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Change in Cardiac Epidemiology in the New Millennium, Current and...
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Change in Cardiac Epidemiology in the New Millennium, Current and Future Trends

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

Deadline for manuscript submissions: closed (20 June 2024) | Viewed by 5202

Special Issue Editors

Dr. Aviram Hochstadt

E-Mail Website
Guest Editor
Department of Cardiology, The Edith Wolfson Medical Center, Holon, Israel
Interests: cardiac epidemiology; cardiac rhythmology; cardiac electrophysiology; arrhythmias
Dr. Tomer Ziv-Baran

E-Mail Website
Guest Editor
School of Public Health, Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv 6997801, Israel
Interests: assessment of biomarkers; interventional cardiology; epidemiological and biostatistical methods; prediction model; knowledge discovery in databases; clinical outcomes in hospitalized patients; health systems management

Special Issue Information

Dear Colleagues,

The field of cardiology has considerably changed over the last few decades. Advances in the understanding of the pathophysiology of cardiac disease, along with newer, better, and more accessible diagnostic abilities and advances in therapeutic modalities, have remarkably changed the diagnostic process and prognosis of cardiac conditions.

Despite the clinical advances in the field, the epidemiology of cardiac risk factors such as diabetes, obesity, lipid disorders, and hypertension has changed, as well with a direct effect on the epidemiology of cardiac diseases. Furthermore, the discovery of previously unknown risk factors, such as coronary calcium score and chronic inflammation, has made the prediction of cardiac disease more specific, bringing cardiac epidemiology closer to the single patient level.

Advances in novel data gathering and analysis that have made novel techniques available, such as big data and machine learning, have allowed us to ascertain new links between previously unconnected entities that have further changed the way we see cardiac epidemiology at the personal and population levels.

This Special Issue aims to highlight the recent changes in the epidemiology of cardiac disease, and to estimate further trends to help epidemiologist clinicians and policymakers.

Dr. Aviram Hochstadt
Dr. Tomer Ziv-Baran
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

  • cardiac epidemiology
  • machine learning
  • big data
  • cardiac diseases
  • epidemiologic trends

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Published Papers (2 papers)

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Research

12 pages, 819 KiB  
Article
Temporal Trends in Patient Characteristics and Clinical Outcomes of TAVR: Over a Decade of Practice
by Nour Karra, Amir Sharon, Eias Massalha, Paul Fefer, Elad Maor, Victor Guetta, Sagit Ben-Zekry, Rafael Kuperstein, Shlomi Matetzky, Roy Beigel, Amit Segev and Israel M. Barbash
J. Clin. Med. 2024, 13(17), 5027; https://doi.org/10.3390/jcm13175027 - 25 Aug 2024
Viewed by 557
Abstract
Background/Objective: Transcatheter aortic valve replacement (TAVR) is indicated for severe aortic stenosis patients with a prohibitive surgical risk. However, its use has been expanding in recent years to include intermediate- and low-risk patients. Thus, registry data describing changes in patient characteristics and outcomes [...] Read more.
Background/Objective: Transcatheter aortic valve replacement (TAVR) is indicated for severe aortic stenosis patients with a prohibitive surgical risk. However, its use has been expanding in recent years to include intermediate- and low-risk patients. Thus, registry data describing changes in patient characteristics and outcomes are needed. The aim of this study was to analyse the temporal changes in patient profiles and clinical outcomes of all-comer TAVR. Methods: Baseline characteristics and VARC-3 outcomes of 1632 consecutive patients undergoing TAVR between 2008 and 2021 were analysed. Results: The annual rate of TAVR increased from 30 procedures in 2008–2009 to 398 in 2020–2021. Over the follow-up period, patient age decreased from 85 ± 4 to 80 ± 6.8 (p < 0.001) and the STS score decreased from 5.9% to 2.8% (p < 0.001). Procedural characteristics significantly changed, representing a shift into a minimally invasive approach: adoption of local anaesthesia (none to 48%, p < 0.001) and preference of transfemoral access (74% in 2011–2012 vs. 94.5% in 2020–2021, p < 0.001). The rates of almost all procedural complications decreased, including major vascular and bleeding complications, acute kidney injury (AKI) and in-hospital heart failure. There was a striking decline in rates of complete atrioventricular block (CAVB) and the need for a permanent pacemaker (PPM). PPM rates, however, remain high (17.8%). Thirty-day and one-year mortality significantly declined to 1.8% and 8.3%, respectively. Multivariable analysis shows that AKI, bleeding and stroke are strong predictors of one-year mortality (p < 0.001). Conclusions: The TAVR procedure has changed dramatically during the last 14 years in terms of patient characteristics, procedural aspects and device maturity. These shifts have led to improved procedural safety, contributing to improved short- and long-term patient outcomes. Full article
(This article belongs to the Special Issue Change in Cardiac Epidemiology in the New Millennium, Current and Future Trends)
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10 pages, 391 KiB  
Article
Cardiovascular Risk Profile and Lipid Management in the Population-Based Cohort Study LATINO: 20 Years of Real-World Data
by Cristina Gavina, Daniel Seabra Carvalho, Marisa Pardal, Marta Afonso-Silva, Diana Grangeia, Ricardo Jorge Dinis-Oliveira, Francisco Araújo and Tiago Taveira-Gomes
J. Clin. Med. 2022, 11(22), 6825; https://doi.org/10.3390/jcm11226825 - 18 Nov 2022
Cited by 9 | Viewed by 4137
Abstract
The rising prevalence of cardiovascular (CV) risk factors in Portugal has translated into more than 35,000 annual deaths due to CV diseases. We performed a multicenter observational cohort study encompassing clinical activities performed between 2000 and 2019 to characterize the CV risk profile [...] Read more.
The rising prevalence of cardiovascular (CV) risk factors in Portugal has translated into more than 35,000 annual deaths due to CV diseases. We performed a multicenter observational cohort study encompassing clinical activities performed between 2000 and 2019 to characterize the CV risk profile and LDL-C management of patients in every CV risk category using electronic health records of a regional population in Portugal. We analyzed data from 14 health centers and 1 central hospital in the north of Portugal of patients between 40 and 80 years that had at least 1 family medicine appointment at these institutions. Living patients were characterized on 31 December 2019. CV risk assessment was computed according to the 2019 ESC/EAS Guidelines. Lipid-lowering therapy (LLT) and achievement of LDL-C targets were assessed. In total, the analysis included 78,459 patients. Patient proportions were 33%, 29%, 22%, and 17% for low, intermediate, high, and very high CV risk, respectively. Moderate-intensity statins were the most frequently used medication across all CV risk categories. High-intensity statins were used in 5% and 10% of high and very high CV risk patients, respectively. Ezetimibe was used in 6% and 10% of high and very high CV risk patients, respectively. LDL-C targets were achieved in 44%, 27%, 7%, and 3% of low, intermediate, high, and very high CV risk patients, respectively. For uncontrolled patients in the high and very high CV risk categories, a median LDL-C reduction of 44% and 53%, respectively, would be required to meet LDL-C targets. There are clear opportunities to optimize LDL-C management in routine clinical practice. The prescription of LLT according to CV risk represents an important missed treatment opportunity. Full article
(This article belongs to the Special Issue Change in Cardiac Epidemiology in the New Millennium, Current and Future Trends)
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