Circulation. 2005;112:3211
(Circulation. 2005;112:3211.)
© 2005 American Heart Association, Inc.
Issue Highlights
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ANTICOAGULATION THERAPY IN ATRIAL FIBRILLATION IN COMBINATION WITH ACUTE MYOCARDIAL INFARCTION INFLUENCES LONG-TERM OUTCOME: A PROSPECTIVE COHORT STUDY FROM THE REGISTER OF INFORMATION AND KNOWLEDGE ABOUT SWEDISH HEART INTENSIVE CARE ADMISSIONS (RIKS-HIA), by Stenestrand et al.
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Atrial fibrillation (AF) is a common arrhythmia after myocardial
infarction (MI). Because of the widespread use of aspirin in
patients recovering from MI and the increasing use of clopidogrel
when a stent is implanted, it is useful to have information
on the safety of the combination of aspirin, clopidogrel, and
warfarin in patients with AF after MI. Investigators in Sweden
report in this issue a prospective cohort study from a registry
of intensive care unit admissions. The use of oral anticoagulants
in patients with AF was associated with a significant reduction
in 1-year mortality and was superior to antiplatelet therapy
alone. An accompanying editorial (see p 3212) places this important
report in perspective alongside the ACC/AHA Guidelines on management
of patients with STEMI and adds support for the use of dual
antiplatelet therapy in combination with oral anticoagulation
in patients with AF after MI. See p
3225.
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DIETARY  -LINOLENIC ACID INTAKE AND RISK OF SUDDEN CARDIAC DEATH AND CORONARY HEART DISEASE, by Albert et al.
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The majority of women who die suddenly do not have an antecedent
history of heart disease. Dietary interventions that are suitable
for use in large populations offer potential means to reduce
these deaths. Intake of long-chain n-3 fatty acids found in
fish have been associated with reduced sudden death. The intermediate-chain
n-3 fatty acid a-linolenic acid (ALA), which is found in plants,
has antiarrhythmic effects in animal models, and a small portion
is converted to long-chain n-3 fatty acids. The impact of ALA
intake on cardiovascular outcomes was investigated in 76 763
women enrolled in the Nurses’ Health Study. Increasing
ALA intake was associated with lower risk of sudden cardiac
death but not with the risk of other fatal or nonfatal coronary
heart disease events. Further assessment is needed to determine
whether increasing dietary ALA is suitable for broad implementation
to reduce sudden death. See p
3232.
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METABOLIC MODULATION WITH PERHEXILINE IN CHRONIC HEART FAILURE: A RANDOMIZED, CONTROLLED TRIAL OF SHORT-TERM USE OF A NOVEL TREATMENT, by Lee et al.
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The prevalence of chronic heart failure in the United States
and throughout the world continues to increase, and a steadfast
search for novel approaches to therapy is essential to reduce
the large burden of death and disability incurred by this condition.
Modulation of the metabolic efficiency of the failing heart
and dysfunctional skeletal muscles in these patients presents
a new frontier from which new therapies may arise. In this issue
of
Circulation, Lee et al present exciting preliminary data
on the use of perhexiline, a drug that blocks muscle mitochondrial
free fatty-acid uptake and augments glucose metabolism. In a
randomized controlled trial, global and regional myocardial
function, skeletal muscle energetics, exercise capacity, and
quality of life were assessed. Dramatic short-term results are
presented and offer promise for further investigation and a
potential clinical role for this type of therapy. An accompanying
editorial by Morrow and Givertz (see p 3218) offers comment
on this seminal study and the emerging field of metabolic modulation
of myocardial energetics. See p
3280.
Visit http://www.circ.ahajournals.org:
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Images in Cardiovascular Medicine
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Unusual Case of Pheochromocytoma With a Surprising Response
to the Intravenous Administration of Norepinephrine. See p
e327.
Cardiac Metastasis: Visualization With Positron Emission Tomography, Computed Tomography, Magnetic Resonance Imaging, Positron Emission Tomography/Computed Tomography, and Positron Emission Tomography/Magnetic Resonance Imaging. See p e329.
Serial Changes of the Electrocardiogram During the Progression of Subarachnoidal Hemorrhage. See p e331.
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Correspondence
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See p
e333.
Related Articles:
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Anticoagulation Therapy in Atrial Fibrillation in Combination With Acute Myocardial Infarction Influences Long-Term Outcome: A Prospective Cohort Study From the Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA)
- Ulf Stenestrand, Johan Lindbäck, Lars Wallentin for the RIKS-HIA Registry
Circulation 2005 112: 3225-3231.
[Abstract]
[Full Text]
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Dietary -Linolenic Acid Intake and Risk of Sudden Cardiac Death and Coronary Heart Disease
- Christine M. Albert, Kyungwon Oh, William Whang, JoAnn E. Manson, Claudia U. Chae, Meir J. Stampfer, Walter C. Willett, and Frank B. Hu
Circulation 2005 112: 3232-3238.
[Abstract]
[Full Text]
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Metabolic Modulation With Perhexiline in Chronic Heart Failure: A Randomized, Controlled Trial of Short-Term Use of a Novel Treatment
- Leong Lee, Ross Campbell, Michaela Scheuermann-Freestone, Rachel Taylor, Prasad Gunaruwan, Lynne Williams, Houman Ashrafian, John Horowitz, Alan G. Fraser, Kieran Clarke, and Michael Frenneaux
Circulation 2005 112: 3280-3288.
[Abstract]
[Full Text]
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Unusual Case of Pheochromocytoma With a Surprising Response to the Intravenous Administration of Norepinephrine
- Jan Pesek, Vladislav Treska, Jiri Ferda, and Petr Mukensnabl
Circulation 2005 112: e327-e328.
[Extract]
[Full Text]
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Cardiac Metastasis: Visualization With Positron Emission Tomography, Computed Tomography, Magnetic Resonance Imaging, Positron Emission Tomography/Computed Tomography, and Positron Emission Tomography/Magnetic Resonance Imaging
- Marcus D. Seemann and Jochen Gaa
Circulation 2005 112: e329-e330.
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[Full Text]
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Serial Changes of the Electrocardiogram During the Progression of Subarachnoidal Hemorrhage
- Moriaki Inoko, Junji Nakashima, Tetsuya Haruna, Kimisato Nakano, Tetsuhiko Yanazume, Eisaku Nakane, Toru Kinugawa, Hisataka Ohwaki, Masatsune Ishikawa, and Ryuji Nohara
Circulation 2005 112: e331-e332.
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Letter Regarding Article by Koch et al, "Impact of Prothesis–Patient Size on Functional Recovery After Aortic Valve Replacement" • Response
- Philippe Pibarot, Jean G. Dumesnil, Giordano Tasca, Colleen Gorman Koch, Farah Khandwala, Fawzy G. Estafanous, Floyd D. Loop, and Eugene H. Blackstone
Circulation 2005 112: e333.
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[Full Text]
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