Volume 9 Issue 6, June 2012

Much debate surrounds the utility of CYP2C19^*2 genotyping in patients receiving clopidogrel after coronary artery stenting. The effectiveness of its use in a point-of-care setting has now been examined and, given the substantial incremental suppression of platelet reactivity achieved, its routine use might soon be a reality.

No suitable tools for predicting long-term mortality after coronary revascularization are available. Current guidance is based on old data from small studies, and does not reflect contemporary revascularization strategies. Two new models for predicting survival, developed using large registry databases, could help guide decision making in patients undergoing percutaneous coronary intervention or CABG surgery.

Particular mutations in cardiac potassium channels are known to be arrhythmogenic. In this Review, the authors discuss the genetic basis, diagnosis, risk stratification, and management of patients with various potassium channelopathies, including long and short QT syndromes, Brugada syndrome, and familial atrial fibrillation.

Multimodality and hybrid imaging combine various imaging modalities to enhance diagnostic accuracy and improve clinical outcomes. Dr. Delgado and colleagues review the use of multiple novel imaging techniques to evaluate plaque burden and stability in patients with coronary artery disease, target cardiac resynchronization therapy in patients with heart failure, and guide transcatheter procedures in patients with valvular heart disease.

Molecular biomarkers could provide a window into the pathophysiology of chronic heart failure, potentially improving our ability to predict adverse outcomes, provide novel drug targets, and even help gauge therapeutic efficacy. In this Review, Ahmad et al. examine some emerging biomarkers of the biomechanical stretch, inflammation, ventricular remodeling, myocardial injury, and renal dysfunction that occur in chronic heart failure, and discuss their potential role within a multimarker-based strategy.

Psychological stress is thought to contribute to the cardiovascular disease process at several stages, including the long-term development of coronary heart disease and acute triggering of cardiac events. In this Review, Steptoe and Kivimäki summarize the evidence for the association between stress and cardiovascular disease, with a focus on external work-related and social stressors. They also discuss the effects of stress-management strategies on cardiovascular health.