Table of contents
October 2008 Volume 5 No 10
Editorial
Cardiovascular disease and the UN Millennium Development Goals: time to move forward
593doi:10.1038/ncpcardio1353 | Full Text | PDF (137K)
Research Highlights
Osteopontin—a novel biomarker of prognosis in chronic heart failure?
594Outcomes of emergency surgery in octogenarians with type A acute aortic dissection
594Drug-eluting stents are as safe as bare-metal stents in patients with diabetes
594Gout is a risk factor for cardiovascular mortality in middle-aged men
595Predicting right ventricular failure in candidates for left ventricular assist devices
595Aprotinin is not recommended in patients undergoing high-risk cardiac surgery
596Heparin contaminant causes adverse effects via the kallikrein system
596Provision of AEDs may not improve survival after sudden cardiac arrest at home
597Clinical Advance
Bioabsorbable drug-eluting stents: the future of coronary angioplasty?
598doi:10.1038/ncpcardio1306 | Full Text | PDF (165K)
Management of elderly patients with aortic valve disease
600doi:10.1038/ncpcardio1310 | Full Text | PDF (164K)
Do patients with long QT syndrome remain at risk for sudden cardiac death after 40 years of age?
602doi:10.1038/ncpcardio1305 | Full Text | PDF (167K)
Which patients with venous thromboembolism are at risk for fatal pulmonary embolism?
604doi:10.1038/ncpcardio1308 | Full Text | PDF (160K)
Eliminating out-of-pocket drug costs may improve outcomes after myocardial infarction—but at what cost to Medicare?
606doi:10.1038/ncpcardio1309 | Full Text | PDF (159K)
Viewpoints
Management of asymptomatic severe aortic stenosis: is aortic valve replacement indicated?
608Patients with asymptomatic, severe aortic stenosis are at risk of cardiac death. In this Viewpoint, Pellikka and Sundt assert that aortic valve replacement should be considered in these patients, if surgery is likely to prolong life expectancy. Risk stratification of the asymptomatic aortic stenosis patient remains inadequate, however, and the decision to operate must be individualized, particularly in the elderly. The authors call for a randomized trial to help optimize the selection of patients for surgery.
doi:10.1038/ncpcardio1304 | Full Text | PDF (169K)
Play an ADAGIO with a STRADIVARIUS: the right patient for CB1 receptor antagonists?
610Results of the STRADIVARIUS and ADAGIO-Lipids trials have fuelled debate about the use of the controversial CB1 receptor antagonist rimonabant. Here, Vincenzo Di Marzo discusses the key findings from these studies and their potential clinical sequelae, and identifies a subgroup of patients who might derive the most benefit from this drug.
doi:10.1038/ncpcardio1319 | Full Text | PDF (190K)
Reviews
From randomized trials to registry studies: translating data into clinical information
613How should trial-derived evidence be interpreted so that findings can be applied directly in patient care? By understanding study design and statistical methodology, the results of observational studies, prospective randomized trials, and registry studies can be reconciled. Here Brown and coworkers examine different study designs and their impact on the interpretation of data.
doi:10.1038/ncpcardio1307 | Full Text | PDF (305K)
The use of high-sensitivity assays for C-reactive protein in clinical practice
621Despite the wealth of research into C-reactive protein (CRP), it remains unclear which patient populations would benefit from and should be targeted for high-sensitivity assay CRP testing. In this important Review, Musunuru et al. address the relevance of CRP in a variety of scenarios encountered in clinical practice—from primary prevention of cardiovascular disease, stroke and diabetes mellitus, to secondary prevention of cardiovascular disease.
doi:10.1038/ncpcardio1322 | Full Text | PDF (466K)
Vascular aging: insights from studies on cellular senescence, stem cell aging, and progeroid syndromes
637Tohru Minamino and Issei Komuro examine the research on age-associated vascular pathophysiology at the cellular level, specifically telomere shortening, DNA damage and the replicative ability of cardiovascular cells, particularly stem cells or progenitor cells. They explore vascular senescence in the context of human progeroid syndromes and what the future holds for the treatment of age-associated vascular disease.
doi:10.1038/ncpcardio1324 | Full Text | PDF (557K)
Case Study
A case of permanent pacemaker lead infection
649Device infection is devastating in individuals with permanent pacemakers or implantable cardioverter-defibrillators. In this month's Case Study, Simon and colleagues present a patient who had a duel pacemaker lead infection and tricuspid valve endocarditis. They examine the best course of action for this serious complication.
doi:10.1038/ncpcardio1327 | Full Text | PDF (282K)
Clinical research
Contribution of patient and physician factors to cardiac rehabilitation referral: a prospective multilevel study
653Cardiac rehabilitation, in most developed countries, is a proven means of reducing mortality but it is grossly underutilized owing to factors involving both the health system and patients. These issues have not been investigated concurrently. In this paper the authors describe a prospective study with a multilevel design to show that the most relevant physician perceptions of such programs are program quality and perceived benefit. For patients, they are barriers to cardiac rehabilitation, which might be conveyed during pre-referral discussions. Work to improve physicians' perceptions and patients' understanding of rehabilitation services might improve use.
doi:10.1038/ncpcardio1272 | Full Text | PDF (370K)
See also: Clinical Context by Scott
Randomized, controlled trial of intramuscular or intracoronary injection of autologous bone marrow cells into scarred myocardium during CABG versus CABG alone
663Studies of the transplantation of autologous bone marrow cells (BMCs) in patients with chronic ischemic heart disease have assessed effects on viable, peri-infarct tissue. In this paper the authors conducted a single-blinded, randomized, controlled study to investigate whether intramuscular or intracoronary administration of BMCs into nonviable scarred myocardium during CABG improves contractile function of scar segments compared with CABG alone. Their data shows that injection of autologous BMCs directly into the scar or into the artery supplying the scar is safe but does not improve contractility of nonviable scarred myocardium, reduce scar size, or improve left ventricular function more than CABG alone.
doi:10.1038/ncpcardio1321 | Full Text | PDF (308K)
Clinical Context
Referral to outpatient cardiac rehabilitation: intervention research at the patient, provider, and health system levels
671doi:10.1038/ncpcardio1320 | Full Text | PDF (172K)
Article Responses
Molecular genetics of arrhythmogenic right ventricular dysplasia/cardiomyopathy
E1doi:10.1038/ncpcardio1350 | Full Text
E713K in desmoglein-2 and arrhythmogenic right ventricular dysplasia/cardiomyopathy
E2doi:10.1038/ncpcardio1351 | Full Text
