Evidence map›Paper›PMID 36983163›Full record

ReviewJournal of clinical medicine2023

Secondary Cardiovascular Prevention after Acute Coronary Syndrome: Emerging Risk Factors and Novel Therapeutic Targets.

Angelo Silverio, Francesco Paolo Cancro, Luca Esposito, Michele Bellino, Debora D'Elia, Monica Verdoia, Maria Giovanna Vassallo, Michele Ciccarelli, Carmine Vecchione, Gennaro Galasso and 1 more

Open access · goldAbstract readReview
In one paragraph

Review in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
6.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

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  11. Electrocardiographic R Wave Peak Time: Correlation With the Severity of Coronary Artery Disease and Prognosis in Patients With Acute Coronary Syndrome.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Angelo SilverioDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy.ORCID 0000-0001-9749-8092
Francesco Paolo CancroDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy.ORCID 0000-0001-7189-8469
Luca EspositoDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy.
Michele BellinoDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy.
Debora D'EliaDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy.
Monica VerdoiaDivision of Cardiology Ospedale degli Infermi, ASL, 13875 Biella, Italy.ORCID 0000-0001-6506-8397
Maria Giovanna VassalloDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy.
Michele CiccarelliDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy.ORCID 0000-0003-2379-1960
Carmine VecchioneDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy.
Gennaro GalassoDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy.ORCID 0000-0002-7265-7613
Giuseppe De LucaDepartment of Clinical and Experimental Medicine, Division of Cardiology, AOU Policlinico G. Martino, University of Messina, 98122 Messina, Italy.ORCID 0000-0001-6031-2899
University of Salerno · ITOspedale degli Infermi · ITUniversity of Messina · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The control of cardiovascular risk factors, the promotion of a healthy lifestyle, and antithrombotic therapy are the cornerstones of secondary prevention after acute coronary syndrome (ACS). However, many patients have recurrent ischemic events despite the optimal control of traditional modifiable risk factors and the use of tailored pharmacological therapy, including new-generation antiplatelet and lipid-lowering agents. This evidence emphasizes the importance of identifying novel risk factors and targets to optimize secondary preventive strategies. Lipoprotein(a) (Lp(a)) has emerged as an independent predictor of adverse events after ACS. New molecules such as anti-PCSK9 monoclonal antibodies, small interfering RNAs, and antisense oligonucleotides can reduce plasma Lp(a) levels and are associated with a long-term outcome benefit after the index event. The inflammatory stimulus and the inflammasome, pivotal elements in the development and progression of atherosclerosis, have been widely investigated in patients with coronary artery disease. More recently, randomized clinical trials including post-ACS patients treated with colchicine and monoclonal antibodies targeting cytokines yielded promising results in the reduction in major cardiovascular events after an ACS. Gut dysbiosis has also raised great interest for its potential pathophysiological role in cardiovascular disease. This evidence, albeit preliminary and needing confirmation by larger population-based studies, suggests the possibility of targeting the gut microbiome in particularly high-risk populations. The risk of recurrent ischemic events after ACS is related to the complex interaction between intrinsic predisposing factors and environmental triggers. The identification of novel risk factors and targets is fundamental to customizing patient clinical management with a precision medicine perspective.

Indexed as

acute coronary syndromecoronary artery diseaseemerging therapiesinflammasomeinflammationlipoprotein(a)microbiotasecondary prevention

Identifiers

PMID36983163
PMCPMC10056379
OpenAlexW4323843344

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.