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The Current Concept and Emerging Treatments of Coronary Artery Disease...
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The Current Concept and Emerging Treatments of Coronary Artery Disease (CAD)

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

Deadline for manuscript submissions: 25 November 2026 | Viewed by 1198

Editors

Dr. Simone Fezzi

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Guest Editor
Division of Cardiology, Cardio-Thoracic Department, University of Verona, 37100 Verona, Italy
Interests: coronary physiology; intracoronary imaging; imaging-derived computational physiology; drug coated balloon and bioresorbable scaffolds; virtual PCI; artificial-intelligence
Special Issues, Collections and Topics in MDPI journals
Dr. Roberto Scarsini

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Guest Editor
Department of Cardiology, University of Verona, 37129 Verona, Italy
Interests: coronary physiology; intracoronary imaging; imaging-derived computational physiology; drug coated balloon and bioresorbable scaffolds; virtual PCI; artificial-intelligence
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, necessitating continual advancements in its diagnosis, treatment, and management. The understanding of CAD progression has expanded, including the role of inflammation, endothelial dysfunction, and plaque instability as critical factors in disease progression, leading to new therapeutic targets.

This Special Issue will dive deep into the current state of PCI, emphasizing the ongoing debate around the appropriateness of stent-based revascularization. Reliance on angiography alone can lead to inappropriate treatment decisions, while physiological assessments are crucial for ensuring that PCI is both appropriate and effective.

Secondly, this Special Issue will focus on the concept of residual angina post-PCI, exploring how suboptimal revascularization and/or microvascular dysfunction contribute to ongoing patient symptoms.

Third, this Special Issue will focus on the emerging role of simulated virtual PCI and advanced imaging-derived technologies and physiological data for better procedural planning and outcomes.

Lastly, new emerging technologies, such as drug-coated balloons and bioresorbable stents, are gaining attention as alternatives to traditional drug-eluting stents. These technologies aim to reduce long-term complications associated with permanent implants, such as late stent thrombosis and restenosis.

This Special Issue highlights the need for ongoing research and collaboration among clinicians, researchers, and industry to further refine and implement these emerging treatments, ultimately improving outcomes for patients with coronary artery disease.

Dr. Simone Fezzi
Dr. Roberto Scarsini
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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized 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

  • coronary physiology
  • intracoronary imaging
  • imaging-derived computational physiology
  • drug-coated balloon and bioresorbable scaffolds
  • virtual PCI
  • artificial intelligence

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Published Papers (2 papers)

