femoral approach. Methods: The Rotational Atherectomy in Calcified Lesions in Korea (ROCK) registry included consecutive patients with severely calcified coronary artery disease who received RA during PCI at nine tertiary centers in Korea. A total of 540 patients who underwent PCI with RA were enrolled between October 2019 and January 2010. We retrospectively investigated the clinical outcomes between the transradial and transfemoral approaches. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE) within 36 months of follow-up. Results: Of the 540 patients, 248 patients (45.9%) were in the transradial group, and 292 patients (54.1%) were in the transfemoral group. There were no significant differences in MACCE (11.3% vs. 17.8%, adjusted hazard ratio [HR]: 1.520; 95% confidence interval: 0.889–2.600; p = 0.126) and procedural success (97.6% vs. 95.2%, p = 0.145). The occurrence of in-hospital bleeding was numerically higher in the transfemoral group, but the difference was not statistically significant (8 [3.2%] vs. 19 [6.5%], p = 0.081) Conclusions: In this study, the transradial approach did not show a significant difference in clinical outcomes but tended to have lower bleeding events compared to the transfemoral approach. RA via the transradial approach can be a useful vascular access option compared to the transfemoral approach. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Personalized Approaches in Cardiovascular Disease)
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15 pages, 858 KiB  
Article
Hemoglobin-to-Creatinine Ratio Predicts One-Year Adverse Clinical Outcomes in ST-Elevation Myocardial Infarction: Retrospective and Propensity Score Matched Analysis
by Luigi Spadafora, Stefano Cacciatore, Mattia Galli, Carlos Collet, Matteo Betti, Gianmarco Sarto, Beatrice Simeone, Erica Rocco, Fabrizio D’Ascenzo, Gaetano Maria De Ferrari, Ovidio De Filippo, Pierre Sabouret, Iginio Colaiori, Roberto Carnevale, Valentina Valenti, Carlo Gaudio, Francesca Romana Zimatore, Giacomo Frati, Francesco Versaci, Sebastiano Sciarretta, Giuseppe Biondi Zoccai and Marco Bernardiadd Show full author list remove Hide full author list
J. Clin. Med. 2025, 14(8), 2756; https://doi.org/10.3390/jcm14082756 - 17 Apr 2025
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Abstract
Background/Objectives: Anemia and renal impairment are key predictors of adverse outcomes in acute coronary syndromes (ACSs). The hemoglobin-to-creatinine (Hb/Cr) ratio combines these parameters into a simple index. This study aimed to evaluate its prognostic value at discharge in patients with ST-elevation myocardial [...] Read more.
Background/Objectives: Anemia and renal impairment are key predictors of adverse outcomes in acute coronary syndromes (ACSs). The hemoglobin-to-creatinine (Hb/Cr) ratio combines these parameters into a simple index. This study aimed to evaluate its prognostic value at discharge in patients with ST-elevation myocardial infarction (STEMI). Methods: The primary endpoint was one-year all-cause mortality; secondary endpoints included major bleeding and the composite of all-cause mortality or reinfarction. Optimal Hb/Cr cut-off values were identified using Liu’s method. Multivariable logistic regression and propensity score matching were used to assess associations with outcomes. Results: We analyzed 11,236 STEMI patients from the PRAISE registry with available hemoglobin and creatinine values at discharge. The optimal cut-points were 13.68 for mortality and 14.42 for secondary endpoints. Patients were stratified into low (<13.68; 26.5%) and high (≥13.68; 73.5%) Hb/Cr groups. The low Hb/Cr group was older, had more comorbidities, and received less intensive therapy. At one year, low Hb/Cr patients had significantly higher rates of all-cause mortality (8.7% vs. 2.4%), major bleeding (5.0% vs. 2.4%), and the composite outcome (11.5% vs. 4.9%). In the multivariate logistic regression, the Hb/Cr ratio was inversely associated with all outcomes, namely all-cause mortality (odds ratio [OR] 0.94; 95% confidence interval [CI]: 0.92–0.96), major bleeding (OR 0.96; 95% CI: 0.94–0.97), and the composite endpoint (OR 0.93; 95% CI: 0.91–0.96). The Hb/Cr ratio outperformed hemoglobin and creatinine alone in predicting mortality (AUC 0.684 vs. 0.649 and 0.645; p < 0.001). Conclusions: The Hb/Cr ratio is independently associated with one-year adverse outcomes in STEMI and may serve as a simple marker of increased vulnerability. Prospective studies are needed to validate its clinical utility. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Personalized Approaches in Cardiovascular Disease)
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11 pages, 896 KiB  
Article
Should the Right Coronary Artery Be Routinely Assessed During Provocative Spasm Testing?
by Olivia Girolamo, Rosanna Tavella, David Di Fiore, Abdul Sheikh, Sivabaskari Pasupathy, Eng Lee Ooi, Jessica A. Marathe, Christopher Zeitz and John F. Beltrame
J. Clin. Med. 2025, 14(4), 1355; https://doi.org/10.3390/jcm14041355 - 18 Feb 2025
Viewed by 344
Abstract
Background/Objectives: The diagnosis of coronary artery spasm (CAS) frequently requires invasive provocation testing, typically utilising acetylcholine (ACh). Although the left coronary artery (LCA) is routinely assessed as a part of the testing protocol, assessment of the right coronary artery (RCA) is often [...] Read more.
