Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.7
3.0
Journals
JCM
Special Issues
Myocardial Infarction: Current Status and Future Challenges
share announcement

Myocardial Infarction: Current Status and Future Challenges

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

Deadline for manuscript submissions: 25 August 2025 | Viewed by 6724

Special Issue Editors

Dr. Isaac Pascual

E-Mail Website
Guest Editor
1. Heart Area, Hospital Universitario Central Asturias (HUCA), 33011 Oviedo, Spain
2. Department of Medicine, University of Oviedo, 33003 Oviedo, Spain
3. Health Research Institute of Asturias (ISPA), 33011 Oviedo, Spain
Interests: inherited cardiomyopathies; sudden cardiac death; coronary artery disease (CAD); cardiovascular risk factors, pharmacological therapy, acute coronary syndrome (ACS); ischemic heart disease; percutaneous coronary intervention; transcatheter valvular devices
Dr. Rebeca Lorca

E-Mail Website
Co-Guest Editor
1. National Reference Unit of Inherited Cardiomyopathies, Hospital Universitario Central Asturias (HUCA), 33011 Oviedo, Spain
2. Department of Medicine, University of Oviedo, 33003 Oviedo, Spain
3. Health Research Institute of Asturias (ISPA), 33011 Oviedo, Spain
Interests: inherited cardiomyopathies; genetics; arrhythmias; heart failure; sudden cardiac death; coronary artery disease; cardiovascular risk factors; pharmacological therapy

Special Issue Information

Dear Colleagues,

Cardiovascular disease remains the leading cause of morbidity and mortality worldwide, with coronary artery disease (CAD) being a major concern. In this regard, acute coronary syndrome (ACS), especially with myocardial infarction (MI), can be one of the most life-threating manifestations of CAD. It is crucial to identify and manage risk factors to prevent the development of premature CAD and its associated complications. CAD is a complex disease with multiple risk factors, including genetics, lifestyle, and environmental factors. Myocardial infarction is a significant health concern that requires early diagnosis, effective management, and ongoing prevention.

This Special Issue, entitled “Myocardial Infarction: Current Status and Future Challenges”, aims to provide a comprehensive platform to bring together contributions from international researchers in the area of myocardial infarction. As a result, we invite all researchers to submit their studies.

Dr. Isaac Pascual
Dr. Rebeca Lorca
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

  • myocardial infarction
  • acute coronary syndrome (ACS)
  • ischemic heart disease
  • coronary artery disease (CAD)
  • percutaneous coronary intervention
  • pharmacological therapy
  • cardiovascular risk factors

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

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

Published Papers (7 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review

14 pages, 1515 KiB  
Article
PCSK9 Inhibitors “Fast Track” Use Versus “Stepwise” Lipid-Lowering Therapy in Patients with Acute Coronary Syndrome: A Retrospective Single-Center Study in a “Real-World” Population
by Davide D’Andrea, Valentina Capone, Alessandro Bellis, Rossana Castaldo, Monica Franzese, Gerardo Carpinella, Fulvio Furbatto, Fulvio La Rocca, Fabio Marsico, Raffaele Marfella, Giuseppe Paolisso, Pasquale Paolisso, Carlo Fumagalli, Maurizio Cappiello, Eduardo Bossone and Ciro Mauro
J. Clin. Med. 2025, 14(9), 2992; https://doi.org/10.3390/jcm14092992 - 26 Apr 2025
Viewed by 184
Abstract
Background: The “fast track” addition (within 48 h) of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) to the optimized oral lipid-lowering therapy (LLT) during hospitalization for acute coronary syndrome (ACS) has been shown to rapidly achieve the low-density lipoprotein cholesterol (LDL-C) therapeutic [...] Read more.
Background: The “fast track” addition (within 48 h) of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) to the optimized oral lipid-lowering therapy (LLT) during hospitalization for acute coronary syndrome (ACS) has been shown to rapidly achieve the low-density lipoprotein cholesterol (LDL-C) therapeutic targets. However, so far, its efficacy in real-world settings remains understudied. Methods: We retrospectively analyzed 128 ACS patients treated at our center, comparing “PCSK9i fast track” use within 48 h to standard “stepwise” LLT. Lipid levels and incidence of major adverse cardiovascular events (MACEs) were evaluated at 30 and 180 days. Results: The “PCSK9i fast track” group achieved significantly lower LDL-C levels at 30 days (41.5 ± 27.5 vs. 85.6 ± 35.9 mg/dL, p < 0.001) and 180 days (29.6 ± 21.0 vs. 59.0 ± 32.4 mg/dL, p < 0.001). Recommended LDL-C targets (<55 mg/dL) were met by 88.3% of the “PCSK9i fast track” group at 180 days, compared with 61.9% of controls (p < 0.001). No significant differences in MACEs were observed between groups. No adverse effects from PCSK9i use were noted. Conclusions: The “PCSK9i fast track” strategy was safe and effective in achieving LDL-C targets more rapidly than conventional approaches in real-world ACS patients. Full article
(This article belongs to the Special Issue Myocardial Infarction: Current Status and Future Challenges)
►▼ Show Figures

