The Treatment of Coronary Artery Disease and the Impact of This on All Cardiomyopathies

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

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 5317

Special Issue Editor


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Guest Editor
French Alliance Clinical Trial, French Clinical Research Infrastructure Network, Paris, France
Interests: coronary artery disease; cardiomyopathies; Interventional cardiology; non-invasive and invasive imaging techniques; cross-modality and multi-modality imaging

Special Issue Information

Dear Colleagues,

The ageing of the population and the global epidemic of diabetes and obesity due to unhealthy eating habits and physical inactivity have led to an increase in the burden of coronary atherosclerosis.

Consequently, patients with cardiomyopathy might present or develop “bystander” coronary artery disease (CAD) in addition to their cardiomyopathy. The prognostic implications of cardiomyopathy and bystander CAD are poorly understood. The progress and evolution of non-invasive and invasive imaging techniques can help to better assess bystander CAD which may require revascularization and secondary prevention measures. However, randomized studies investigating the clinical benefits of revascularization are lacking. On the other hand, it is now widely acknowledged that coronary microvascular disease plays an important role in all cardiomyopathies.

In this Special Issue, we will present the clinical characteristics of bystander CAD in all forms of cardiomyopathy. We will expose the strengths and weaknesses of non-invasive and invasive imaging techniques as well as describe the use of cross-modality and multi-modality imaging in this setting. Finally, we will propose randomized clinical trials designed to evaluate treatment strategies.

I am sure that this Special Issue will allow readers to have a more precise knowledge regarding cardiomyopathy and bystander CAD, which will improve the management of their patients.

Prof. Dr. Gilles Barone-Rochette
Guest Editor

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Keywords

  • Cardiomyopathy
  • Bystander Coronary artery disease
  • Non-invasive and invasive imaging techniques
  • Multi-modality imaging
  • Revascularization

Published Papers (2 papers)

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13 pages, 1759 KiB  
Article
Prognosis of Coronary Atherosclerotic Burden in Non-Ischemic Dilated Cardiomyopathies
by Marjorie Canu, Léa Margerit, Ismail Mekhdoul, Alexis Broisat, Laurent Riou, Loïc Djaileb, Clémence Charlon, Adrien Jankowski, Michele Magnesa, Caroline Augier, Stéphanie Marlière, Muriel Salvat, Charlotte Casset, Marion Maurin, Carole Saunier, Daniel Fagret, Catherine Ghezzi, Gerald Vanzetto and Gilles Barone-Rochette
J. Clin. Med. 2021, 10(10), 2183; https://doi.org/10.3390/jcm10102183 - 18 May 2021
Cited by 3 | Viewed by 2266
Abstract
Background: Atherosclerosis is associated with a worse prognosis in many diseases such as ischemic cardiomyopathy, but its impact in non-ischemic dilated cardiomyopathy (dCMP) is lesser known. Our aim was to study the prognostic impact of coronary atherosclerotic burden (CAB) in patients with dCMP. [...] Read more.
Background: Atherosclerosis is associated with a worse prognosis in many diseases such as ischemic cardiomyopathy, but its impact in non-ischemic dilated cardiomyopathy (dCMP) is lesser known. Our aim was to study the prognostic impact of coronary atherosclerotic burden (CAB) in patients with dCMP. Methods: Consecutive patients with dCMP and left ventricular (LV) dysfunction diagnosed by concomitant analysis of invasive coronary angiography (ICA) and CMR imaging were identified from registry-database. CAB was measured by Gensini score. The primary composite endpoint was the occurrence of major adverse cardiovascular events (MACE) defined as cardiovascular (CV) mortality, non-fatal MI and unplanned myocardial revascularization. The results of 139 patients constituting the prospective study population (mean age 59.4 ± 14.7 years old, 74% male), average LV ejection fraction was 31.1 ± 11.02%, median Gensini score was 0 (0–3), and mid-wall late gadolinium enhancement (LGE) was the most frequent LGE pattern (42%). Over a median follow-up of 2.8 years, 9% of patients presented MACE. Patients with MACE had significantly higher CAB compared to those who were free of events (0 (0–3) vs. 3.75 (2–15), p < 0.0001). CAB remained the significant predictor of MACE on multivariate logistic analysis (OR: 1.12, CI: 1.01–1.23, p = 0.02). Conclusion: High CAB may be a new prognostic factor in dCMP patients. Full article
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10 pages, 346 KiB  
Article
Comparison of Short- and Long-Term Prognosis between ST-Elevation and Non-ST-Elevation Myocardial Infarction
by Frédéric Bouisset, Jean-Bernard Ruidavets, Jean Dallongeville, Marie Moitry, Michele Montaye, Katia Biasch and Jean Ferrières
J. Clin. Med. 2021, 10(2), 180; https://doi.org/10.3390/jcm10020180 - 07 Jan 2021
Cited by 16 | Viewed by 2531
Abstract
Background: Available data comparing long-term prognosis according to the type of acute coronary syndrome (ACS) are scarce, contradictory, and outdated. Our aim was to compare short- and long-term mortality in ST-elevated (STEMI) and non-ST-elevated myocardial infarction (non-STEMI) ACS patients. Methods: Patients presenting with [...] Read more.
Background: Available data comparing long-term prognosis according to the type of acute coronary syndrome (ACS) are scarce, contradictory, and outdated. Our aim was to compare short- and long-term mortality in ST-elevated (STEMI) and non-ST-elevated myocardial infarction (non-STEMI) ACS patients. Methods: Patients presenting with an inaugural ACS during the year 2006 and living in one of the three areas in France covered by the Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) registry were included. Results: A total of 1822 patients with a first ACS—1121 (61.5%) STEMI and 701 (38.5%) non-STEMI—were included in the study. At the 28-day follow-up, the mortality rates were 6.7% and 4.7% (p = 0.09) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 28-day probability of death was significantly lower for non-STEMI ACS patients (Odds Ratio = 0.58 (0.36–0.94), p = 0.03). At the 10-year follow-up, the death rates were 19.6% and 22.8% (p = 0.11) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 10-year probability of death did not significantly differ between non-STEMI and STEMI events (OR = 1.07 (0.83–1.38), p = 0.59). Over the first year, the mortality rate was 7.2%; it then decreased and stabilized at 1.7% per year between the 2nd and 10th year following ACS. Conclusion: STEMI patients have a worse vital prognosis than non-STEMI patients within 28 days following ACS. However, at the 10-year follow-up, STEMI and non-STEMI patients have a similar vital prognosis. From the 2nd year onwards following the occurrence of a first ACS, the patients become stable coronary artery disease patients with an annual mortality rate in the 2% range, regardless of the type of ACS they initially present with. Full article
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