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(Circulation. 2004;110:3743.)
© 2004 American Heart Association, Inc.
Issue Highlights
CARDIAC MORTALITY IS HIGHER AROUND CHRISTMAS AND NEW YEAR’S THAN AT ANY OTHER TIME: THE HOLIDAYS AS A RISK FACTOR FOR DEATH, by Phillips et al.It has long been appreciated that cardiovascular mortality increases in the winter months. Speculation on the mechanisms have centered on whether the winter peak was related to climate. In this issue of Circulation, Phillips and colleagues observe that over and above the winter mortality peak, there is an approximately 5% excess in both cardiac and noncardiac deaths on both Christmas and New Year’s days. The investigators examined data from the United States from 1973-2001, representing 53 million deaths, and found that the excess holiday mortality actually has increased over time. The investigators observed that the holiday spike was more notable for outpatient than inpatient deaths, leading the authors to speculate that delays in seeking treatment may contribute to the excess holiday mortality. The authors explore many potential possible explanations of their findings, but clearly further research is needed to uncover the mechanisms definitively. See p 3781.
PREDICTORS OF QUALITY-OF-LIFE BENEFIT AFTER PERCUTANEOUS CORONARY INTERVENTION, by Spertus et al.
The primary benefit of percutaneous coronary intervention (PCI) is to improve quality of life and reduce symptom burden. Many investigators have identified patient characteristics associated with the risk of complications, but few have sought to determine which patients experience the most quality-of-life benefit. Spertus and colleagues, in a prospective, observational study of 1518 patients undergoing PCI as part of nonacute care, determined the correlates of improved quality of life 1 year after the procedure using the Seattle Angina Questionnaire. This information can assist physicians and their patients in estimating the benefit of PCI in stable patients. See p 3789.
DETECTION OF CARDIAC ALLOGRAFT REJECTION AND RESPONSE TO IMMUNOSUPPRESSIVE THERAPY WITH PERIPHERAL BLOOD GENE EXPRESSION, by Horwitz et al.
The detection of cardiac transplant rejection is difficult. Endomyocardial biopsy, the "gold standard," is less than perfect because of its invasive nature and vulnerability to sampling error. Horwitz et al advance the novel concept that gene profiling of leukocytes may provide a noninvasive way to detect and follow cardiac rejection. Their elegant findings constitute proof of this principle by showing that leukocyte gene profiling was able to distinguish patients with from those without rejection, and, further, to follow the course of resolution. If validated in larger trials, this new approach offers an important breakthrough in the management of transplant recipients. See p 3815.
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Clinician Update
Clinical Utility of Serial and Continuous ST-Segment Recovery Assessment in Patients With Acute ST-Elevation Myocardial Infarction: Assessing the Dynamics of Epicardial and Myocardial Reperfusion. See p e533.
Images in Cardiovascular Medicine
Scimitar Syndrome With Esophageal Varices: Magnetic Resonance Angiography Detects Anomalous Pulmonary Venous Return. See p e540.
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Correspondence
Letter Regarding Article by Li et al,"C-Reactive Protein Upregulates Complement-Inhibitory Factors in Endothelial Cells." See p e542.
Related Articles:
Circulation 2004 110: 3789-3794.
Circulation 2004 110: 3815-3821.
Circulation 2004 110: 3781-3788.
Circulation 2004 110: e533-e539.
Circulation 2004 110: e540-e541.
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