Background/Objectives: The diagnosis of coronary artery spasm (CAS) frequently requires invasive provocation testing, typically utilising acetylcholine (ACh). Although the left coronary artery (LCA) is routinely assessed as a part of the testing protocol, assessment of the right coronary artery (RCA) is often avoided since it requires the insertion of a temporary pacing wire. We sought to compare the prevalence of inducible CAS in the LCA and RCA, among patients with CAS undergoing multivessel spasm provocation testing with ACh. Methods: A local multi-institutional ANOCA (angina and non-obstructive coronary arteries) database was analysed, which included 316 patients with angina and suspected CAS who underwent provocation testing (single vessel n = 266, multivessel n = 50) with incremental bolus doses of intracoronary ACh (25, 50, 100 μg in the LCA; 25, 50 μg in the RCA). CAS was defined as >90% constriction of the epicardial coronary artery as assessed visually on coronary angiography. Results: In the 50 patients (55 ± 10 years, 77% female) who underwent multivessel spasm provocation testing, CAS was induced in 20 patients (40%), with ACh provoking CAS only in the LCA system in 45%, only in the RCA system in 35%, and both LCA/RCA in 20%. Conclusions: These findings demonstrate that assessing only the LCA may miss up to one-third of CAS cases. Therefore, it is essential to routinely evaluate the RCA, particularly when no inducible spasm is detected in the LCA. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Personalized Approaches in Cardiovascular Disease)
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Review

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15 pages, 840 KiB  
Review
Rethinking Pulmonary Embolism Management with an Interventional Perspective
by Panayotis K. Vlachakis, Stergios Soulaidopoulos, Emmanouil Mantzouranis, Panagiotis Theofilis, Paschalis Karakasis, Anastasios Apostolos, Ioannis Kachrimanidis, Maria Drakopoulou, Costas Tsioufis and Konstantinos Toutouzas
J. Clin. Med. 2025, 14(9), 3085; https://doi.org/10.3390/jcm14093085 - 29 Apr 2025
Abstract
Pulmonary embolism (PE) remains a major cardiovascular emergency associated with significant morbidity and mortality. Despite advances in risk stratification models, accurately predicting which intermediate-high-risk patients will deteriorate remains challenging. Systemic thrombolysis, while effective in high-risk PE, is not a viable option for a [...] Read more.
Pulmonary embolism (PE) remains a major cardiovascular emergency associated with significant morbidity and mortality. Despite advances in risk stratification models, accurately predicting which intermediate-high-risk patients will deteriorate remains challenging. Systemic thrombolysis, while effective in high-risk PE, is not a viable option for a significant proportion of patients due to contraindications, and its efficacy in the intermediate-high-risk group remains inconclusive. Drawing parallels from acute myocardial infarction and stroke, where percutaneous interventions have revolutionized treatment, interventional therapies are emerging as a promising alternative for PE management. However, challenges persist regarding optimal patient selection, procedural timing, and balancing efficacy with safety. The establishment of pulmonary embolism response teams (PERTs) has played a crucial role in streamlining decision-making and facilitating access to advanced therapies. As novel catheter-based techniques continue to evolve, the field of PE management is undergoing a paradigm shift, mirroring the transformation seen in acute coronary and cerebrovascular care, positioning interventional approaches at the forefront of therapy. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Personalized Approaches in Cardiovascular Disease)
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Other

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46 pages, 1735 KiB  
Systematic Review
Gender Differences in Clinical Practice Regarding Coronary Heart Disease: A Systematic Review
by Emily Caitlin Lily Knox, Inmaculada Mateo-Rodríguez, Antonio Daponte-Codina, Fernando Rosell-Ortiz, Silvia Solá-Muñoz, Antía Codina-Rodríguez, Héctor Bueno and José Ignacio Ruiz-Azpiazu
J. Clin. Med. 2025, 14(5), 1583; https://doi.org/10.3390/jcm14051583 - 26 Feb 2025
Viewed by 747
Abstract
Background/Objectives: A systematic review was performed with the aim of analysing potential sex differences in the overall treatment of coronary heart disease (CHD). Methods: Studies published between January 2011 and November 2023 that conducted a sex-based analysis of the provision of [...] Read more.
Background/Objectives: A systematic review was performed with the aim of analysing potential sex differences in the overall treatment of coronary heart disease (CHD). Methods: Studies published between January 2011 and November 2023 that conducted a sex-based analysis of the provision of any type of therapeutic measure to treat CHD were included. A search was performed of the Web of Science database in November 2023, resulting in 9070 articles. Study quality was examined using the Newcastle–Ottawa scale. A worksheet was produced to extract data pertaining to the title, year of publication, sample, context, study design, dependent variables, time-frame, treatment type, and outcomes reported by each article. This systematic review followed PRISMA guidelines, and the research protocol was submitted to PROSPERO (CRD42022330238). Results: A total of 80 articles presenting data representing 560.070,624 individual datapoints were selected to comprise the final sample. The main findings revealed that the majority of studies highlighted inequalities that disadvantaged females in all analysed treatment categories (pharmacological treatment, invasive interventions, rehabilitation programmes, and other treatment types). Conclusions: Despite the abundance of evidence on the need to improve healthcare provision to females with CHD, few studies examined the reasons or mechanisms underlying the inequalities identified. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Personalized Approaches in Cardiovascular Disease)
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