Figure 1

16 pages, 5310 KiB  
Article
Acute Myocardial Infarction Mortality in the Older Population of the United States: An Analysis of Demographic and Regional Trends and Disparities from 1999 to 2022
by Ali Bin Abdul Jabbar, Mason Klisares, Kyle Gilkeson and Ahmed Aboeata
J. Clin. Med. 2025, 14(7), 2190; https://doi.org/10.3390/jcm14072190 - 23 Mar 2025
Viewed by 384
Abstract
Background/Objectives: Acute myocardial infarction (AMI) has been a leading cause of mortality in the US. Though AMI mortality has been decreasing in the US, significant disparities have persisted. We aim to evaluate disparities in AMI-related deaths in the US from 1999 to [...] Read more.
Background/Objectives: Acute myocardial infarction (AMI) has been a leading cause of mortality in the US. Though AMI mortality has been decreasing in the US, significant disparities have persisted. We aim to evaluate disparities in AMI-related deaths in the US from 1999 to 2022. Methods: Data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) multiple causes of death database were used to analyze death certificates from 1999 to 2022 for AMI-related deaths among United States older adults (aged ≥ 65) for overall trend and disparities based on demographic (sex, race/ethnicity, and ten-year age groups) and regional (census regions, rural-urban status, and states) subgroups. Rural and urban status were distinguished using definitions set by the 2013 NCHS Urban-Rural Classification scheme for counties. These data come from the 2010 Census report and are updated from the 2006 NCHS Urban-Rural Classification scheme for counties. The crude mortality rate (CMR) and age-adjusted mortality rates (AAMRs) per 100,000 people were used to calculate annual percentage changes (APCs) and average annual percentage changes (AAPCs) using Joinpoint regression analysis. Results: From 1999 to 2022, there were 3,249,542 deaths due to AMI. Overall, age-adjusted mortality rates (AAMRs) decreased by 62.78% from 563.2 * (95% CI 560.3–565.7) in 1999 to a nadir at 209.6 * (208.3–210.8) in 2019, with an AAPC of −4.96 * (95% CI −5.11 to −4.81). There were a total of 355,441 deaths from AMI from 2020 to 2022; 21,216 (5.97%) of those were from AMI with COVID-19 infection. An increase of 11.4% was observed from an AAMR of 209.6 * (95% CI 208.3–210.8) in 2019 to 233.5 * (95% CI 232.2–234.8) in 2021. From 2021 to 2022, the AAMR of AMI decreased from 233.5 * (95% CI 232.2–234.8) to 209.8 * (95% CI 208.6–211), recovering to the 2019 levels. The AAMR for AMI excluding associated COVID-19 infection was 217.2 at its peak in 2021, which correlates to only a 3.63% increase from 2019. Significant disparities in AMI mortality were observed, with higher mortality rates in men, African Americans, the oldest age group (age ≥ 85), and those living in southern states and rural areas. Conclusions: AMI mortality in the older adult population of the US has significantly decreased from 1999 to 2019, with a brief increase during the pandemic from 2019 to 2021, followed by recovery back to the 2019 level in 2022. The majority of the rise observed during the pandemic was associated with COVID-19 infection. Despite remarkable improvement in mortality, significant disparities have persisted, with men, African Americans, and those living in rural areas and the southern region of the US having disproportionately higher mortality. Full article
(This article belongs to the Special Issue Myocardial Infarction: Current Status and Future Challenges)
►▼ Show Figures