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Research

13 pages, 670 KB  
Article
Long-Term Outcomes in NSTEMI Patients Based on Coronary TIMI Flow State on Presentation
by Tarek Abdeldayem, Hilal Khan, Mohamed Farag, Ioakim Spyridopoulos, Mohammad Alkhalil, Scott Wilkes, Emmanouil S. Brilakis, Bilal Bawamia and Mohaned Egred
J. Clin. Med. 2026, 15(12), 4486; https://doi.org/10.3390/jcm15124486 - 10 Jun 2026
Viewed by 298
Abstract
Background/Objectives: People with non-ST-segment elevation myocardial infarction (NSTEMI) with an occluded culprit vessel represent a unique subset of patients; however, their long-term outcomes remain unclear. This study aimed to compare 5-year mortality between NSTEMI patients treated with percutaneous coronary intervention (PCI) based [...] Read more.
Background/Objectives: People with non-ST-segment elevation myocardial infarction (NSTEMI) with an occluded culprit vessel represent a unique subset of patients; however, their long-term outcomes remain unclear. This study aimed to compare 5-year mortality between NSTEMI patients treated with percutaneous coronary intervention (PCI) based on TIMI flow states in the culprit vessel on presentation (TIMI 0-1 compared to TIMI 2-3). Methods: A retrospective analysis of prospectively collected data of all NSTEMI patients who underwent PCI from 2012 to 2019 at a tertiary cardiac center (The Freeman Hospital, Newcastle-Upon-Tyne, UK) with follow up for 5 years until January 2024. Patients were identified from the database and categorized based on pre-procedural TIMI flow in the culprit vessel. A propensity score was used to pair TIMI 0-1 patients with a matched cohort of TIMI 2-3 patients. The primary outcome was 5-year all-cause mortality. Results: A total of 775 patients with TIMI 0-1 flow were matched with 750 patients who had TIMI 2-3 flow. Patients with TIMI 0-1 flow were more likely to have transient ST elevation (24% vs. 18%, p < 0.001) or Q waves (4% vs. 1%, p < 0.001) compared with patients who had TIMI 2-3 flow. They were also more likely to have moderately to severely impaired left ventricular systolic function compared with patients with TIMI 2-3 flow (21% vs. 16%, p = 0.01). In-hospital mortality (1.2% vs. 1.2%, p = NS), 1-year mortality (5% vs. 6.9%, p = NS), and 5-year mortality (16% vs. 18%, p = 0.34) were not significantly different between the two groups. The use of glycoprotein IIb/IIIa antagonists was associated with lower mortality, HR 0.64 (0.46 to 0.87). Conclusions: NSTEMI patients with occluded culprit vessels who underwent PCI had similar in-hospital and long-term outcomes to patients with patent culprit vessels. The use of glycoprotein IIb/IIIa inhibitors appears to be associated with lower mortality. Full article
(This article belongs to the Special Issue The Current Concept and Emerging Treatments of Coronary Artery Disease (CAD))
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11 pages, 3474 KB  
Article
Seeing the Unseen: Enhanced Stent Visualization Reveals Hidden Coronary Stent Complications
by Carlotta Rossignoli, Chiara Bianchi, Hesham Abu Abied, Alberto Zamboni, Francesco Bacchion, Giorgio Morando, Antonio Mugnolo, Simone Biscaglia and Gabriele Venturi
J. Clin. Med. 2026, 15(10), 3907; https://doi.org/10.3390/jcm15103907 - 19 May 2026
Viewed by 668
Abstract
Background: Accurate evaluation of stent implantation during percutaneous coronary intervention (PCI) is essential to reduce both early and late adverse events. Conventional coronary angiography, although routinely used, has limited spatial resolution and may fail to detect subtle mechanical abnormalities in implanted stents. [...] Read more.
Background: Accurate evaluation of stent implantation during percutaneous coronary intervention (PCI) is essential to reduce both early and late adverse events. Conventional coronary angiography, although routinely used, has limited spatial resolution and may fail to detect subtle mechanical abnormalities in implanted stents. Enhanced stent visualization (ESV) is an X-ray-based post-processing technique that improves delineation of stent struts without additional contrast or intracoronary instrumentation. Methods: We report a retrospective case series of five patients who underwent complex PCI where ESV was used as an adjunctive imaging modality. Clinical scenarios included left main interventions, bifurcation lesions, multivessel disease, and acute coronary syndromes. The ability of ESV to detect mechanical complications not evident on angiography was assessed. The impact of ESV on procedural decision-making was also assessed. Results: ESV enabled identification of mechanical complications in all cases, including stent fracture, stent loss, stent dislodgement, stent underexpansion, and geographical miss. These findings were not clearly appreciable when using angiography alone. In each case, ESV directly influenced intraprocedural management, prompting immediate corrective actions such as additional stent implantation, stent retrieval, or further optimization with post-dilatation or intravascular lithotripsy. This resulted in improved procedural outcomes and optimized stent deployment. Conclusions: In this small retrospective case series, ESV provided incremental diagnostic value over conventional angiography by detecting otherwise unrecognized mechanical complications and guiding real-time procedural optimization. While these findings suggest a potential role for ESV in complex PCIs, larger prospective studies are required to confirm its clinical impact. Full article
(This article belongs to the Special Issue The Current Concept and Emerging Treatments of Coronary Artery Disease (CAD))
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