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Clinical and Interventional Therapeutic Advances of Acute Myocardial Infarction

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Special Issue Editors

Dr. Konstantinos C. Theodoropoulos

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First Cardiology Department, University General Hospital AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
Interests: PCI; intracoronary imaging; coronary artery disease; ACS; antiplatelet agents

Prof. Dr. Antonios Ziakas

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Guest Editor

First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
Interests: PCI; CTO PCI; radial access; structural heart disease (TAVI, PFO)
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Special Issue Information

Dear Colleagues,

We are preparing a new Special Issue entitled ‘Clinical and Interventional Therapeutic Advances of Acute Myocardial Infarction’, scheduled to be published in the Journal of Clinical Medicine, and we would like to invite you to submit your research papers. Acute myocardial infarction remains a major cause of death and morbidity, despite progress in pharmacological and interventional treatments. New and more potent antiplatelet agents, new stent platforms, intracoronary imaging, calcium modification devices, and PPCI via snuffbox are some of the therapeutic advances we are experiencing in daily practice. Therefore, researchers in the field of interventional cardiology and treatment of acute myocardial infarction are invited to submit their research work, original articles, and reviews to this Special Issue.

Dr. Konstantinos C. Theodoropoulos
Prof. Dr. Antonios Ziakas
Guest Editors

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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.

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Published Papers (2 papers)

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Research

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12 pages, 1271 KB

Open AccessArticle

The Prognostic Role of C-Reactive Protein Velocity in Patients with First Acute Myocardial Infarction

by Stylianos Daios, Vasileios Anastasiou, Dimitrios V. Moysidis, Matthaios Didagelos, Andreas S. Papazoglou, Christos Gogos, Nikolaos Stalikas, Efstratios Alexiadis, Konstantinos C. Theodoropoulos, Eleftheria Ztriva, Georgia Kaiafa, Kali Makedou, Vasileios Kamperidis, Antonios Ziakas and Christos Savopoulos

J. Clin. Med. 2025, 14(21), 7633; https://doi.org/10.3390/jcm14217633 - 28 Oct 2025

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Abstract

Background/Objectives: Inflammation plays a key role in the pathophysiology of acute myocardial infarction (AMI). Yet static measures of C-reactive protein (CRP) provide limited prognostic information. CRP velocity (CRPv), which reflects the rate of CRP rise within the first 24 h, may better depict the dynamic inflammatory response. To investigate the prognostic role of CRPv in patients presenting with a first AMI. Methods: Consecutive patients presenting with first AMI were enrolled. CRPv was calculated as the difference between CRP at admission and after 24 ± 8 h, divided by time. A prognostic CRPv cut-off was derived from spline curve analysis to dichotomize the population. Patients were followed up for the primary composite endpoint of cardiovascular death, non-fatal AMI, and hospitalization for heart failure. Results: Among 604 patients, 189 (31.3%) had CRPv ≥ 1.36 mg/L/h and 415 (68.7%) had CRPv < 1.36 mg/L/h. Higher hs-cTnT (adjusted odds ratio [aOR] 2.552, 95% CI, 1.520–4.286; p < 0.001) and NT-proBNP (aOR 2.229, 95% CI, 1.241–4.002; p = 0.007) were independently associated with CRPv ≥ 1.36 mg/L/h. At a median follow-up of 13.8 months, 115 patients (19.0%) reached the primary composite endpoint. High CRPv patients had significantly lower event-free survival rate than low CRPv patients (66.7% vs. 85.5%, log-rank p < 0.001). CRPv independently predicted the primary composite endpoint [adjusted hazard ratio 1.226, 95% CI 1.102–1.364, p < 0.001]. Adding CRPv on top of clinical, echocardiographic, and biochemical risk factors significantly improved model discrimination (p < 0.001), whereas single CRP on admission (p = 0.947) or CRP 24 ± 8 h from admission (p = 0.064) did not. Conclusions: CRPv appears to be a robust predictor of adverse outcomes in first AMI patients, offering incremental prognostic value beyond established clinical and biomarker indices. Its feasibility and low cost support its integration into early clinical risk stratification. Full article

(This article belongs to the Special Issue Clinical and Interventional Therapeutic Advances of Acute Myocardial Infarction)

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Review

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29 pages, 3463 KB

Open AccessReview

Use of Calcium Modification in Percutaneous Coronary Intervention: A Comprehensive Review

by Noyan Ramazani, Ala W. Abdallah, Michael V. DiCaro, Divyansh Sharma, Aditi Singh and KaChon Lei

J. Clin. Med. 2025, 14(22), 8130; https://doi.org/10.3390/jcm14228130 - 17 Nov 2025

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Abstract

Calcified coronary lesions remain a challenge in percutaneous coronary intervention (PCI) in both situations of acute myocardial infarction (MI) and stable coronary syndrome. It significantly increases the risk of procedural complications due to difficulty in equipment delivery, balloon expansion, and stent delivery. Furthermore, stent thrombosis, dissection, perforation, and future in-stent restenosis occur more frequently in calcified coronary lesions, impacting repeat target vessel revascularization and increasing the risk of future MI. With intracoronary imaging (intravascular ultrasound and optical coherence tomography), peri-procedural success for treating calcified lesions has increased significantly. Different modalities of calcium modification techniques have since been introduced. This review will discuss the pathophysiology and phenotypes of calcium deposition in the coronary vessels, including eccentric calcified plaques and calcified nodules. We will also focus on calcium modification techniques and their mechanisms: (1) Balloon escalation technique, (2) intravascular lithotripsy, (3) orbital atherectomy, and (4) rotational atherectomy. We will focus on the strengths and limitations of each technique, based on current recommendations and expert consensus from SCAI. We will also provide contemporary evidence of each modality for treating different phenotypes of calcified lesions. In summary, this article provides a comprehensive review of current guidelines for optimizing the treatment of calcified coronary lesions in PCI. Full article

(This article belongs to the Special Issue Clinical and Interventional Therapeutic Advances of Acute Myocardial Infarction)

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