Special Issues

Special Issue Title: Contemporary Management of Special Subsets of Acute Coronary Syndromes Patients

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· Deadline for manuscript submissions:  30 September 2021

Special Issue Editor

Guest Editor

        Dr Leonardo De Luca

        A.O. San Camillo-Forlanini, Rome, Italy

Website | E-Mail

Interests: Acute Coronary Syndromes; Pharmacology and Pharmacotherapy; Interventional Cardiology; Acute heart failure

Special Issue Information

Dear Colleagues,

It is my great pleasure and honor to announce this Special Issue on “Contemporary Management of Special Subsets of Acute Coronary Syndromes Patients”. In recent decades, treatment and outcome of patients with acute coronary syndromes (ACS) have significantly improved. Reperfusion therapy together with antithrombotic strategies have dramatically decresed the rate of adverse clinical events of patients hospitalized with ACS worldwide. However, different subgroups of patients such as those who develop cardiogenic shock or acute heart failure, those on dialysis or the so-called frail patients, still present very high event rates. In these patients, a personalization of care is highly desirable. In this Special issue we want to summarize and comment on the current evidence in favor of a specific treatment in each single subgroup of patients with ACS at high risk and try to identify specific diagnostic-therapeutic pathways.

We look forward to receiving your original research or review articles.

Dr Leonardo De Luca

Guest Editor


Manuscript Submission Information

Manuscripts should be submitted online at https://rcm.imrpress.org 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 papers will be 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 double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Reviews in Cardiovascular Medicine is an international peer-reviewed open access quarterly journal published by IMR Press.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is $1950. Submitted papers should be well formatted and use good English.


Acute coronary syndromes; Chronic kidney disease; Elderly; Diabetes mellitus; Frailty; Comorbidities

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Planned Papers

Title: ACS in TAVI
Authors: Jneid, Hani

Title: ACS in elderly
Authors: Jneid, Hani

Title: Acute Coronary Syndrome and Cancer: It's hight time of a break through!
Authors: Fabiana Lucà

