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(Circulation. 2006;113:2565.)
© 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.

	ASPIRIN USE AND OUTCOMES IN A COMMUNITY-BASED COHORT OF 7352 PATIENTS DISCHARGED AFTER FIRST HOSPITALIZATION FOR HEART FAILURE, by McAlister et al.

 
Throughout the 1990s, data from large clinical trials in heart failure and some smaller mechanistic studies suggested that chronic treatment with aspirin may lessen the outcome benefit of treatment with angiotensin-converting enzyme (ACE) inhibitors. Prospective trials designed to specifically answer this clinically relevant, though vexing, question have been either inconclusive or challenging to conduct. In this issue of Circulation, McAlister and colleagues report on an analysis of a large observational database of >7000 patients followed long-term after hospitalization for heart failure, specifically to examine the impact of aspirin use or non-use on outcomes with respect to the use/non-use of ACE inhibitors and other clinical factors. They found that aspirin use did not unfavorably affect outcomes, even in patients without coronary disease or those with renal dysfunction, and aspirin use did not appear to attenuate the benefits of ACE inhibitors. In an accompanying editorial, Jhund and McMurray (see p 2566) discuss the strength of evidence that clinicians can glean from retrospective subgroup analysis of clinical trials, as well as large observational databases such as those presented in this paper, to inform clinical decisions when no prospective trial data exist. See p 2572.

	ENDOVASCULAR STENTING OF OBSTRUCTED RIGHT VENTRICLE-TO-PULMONARY ARTERY CONDUITS: A 15-YEAR EXPERIENCE, by Peng et al.

 
Postoperative right ventricular outflow tract obstruction is a common problem in patients with various forms of congenital heart disease. The optimal timing and type of management for this problem is subject to debate, and practices vary considerably among centers and individual practitioners. Peng and colleagues describe a 15-year single-institution experience with transcatheter placement of bare metal stents . . . [Full Text of this Article]

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