Volume 13 Issue 9, September 2016

After some alarming results of intensified glucose control in patients with type 2 diabetes mellitus, and noninferiority (without superiority) of alogliptin, saxagliptin, sitagliptin, and lixisenatide treatment compared with placebo, the positive results in survival and cardiovascular and renal outcomes with empagliflozin and liraglutide have been acknowledged with enthusiasm by diabetologists and should deeply interest cardiologists.

Clinical guidelines advocate oral anticoagulation (OAC) for stroke prevention in patients with atrial fibrillation and ≥1 risk factors for stroke, but 40% of eligible patients receive aspirin, and those at greatest risk are least likely to be prescribed OAC. Why is there a discrepancy between guidelines and clinical practice?

Nutraceuticals are natural compounds that are beneficial for the prevention or treatment of disease. In their Review, Moss and Ramji summarize the preclinical and clinical studies to evaluate the efficacy of various nutraceuticals, such as polyunsaturated fatty acids, flavanols, and vitamins C and E, for the prevention of atherosclerosis.

A range of established and emerging invasive and noninvasive imaging modalities can be used to evaluate various parameters of coronary atherosclerosis, including functional severity, plaque burden, and high-risk characteristics. In this Review, Dweck et al. assess the relative strengths and weaknesses of these techniques, how they might be complementary when used in combination, and barriers that exist to their translation into clinical practice.

The mechanisms of thromboembolism in patients with atrial fibrillation are complex and not well understood, and existing stroke risk scores are limited in their predictive capacity. In this Review, Calenda et al. discuss stroke risk assessment in atrial fibrillation and explain how the atrial myopathy concept might help to refine stroke risk prediction.

Diagnosis and treatment in patients with an aborted cardiac arrest (ACA) pose a challenge for cardiologists, because the underlying causes of ACA and the appropriate therapies are varied. In this Perspectives article, Schwartz and Dagradi offer their view on how genetics is shaping the management of survivors of ACA, and discuss the importance of genetic testing for the protection of these patients and their families.