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(Circulation. 2007;115:2789.)
© 2007 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.

	OUTCOMES AND OPTIMAL ANTITHROMBOTIC THERAPY IN WOMEN UNDERGOING FIBRINOLYSIS FOR ST-ELEVATION MYOCARDIAL INFARCTION, by Mega et al.

 
The manifestations, complications, and outcomes of cardiovascular disease differ between women and men. Because of these differences, the safety and efficacy of pharmacological reperfusion and antithrombotic therapies in women with ST-elevation myocardial infarction have been of particular interest. In this issue of Circulation, Mega and colleagues report on the characteristics and treatment-specific outcomes of 4783 women with ST-elevation myocardial infarction with planned fibrinolysis randomized to enoxaparin or unfractionated heparin in the Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment–Thrombolysis in Myocardial Infarction (ExTRACT-TIMI) 25 study. In this large, contemporary clinical trial, women, when compared with men, presented with a profile of higher baseline risk and had increased short-term mortality. After adjusting for age and other clinical variables, women continued to have a 1.25-fold higher 30-day risk of death but similar risk of intracerebral hemorrhage. The relative risk reduction in death and nonfatal myocardial infarction for enoxaparin versus unfractionated heparin was similar in women and men, with a larger absolute risk reduction observed in women. Although the excess risk of bleeding with enoxaparin was seen for both women and men, net clinical benefit strongly favored enoxaparin in both sexes. See p 2822 (editorial p 2796).

	CLINICAL REMINDERS ATTACHED TO ECHOCARDIOGRAPHY REPORTS OF PATIENTS WITH REDUCED LEFT VENTRICULAR EJECTION FRACTION INCREASE USE OF ß-BLOCKERS: A RANDOMIZED TRIAL, by Heidenreich et al.

 
Despite strong evidence that specific treatments improve outcomes for selected patient groups, studies indicate that underutilization of these effective therapies remains common. Although many experts have recommended interventions to improve practice, few have undergone rigorous scrutiny. Moreover, with the emergence of increasingly sophisticated health information technology, there is a need to determine if . . . [Full Text of this Article]

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