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The time course of events after acute coronary syndromes (ACS) might influence the timing and duration of therapeutic interventions. In this paper the authors study the timing of death, reinfarction, stroke, and major bleeding within 6 months of ACS in 46,829 patients enrolled in the Global Registry of Acute Coronary Events (GRACE). Their data shows that the timing of events after ACS was affected by ST category and influenced by GRACE risk score within each electrocardiographic category of ACS. They recommend that risk stratification should, therefore, include multiple risk factors rather than ST shift alone.
The metabolic syndrome is a major public-health concern worldwide, and the Japanese are attempting to address the issue at a national level. Their criteria for this syndrome, in contrast to various others, include measurement of waist circumference. Here, Fujita discusses country-specific impact of the metabolic syndrome, using the evolution of the Japanese diagnostic criteria as a model.