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Atrioventricular and intraventricular blocks in the setting of acute coronary syndromes: a narrative review
Marco Schiavone, Federica Sabato, Cecilia Gobbi, Marialessia Denora, Lucrezia Zanchi, Alessio Gasperetti, Giovanni B. Forleo
Reviews in Cardiovascular Medicine    2021, 22 (2): 287-294.   DOI: 10.31083/j.rcm2202036
Abstract184)   HTML22)    PDF(pc) (2126KB)(265)       Save
Acute coronary syndromes (ACS) might be complicated by atrioventricular (AV) and intraventricular (IV) blocks in a significant number of cases, and often represent a diagnostic and a therapeutic challenge. These conduction disturbances are predictors of adverse prognosis, with complete AV blocks presenting the most severe outcomes, showing an increased in-hospital mortality. With the advent of emergency percutaneous coronary intervention (PCI) and the end of the thrombolysis era, the incidence of both AV and IV blocks has surely decreased, but their prognosis in this setting still remains a matter of debate. The aim of this review is to evaluate the current knowledge on AV and IV blocks in the AMI setting with or without ST segment elevation.
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Independent predictors of in-hospital and 1-year mortality rates in octogenarians with acute myocardial infarction
Florina Căruntu, Diana Aurora Bordejevic, Bogdan Buz, Alexandru Gheorghiu, Mirela Cleopatra Tomescu
Reviews in Cardiovascular Medicine    2021, 22 (2): 489-497.   DOI: 10.31083/j.rcm2202056
Abstract157)   HTML12)    PDF(pc) (694KB)(234)       Save
Older age is known as a negative prognostic parameter in acute myocardial infarction (AMI) patients. In this study, we aimed to explore age-associated differences in treatment protocols, in-hospital and 1-year mortality. This cohort observational study included 277 consecutive AMI patients, separated into 2 groups according to whether their age was ≥80 years or not. We found that group I patients (aged ≥80 years) had a notably lower rate of percutaneous coronary intervention (PCI) performed (P < 0.0001) and a notably higher in-hospital death rate (P < 0.003). The multivariate logistic regression analysis found that three variables were independent predictors of in-hospital mortality: age ≥80 years (P < 0.0001), LVEF <40% (P < 0.0001), and Killip class ≥3 (P < 0.0001). The 1-year death rate was again significantly higher in group I patients (P < 0.001) and was independently predicted by the triple-vessel coronary artery disease (P = 0.004) and an LVEF <40% at admission (P = 0.001). The 1-year readmission rate was superior in group I (P < 0.01) and independently predicted by an age ≥80 years (P < 0.001), and an history of congestive heart failure (P < 0.0001) or permanent atrial fibrillation (P < 0.001). We concluded that patients aged ≥80 benefit less often from a PCI and have higher rates of in-hospital mortality, as well as of 1-year readmission and mortality rates.
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Long-term management of Takotsubo syndrome: a not-so-benign condition
Matteo Sclafani, Luca Arcari, Domitilla Russo, Giacomo Tini, Luca Rosario Limite, Luca Cacciotti, Massimo Volpe, Camillo Autore, Maria Beatrice Musumeci
Reviews in Cardiovascular Medicine    2021, 22 (3): 597-611.   DOI: 10.31083/j.rcm2203071
Abstract183)   HTML26)    PDF(pc) (1089KB)(215)       Save
Takotsubo syndrome (TTS) is an intriguing clinical entity, characterized by usually transient and reversible abnormalities of the left ventricular systolic function, mimicking the myocardial infarction with non-obstructive coronary arteries. TTS was initially regarded as a benign condition, however recent studies have unveiled adverse outcomes in the short- and long-term, with rates of morbidity and mortality comparable to those experienced after an acute myocardial infarction. Given the usual transient nature of TTS, this is an unexpected finding. Moreover, long-term mortality seems to be mainly driven by non-cardiovascular causes. The uncertain long-term prognosis of TTS warrants a comprehensive outpatient follow-up after the acute event, although there are currently no robust data indicating its modality and timing. The aim of the present review is to summarize recent available evidence regarding long-term prognosis in TTS. Moreover methods, timing and findings of the long-term management of TTS will be discussed.
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Management of myocardial infarction with Nonobstructive Coronary Arteries (MINOCA): a subset of acute coronary syndrome patients
Anthony G. Matta, Vanessa Nader, Jerome Roncalli
Reviews in Cardiovascular Medicine    2021, 22 (3): 625-634.   DOI: 10.31083/j.rcm2203073
Abstract201)   HTML35)    PDF(pc) (860KB)(321)       Save
Myocardial infarction with non-obstructive coronary artery disease (MINOCA) represents a significant proportion (up to 15%) of acute myocardial infarction (AMI) population. MINOCA is diagnosed in patients who fullfilled the fourth universal definition of AMI in the absence of significant obstructive coronary artery disease on coronary angiography. MINOCA is a group of heterogeneous diseases with different pathophysiological mechanisms requiring multimodality imaging. Left ventriculography, cardiac magnetic resonance imaging and intra-coronary imaging (IVUS, OCT) are useful tools playing a pivotal role in the diagnostic work-up. There are no standard guidelines on the management of MINOCA patients and the therapeutic approach is personalized, thereby detecting the underlying aetiology is fundamental to initiate an early appropriate cause-targeted therapy.
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Management of antithrombotic therapy in patients with atrial fibrillation and acute coronary syndromes
Călin Pop, Diana Țînț, Antoniu Petris
Reviews in Cardiovascular Medicine    2021, 22 (3): 659-675.   DOI: 10.31083/j.rcm2203076
Abstract199)   HTML26)    PDF(pc) (184KB)(406)       Save
