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A study by Li and coworkers demonstrates that antihypertensive-drug use and untreated hypertension in pregnancy increase the risk of congenital malformations. Supported by the results of meta-analysis, this study heralds a major shift in our understanding of the fetal risks of hypertension and the medications used to treat this condition.
The practice of same-day discharge after uncomplicated percutaneous coronary intervention in the USA has been analyzed using a large database including >700,000 patients and, overall, is safe when compared with patients who stay in hospital overnight, but is still rarely used.
A subanalysis of the REACH Registry provides a contemporary 'real-world' demonstration of the impact of ethnic and racial differences in cardiovascular risk factors and mortality. This work reinforces the growing notion of ethnicity-specific variations in the risks and outcomes associated with atherothrombotic disease.
The 2011 United Nations summit on noncommunicable diseases (of which cardiovascular diseases are the major component) heralded a new era in global health priorities and strategy. However, clinicians and health administrators alike might overlook the potential convergence of communicable and noncommunicable pathways to heart disease in individuals and communities with cardiovascular risk factors.
In late 2010 and in 2011, the results of the first randomized controlled trial of transcatheter aortic valve implantation (TAVI) were received with much excitement. In this Review, Dr. Rodés-Cabau discusses the main characteristics of transcatheter valves and the TAVI procedure, and evaluates the acute and late outcomes associated with TAVI.
Ectopic foci in pulmonary veins can trigger episodes of atrial fibrillation, but how these foci arise remains unclear. Dr Mark Shen and colleagues review the role of the autonomous nervous system in the induction and maintenance of atrial arrhythmias, and discuss neural modulation as a treatment strategy for patients with atrial fibrillation.
Drs. Chaitman and Laddu review the various approved and experimental pharmacological approaches to treating angina in the context of data from clinical trials, and discuss ongoing and future studies. They also compare the merits of optimal medical therapy with prompt or delayed revascularization by percutaneous coronary intervention or CABG surgery as antianginal strategies.
Restenosis of atherosclerotic lesions after initial treatment with angioplasty and stenting occurs in around 15% of patients. Although this condition is complex and the causative mechanisms have not yet been fully identified, they are thought to include inflammation, proliferation, and matrix remodeling with some patients being more 'predisposed' to developing restenosis than others. In this Review, Jukema and colleagues evaluate the available evidence on the pathophysiology of restenosis and provide an overview of the various risk factors for this disease.