Figure 1

19 pages, 669 KiB  
Article
Comparison of the Effects of Endurance Training Conducted in Conditions of Normoxia and Artificial Hypoxia in Patients After Myocardial Infarction
by Agata Nowak-Lis, Zbigniew Nowak, Dominika Grzybowska-Ganszczyk, Paweł Jastrzębski and Anna Konarska-Rawluk
J. Clin. Med. 2025, 14(6), 1790; https://doi.org/10.3390/jcm14061790 - 7 Mar 2025
Viewed by 603
Abstract
Background/Objective: Attention should be paid to the introduction of more functional training methods during the second stage of cardiac rehabilitation, which imitate everyday activities to some extent. The main purpose of this research was to analyze the effects of a 22-day training [...] Read more.
Background/Objective: Attention should be paid to the introduction of more functional training methods during the second stage of cardiac rehabilitation, which imitate everyday activities to some extent. The main purpose of this research was to analyze the effects of a 22-day training program carried out in normobaric hypoxic conditions corresponding to the altitude of 3000 m a.s.l. in patients after myocardial infarction and to compare it with the same training conducted in normoxic conditions. Material and Methods: This study included 36 patients after myocardial infarction who underwent percutaneous angioplasty with stent implantation. They were examined before and after 2 days of training sessions: day one, spiroergometric exercise test on a mechanical treadmill, blood collection for laboratory tests; day two, echocardiography of the heart. Than patients underwent 22 days of training in hypoxic conditions. At the end of experiment patients had the same examinations as day one and two. Results: Training conducted in hypoxic conditions had a wider impact on spiroergometrical parameters. Significant, beneficial changes were demonstrated in relation to test duration, distance covered, energy expenditure MET, respiratory exchange ratio RER, as well as resting values of systolic and diastolic blood pressure. There were no changes in parameters for morphology, cytokines, and fibrinogen. There were some differences in relation to echocardiography examinations. Conclusions: The conditions in which the rehabilitation training was conducted affect the level of exercise tolerance. The hypoxic conditions in which the training was conducted affected only two hemodynamic parameters: LVESd and e’ septal. Rehabilitation training conducted in various environmental conditions had an impact only on the IL-10 value. Full article
(This article belongs to the Special Issue Myocardial Infarction: Current Status and Future Challenges)
►▼ Show Figures

