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(Circulation. 2006;113:1633.)
© 2006 American Heart Association, Inc.
Issue Highlights
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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CLINICAL FEATURES OF ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA/CARDIOMYOPATHY ASSOCIATED WITH MUTATIONS IN PLAKOPHILIN-2, by Dalal et al. |
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and
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PLAKOPHILIN-2 MUTATIONS ARE THE MAJOR DETERMINANT OF FAMILIAL ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA/CARDIOMYOPATHY, by van Tintelen et al. |
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Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) may be challenging to diagnose because of variable expressivity and penetrance. There are multiple gene mutations responsible for the disease, with overlapping clinical phenotypes, analogous to other inherited cardiac diseases with arrhythmia vulnerability. Most of the genes associated with ARVD/C encode for desmosomal proteins involved in cell-to-cell adhesion. In this issue of Circulation, 2 reports by Dalal et al and van Tintelen et al sought to determine the prevalence and clinical expression of mutations in the plakophilin-2 gene (PKP2) in ARVD/C patients. Both groups found a high frequency of PKP2 mutations in patients with familial ARVD/C. Dalal and colleagues found that patients with PKP2 mutations presented earlier in life. However, neither study could identify distinguishing clinical features associated with PKP2 mutations compared with other (non-PKP2) patients with ARVD/C. They conclude that molecular genetic testing for PKP2 mutations may allow presymptomatic identification of ARVD/C and may refine treatment strategies. See pp 1641 and 1650 (and editorial on p 1634).
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EFFECT OF CLOPIDOGREL PREMEDICATION IN OFF-PUMP CARDIAC SURGERY: ARE WE FORFEITING THE BENEFITS OF REDUCED HEMORRHAGIC SEQUELAE? by Kapetanakis et al. |
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Dual antiplatelet therapy with aspirin and clopidogrel reduces major adverse cardiovascular events after unstable angina, enhances infarct-related artery patency after thrombolytic therapy in ST-elevation myocardial infarction, and decreases post--percutaneous coronary intervention thrombotic complications after both elective and urgent stenting procedures. However, the enhanced efficacy of dual antiplatelet therapy is associated with an increased risk of bleeding that is particularly troublesome for patients requiring surgical revascularization because of the irreversible nature of clopidogrel action. In this issue of Circulation, Kapetanakis
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