Opinion in 2012

Despite advances in prevention of cardiovascular disease, a high proportion of cardiac events occur in asymptomatic people who do not have a high level of risk. Much remains unknown about the value of novel risk markers for the identification of candidates for primary prevention. Here, Polonsky and Greenland argue that clinical trials of these markers in asymptomatic, low-risk populations are greatly needed to determine their effectiveness.

A major problem in Central and South America, Chagas disease is now also affecting individuals residing in other parts of the world. Many patients with late-stage disease have chronic cardiomyopathy and associated arrhythmias. In this Perspectives article, Professor Benaim and Dr Paniz Mondolfi discuss the potential for amiodarone and dronedarone to be used as dual-action (antiarrhythmic and antiparasitic) agents in patients with Chagas disease.

Many barriers exist to the translation and implementation of European and US guidelines for cardiovascular disease into clinical practice in China, but also to the development of Chinese-specific guidelines. Professors Zhao and Hu give their expert perspectives on the multifaceted reasons for these barriers, and how future guidelines for Chinese clinical practice should be developed and applied.

The primary objective of invasive treatment strategies for multivessel coronary artery disease is complete anatomical revascularization. As objective evidence of ischemia can be provided by a functional assessment based on fractional flow reserve, the focus of contemporary treatment could shift from anatomical to functional revascularization. In this Perspectives article, the authors summarize the data that supports contemporary functional revascularization and its applicability to real-world practice.