Figure 1

13 pages, 3009 KiB  
Article
Revascularization of Chronic Total Occlusions vs. Planned Complex Percutaneous Coronary Intervention: Long-Term Outcomes and Mortality
by Marcel Almendarez, Alberto Alperi, Isaac Pascual, Rut Alvarez-Velasco, Rebeca Lorca, Daniel Hernández-Vaquero, José Luis Betanzos, Juan Francisco Ortiz de Zarate, Raul Ptaszynski, Paula Antuña, Luis Arboine and Pablo Avanzas
J. Clin. Med. 2025, 14(3), 758; https://doi.org/10.3390/jcm14030758 - 24 Jan 2025
Viewed by 685
Abstract
Introduction: The number of chronic total occlusion (CTO) revascularization procedures has continuously increased, obtaining better results in recent years. However, there are few data regarding long-term outcomes and no comparisons to planned complex non-CTO percutaneous coronary intervention (PCI). Methods: We included all patients [...] Read more.
Introduction: The number of chronic total occlusion (CTO) revascularization procedures has continuously increased, obtaining better results in recent years. However, there are few data regarding long-term outcomes and no comparisons to planned complex non-CTO percutaneous coronary intervention (PCI). Methods: We included all patients undergoing planned complex PCI. Our main objective was to compare a combined endpoint of all-cause death, myocardial infarction, and target vessel revascularization at the long-term follow-up of CTO PCI versus planned complex non-CTO PCI. We compared the groups using multivariable Cox regression and performed a propensity score matching analysis to control the baseline characteristics. We repeated the analysis for the separate components of the primary endpoint. Results: From January 2018 to June 2023, 1394 complex coronary PCIs were performed at our center. After excluding 393 non-planned cases, 201 CTO PCIs and 800 non-CTO PCIs were included. The mean follow-up was 2.5 ± 1.5 years. The composite endpoint occurred in 23 (11.6%) CTO PCIs and 219 (28.2%) planned non-CTO PCIs. The multivariable Cox regression using the CTO group as the reference showed a lower risk for the primary outcome (HR: 0.59; 95% CI 0.37–0.95; p = 0.031). After matching, a total of 195 adequately balanced pairs were obtained. The CTO group presented a lower risk for the primary combined outcome (HR: 0.46; 95% CI 0.27–0.76; p = 0.003). Conclusions: In patients undergoing planned complex PCI, those in the CTO group presented a reduced risk of all-cause death, myocardial infarction, and target vessel revascularization at the end of the follow-up. Full article
(This article belongs to the Special Issue Myocardial Infarction: Current Status and Future Challenges)
►▼ Show Figures

Figure 1

13 pages, 4340 KiB  
Article
Air Pollution and Myocardial Infarction—A New Smoker’s Paradox?
by Friederike von Lewinski, Franz Quehenberger, Michael Sacherer, Valentin Taucher, Christoph Strohhofer, Klemens Ablasser, Nicolas Verheyen, Caren Sourij, Andreas Kainz, Gerit Wünsch, Andrea Berghold, Thomas M. Berghaus, Sadeek Sidney Kanoun Schnur, Andreas Zirlik and Dirk von Lewinski
J. Clin. Med. 2024, 13(23), 7324; https://doi.org/10.3390/jcm13237324 - 2 Dec 2024
Viewed by 875
Abstract
Background/Objectives: Ambient air pollution is a significant public health concern, known to affect cardiovascular health adversely. Research has identified both long-term and short-term cardiovascular risks associated with various air pollutants, including those linked to acute coronary syndromes. However, the observed effects are rather [...] Read more.
Background/Objectives: Ambient air pollution is a significant public health concern, known to affect cardiovascular health adversely. Research has identified both long-term and short-term cardiovascular risks associated with various air pollutants, including those linked to acute coronary syndromes. However, the observed effects are rather small, with most data sourced from highly polluted regions. Methods: This study utilized a prospective registry database, documenting 12,581 myocardial infarction (MI) events in Styria, Austria from January 2007 to December 2015. Pollutants analyzed included particulate matter (PM2.5, PM10) and gases, such as NO2, CO, SO2, O3 and NOx. We employed generalized linear models to examine the interaction of each of these pollutants on the daily incidence of MI. Additionally, we conducted separate analyses for patients with specific comorbidities: diabetes mellitus (DM), arterial hypertension (HTN), heart failure with reduced ejection fraction (HFrEF), chronic obstructive pulmonary disease (COPD) and current smokers. Results: No significant associations were identified between any of the pollutants and MI incidence, both in the overall cohort and in patient subgroups with DM, HTN, HFrEF or COPD. However, among active smokers, we observed a decreased relative risk of MI associated with elevated levels of NO2, CO, SO2 and NOx on the day of MI (p < 0.01 for all pollutants). Conversely, an increased MI risk was associated with rising ozone levels (p = 0.0027). This counterintuitive finding aligns with previously published data and may suggest a new dimension to the “smoker’s paradox”. Conclusions: In regions with low pollution levels, air pollutants pose only minor or insignificant short-term risks for myocardial infarction. Active smokers exhibit an altered response to ambient air pollution. Full article
(This article belongs to the Special Issue Myocardial Infarction: Current Status and Future Challenges)
►▼ Show Figures