If atrial fibrillation (AF) and acute coronary syndrome (ACS) coexist, they should be treated with combined antithrombotic therapy. To reduce the risk of bleeding while maintaining the desired antithrombotic effect, choices should be made for each patient according to the balance between the bleeding and the thrombotic risk. There are many ways to select the type and dose of the oral anticoagulant (OAC) and P2Y12 inhibitors. As a rule of thumb, aspirin and P2Y12 inhibitors should be recommended to all patients. The duration of this combination therapy is a matter of debate; available data promote an initial period of one to four weeks of triple antithrombotic association with aspirin and P2Y12 inhibitors (clopidogrel in the absence of high ischaemic risk) and preferable direct oral anticoagulants (DOACs). On discontinuing aspirin, double therapy with P2Y12 inhibitors and a DOAC provides similar efficacy and superior safety for many patients on ACS medical or interventional treatment, especially if the risk of bleeding is high and that of thrombosis is low. Further studies are needed to clarify the concerns for a slight augmentation in the number of ischaemic cases (myocardial infarction and stent thrombosis) with double antithrombotic regimen in patients at high ischaemic risk.
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Current evidence in the diagnosis and management of cardiogenic shock complicating acute coronary syndrome
Rasha Kaddoura, Salah Elbdri
Reviews in Cardiovascular Medicine    2021, 22 (3): 691-715.   DOI: 10.31083/j.rcm2203078
Abstract548)   HTML71)    PDF(pc) (2662KB)(426)       Save
Cardiogenic shock (CS) is a hemodynamically complex and highly morbid syndrome characterized by circulatory collapse and inadequate end-organ perfusion due to impaired cardiac output. It is usually associated with multiorgan failure and death. Mortality rate is still high despite advancement in treatment. CS has been conceptualised as a vicious cycle of injury and decompensation, both cardiac and systemic. Interrupting the vicious cycle and restoring the hemodynamic stability is a fundamental treatment of CS. Acute coronary syndrome (ACS) is the most frequent cause of CS. Early coronary revascularization is a cornerstone therapy that reduces mortality in patients with ACS complicated by CS. Early diagnosis of CS accompanied with invasive hemodynamics, helps in identification of CS phenotype, classification of CS severity, stratification of risk and prognostication. This can guide a tailored and optimized therapeutic approach. Inotropes and vasopressors are considered the first-line pharmacological option for hemodynamic instability. The current availability of the mechanical circulatory support devices has broadened the therapeutic choices for hemodynamic support. To date there is no pharmacological or nonpharmacological intervention for CS that showed a mortality benefit. The clinical practices in CS management remain inconsistent. Herein, this review discusses the current evidence in the diagnosis and management of CS complicating ACS, and features the changes in CS definition and classification.
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Current management and prognosis of patients with recurrent myocardial infarction
Leonardo De Luca, Luca Paolucci, Annunziata Nusca, Rita Lucia Putini, Fabio Mangiacapra, Enrico Natale, Gian Paolo Ussia, Furio Colivicchi, Francesco Grigioni, Francesco Musumeci, Domenico Gabrielli
Reviews in Cardiovascular Medicine    2021, 22 (3): 731-740.   DOI: 10.31083/j.rcm2203080
Abstract132)   HTML23)    PDF(pc) (131KB)(217)       Save
Recurrent myocardial infarction (re-MI) is a common event following acute coronary syndrome (ACS), especially during the first year. According to epidemiological studies, patients who experience re-MI are at higher risk of all-cause cardiovascular events and mortality. The cornerstones of re-MI prevention include complete functional coronary revascularization, effective dual antiplatelet therapy and secondary prevention strategies. Notwithstanding this, some controversy still exists on the definition and management of re-MI, and no dedicated studies have been designed or conducted so far in this setting. We here provide an overview of epidemiological and prognostic data on ACS patients experiencing re-MI, along with current available treatment and preventive options.
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Clinical characteristics and outcomes in acute myocardial infarction patients aged ≥65 years in Western Romania
Florina Caruntu, Diana Aurora Bordejevic, Mirela Cleopatra Tomescu, Ioana Mihaela Citu
Reviews in Cardiovascular Medicine    2021, 22 (3): 911-918.   DOI: 10.31083/j.rcm2203098
Abstract68)   HTML14)    PDF(pc) (248KB)(486)       Save
Older age is known as a negative prognostic parameter in patients with acute myocardial infarction (AMI). In this study, we aimed to investigate age-related differences in treatment protocols, in-hospital and 1-year mortality. This retrospective observational single-center study enrolled consecutive AMI patients with an urgent percutaneous coronary intervention (PCI) as the main method of myocardial revascularization. The patients divided were divided by age into group I (≥65 years) and group II (<65 years). The primary endpoint was in-hospital mortality, the secondary endpoints were 1-year mortality and rehospitalization rates. Of the 522 admitted with AMI, 476 were enrolled in the study. The mean age was 67 ± 13 years; 62% were men. Group I patients had a significantly lower rate of performed PCI (65% vs. 79%, P < 0.001). 53 patients (12.3%) died during hospitalization, and this proportion was notably higher in the older population (20% vs. 6%, P < 0.0001). The cardiac causes of death were more frequent in group I patients (12% vs. 5.6%, P = 0.016). The multivariate logistic regression selected two variables as independent predictors for the risk of in-hospital death: age ≥65 years (P = 0.0170), and Killip class at admission (P < 0.0001). The 1-year mortality was 3.3%, slightly higher in group I patients (4.8% vs. 1.5%, P = 0.05). In conclusion, patients aged ≥65 years have three times higher in-hospital mortality, but similar 1-year mortality and readmission rates when compared with the younger patients. It is obvious that there is a large potential for improvement of the AMI care in this age group of patients.
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