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Cell therapy for myocardial infarction has received widespread attention. Although short-term effects have been encouraging, Yousef et al. now report substantial benefit of bone marrow mononuclear cells over 5 years of follow-up in an open-label series of 62 patients. Long-term follow-up of randomized trials is eagerly awaited and novel approaches of cell therapy are currently under investigation.
Ultrasonographic screening of older men to detect abdominal aortic aneurysms has been added to the list of programs supported by the National Health Service in England and Scotland, and by Medicare in the US. Two articles in the British Medical Journal addressing the cost-effectiveness of this practice have provided markedly discordant results.
Transcatheter aortic valve implantation has evolved as a viable therapeutic option for high-risk, elderly patients with symptomatic aortic stenosis in select cardiac centers with experience of the procedure. In this article we consider the findings reported by Webb et al. and discuss current criteria for selection of patients, technical features, clinical results, and future developments in this rapidly advancing area.
Factor Xa inhibitors, a new class of oral anticoagulants, have been evaluated in the phase II ATLAS ACS-TIMI 46 and APPRAISE trials. Addition of these agents to standard therapy has tended to reduce the incidence of adverse cardiovascular events at the expense of a dose-dependent increase in the risk of bleeding complications.
In this extensive Review, Stefan Pilz and colleagues discuss the potential mechanisms by which vitamin D might affect blood pressure and explore the clinical evidence for an association between vitamin D and arterial hypertension. The authors also make recommendations for vitamin D supplementation in patients with hypertension and 25-hydroxyvitamin D levels below target values.
Individualized drug therapy requires physicians to be able to accurately predict an individual's response to a drug. 'Pharmacogenetics' is the study of the role of inheritance in variation in drug response phenotypes. Pharmacogenetics is now moving genome-wide to become 'pharmacogenomics'. This article reviews the development, promise and challenges of pharmacogenomics, using examples of drugs used to treat or prevent cardiovascular disease.
Treatment of hypertension is associated with a reduction in the risk of cardiovascular complications such as stroke. In this Review, Morris Brown discusses vaccines that target components of the renin–angiotensin system as a potential strategy not only for treating hypertension, but for preventing the development of treatment-resistant hypertension.
Myocardial angiogenesis occurs in response to hypoxia in ischemic tissues. This Review discusses imaging techniques that can be used to assess the effectiveness of exogenous angiogenic agents in promoting the growth of collateral vessels in ischemic myocardium.
Ongoing medical education and recertification of specialists is important in minimizing medical errors and ensuring that patients receive quality care. This Review discusses the processes by which cardiovascular specialists are assessed in different geographical regions.