Figure 1

Review

Jump to: Research

18 pages, 729 KiB  
Review
Management of Myocardial Infarction and the Role of Cardiothoracic Surgery
by Shannon Parness, Panagiotis Tasoudis, Chris B. Agala and Aurelie E. Merlo
J. Clin. Med. 2024, 13(18), 5484; https://doi.org/10.3390/jcm13185484 - 15 Sep 2024
Viewed by 1925
Abstract
Myocardial infarction (MI) is a leading cause of mortality globally and is predominantly attributed to coronary artery disease (CAD). MI is categorized as ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI), each with distinct etiologies and treatment pathways. The goal in treatment for both [...] Read more.
Myocardial infarction (MI) is a leading cause of mortality globally and is predominantly attributed to coronary artery disease (CAD). MI is categorized as ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI), each with distinct etiologies and treatment pathways. The goal in treatment for both is restoring blood flow back to the myocardium. STEMI, characterized by complete occlusion of a coronary artery, is managed urgently with reperfusion therapy, typically percutaneous coronary intervention (PCI). In contrast, NSTEMI involves a partial occlusion of a coronary artery and is treated with medical management, PCI, or coronary artery bypass grafting (CABG) depending on risk scores and clinical judgment. The Heart Team approach can assist in deciding which reperfusion technique would provide the greatest benefit to the patient and is especially useful in complicated cases. Despite advances in treatment, complications such as cardiogenic shock (CS) and ischemic heart failure (HF) remain significant. While percutaneous coronary intervention (PCI) is considered the primary treatment for MI, it is important to recognize the significance of cardiac surgery in treatment, especially when there is complex disease or MI-related complications. This comprehensive review analyzes the role of cardiac surgery in MI management, recognizing when it is useful, or not. Full article
(This article belongs to the Special Issue Myocardial Infarction: Current Status and Future Challenges)
►▼ Show Figures

Figure 1

19 pages, 863 KiB  
Review
Hypothermia for Cardioprotection in Acute Coronary Syndrome Patients: From Bench to Bedside
by Nikolaos Pyrpyris, Kyriakos Dimitriadis, Panagiotis Iliakis, Panagiotis Theofilis, Eirini Beneki, Dimitrios Terentes-Printzios, Athanasios Sakalidis, Alexios Antonopoulos, Konstantinos Aznaouridis and Konstantinos Tsioufis
J. Clin. Med. 2024, 13(18), 5390; https://doi.org/10.3390/jcm13185390 - 12 Sep 2024
Cited by 2 | Viewed by 1413
Abstract
Early revascularization for patients with acute myocardial infarction (AMI) is of outmost importance in limiting infarct size and associated complications, as well as for improving long-term survival and outcomes. However, reperfusion itself may further damage the myocardium and increase the infarct size, a [...] Read more.
Early revascularization for patients with acute myocardial infarction (AMI) is of outmost importance in limiting infarct size and associated complications, as well as for improving long-term survival and outcomes. However, reperfusion itself may further damage the myocardium and increase the infarct size, a condition commonly recognized as myocardial reperfusion injury. Several strategies have been developed for limiting the associated with reperfusion myocardial damage, including hypothermia. Hypothermia has been shown to limit the degree of infarct size increase, when started before reperfusion, in several animal models. Systemic hypothermia, however, failed to show any benefit, due to adverse events and potentially insufficient myocardial cooling. Recently, the novel technique of intracoronary selective hypothermia is being tested, with preclinical and clinical results being of particular interest. Therefore, in this review, we will describe the pathophysiology of myocardial reperfusion injury and the cardioprotective mechanics of hypothermia, report the animal and clinical evidence in both systemic and selective hypothermia and discuss the potential future directions and clinical perspectives in the context of cardioprotection for myocardial reperfusion injury. Full article
(This article belongs to the Special Issue Myocardial Infarction: Current Status and Future Challenges)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-7
Back to TopTop