Circulation. 2007;116:685
doi: 10.1161/CIRCULATIONAHA.107.185626
(Circulation. 2007;116:685.)
© 2007 American Heart Association, Inc.
Issue Highlights
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REGRESSION OF ELECTROCARDIOGRAPHIC LEFT VENTRICULAR HYPERTROPHY DURING ANTIHYPERTENSIVE THERAPY AND REDUCTION IN SUDDEN CARDIAC DEATH: THE LIFE STUDY, by Wachtell et al.
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ECG-detected left ventricular hypertrophy, one of the original
Framingham "factors of risk" for coronary heart disease, is
also a risk factor for sudden death and major nonfatal cardiovascular
events. In this issue, Wachtell and colleagues use the extensive
data from the Losartan Intervention for Events (LIFE) trial
of >9000 patients with hypertension and ECG left ventricular
hypertrophy to address whether regression of ECG markers of
the left ventricular hypertrophy (voltage) is associated with
reduced risk of sudden death. They confirm the importance of
ECG left ventricular hypertrophy and provide new data that reduction
in voltage was associated with lower risk of sudden death. See
p
700.
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INCIDENCE AND PREDICTORS OF DRUG-ELUTING STENT THROMBOSIS DURING AND AFTER DISCONTINUATION OF THIENOPYRIDINE TREATMENT, by Airoldi et al.
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Drug-eluting stents have been shown to reduce restenosis in
randomized trials and in registries that represent a broader
spectrum of patients. Recently, it has been shown that very
late stent thrombosis is increased in the broader group of patients
receiving drug-eluting stents. The prolonged use of dual antiplatelet
therapy has been suggested as a potential means of reducing
this late complication. This prospective observational study
followed 3021 patients who received a drug-eluting stent. At
18 months, stent thrombosis was observed in 1.9% of patients.
Forty-two patients developed stent thrombosis within 6 months;
and 16, between 6 and 18 months. On multivariable analysis,
discontinuation of thienopyridine therapy was the strongest
predictor of stent thrombosis within the first 6 months (hazard
ratio, 13.74;
P< 0.001). No obvious relationship was evident
from discontinuation of thienopyridine therapy after 6 months,
but due to the small number of events, firm conclusions cannot
be drawn. See p 745 (editorial p
696)
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PERCUTANEOUS TRANSARTERIAL AORTIC VALVE REPLACEMENT IN SELECTED HIGH-RISK PATIENTS WITH AORTIC STENOSIS, by Webb et al.
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Aortic valve replacement for severe aortic stenosis is considered
too high risk in some patients due to age and significant comorbidities.
Percutaneous valve replacement offers an alternative in such
patients; however, the current experience is limited. The study
by Webb et al reports on the initial experience with transcatheter
aortic valve replacement using a balloon expandable device in
50 very-high-risk patients with aortic stenosis. The average
age was 82 years. The procedural mortality was 2%, and the 30
day mortality was 12%, as compared with the predicted mortality
of 28%. Aortic valve area increased from 0.6±0.2 to 1.7±0.4
cm
2. With experience, the procedural success rose from 76% in
the first 25 patients to 96% subsequently. Of patients having
an initially successful procedure, 81% (35/43) were alive at
a median follow-up of 359 days. Although aortic valve replacement
remains the first line of therapy for symptomatic aortic stenosis,
percutaneous aortic valve replacement may be an option for selected
very high risk patients. See p
755.
Visit http://circ.ahajournals.org:
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Images in Cardiovascular Medicine
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Asymptomatic Huge Popliteal Pseudoaneurysm With 2 Internal Solid
Thrombi. See p
e139.
Large Free Floating Intra-Aortic Thrombus. See p e142.
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Book Review
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Cardiovascular Regeneration and Stem Cell Therapy. See p
e144.
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Correspondence
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See p
e146.
Related Articles:
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Drug-Eluting Stents: Dual Antiplatelet Therapy for Every Survivor?
- Anthony A. Bavry and Deepak L. Bhatt
Circulation 2007 116: 696-699.
[Extract]
[Full Text]
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Asymptomatic Huge Popliteal Pseudoaneurysm With 2 Internal Solid Thrombi
- Shumpei Mori, Mitsuru Abe, Atsushi Kawamura, Kei Kazuno, Masahiro Higashi, Hatsue Ishibashi-Ueda, and Hiroshi Nonogi
Circulation 2007 116: e139-e141.
[Extract]
[Full Text]
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Large Free-Floating Intra-Aortic Thrombus
- Siamak Mohammadi, Sylvain Trahan, Santiago Miro, and Francois Dagenais
Circulation 2007 116: e142-e143.
[Extract]
[Full Text]
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Cardiovascular Regeneration and Stem Cell Therapy
- Joshua M. Hare
Circulation 2007 116: e144-e145.
[Extract]
[Full Text]
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Letter Regarding Article by Gammie et al, "Influence of Hospital Procedural Volume on Care Process and Mortality for Patients Undergoing Elective Surgery for Mitral Regurgitation"
- Jeffrey H. Shuhaiber and Hans Shuhaiber
Circulation 2007 116: e146.
[Extract]
[Full Text]
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Regression of Electrocardiographic Left Ventricular Hypertrophy During Antihypertensive Therapy and Reduction in Sudden Cardiac Death: The LIFE Study
- Kristian Wachtell, Peter M. Okin, Michael H. Olsen, Björn Dahlöf, Richard B. Devereux, Hans Ibsen, Sverre E. Kjeldsen, Lars H. Lindholm, Markku S. Nieminen, and Kristian Thygesen
Circulation 2007 116: 700-705.
[Abstract]
[Full Text]
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Percutaneous Transarterial Aortic Valve Replacement in Selected High-Risk Patients With Aortic Stenosis
- John G. Webb, Sanjeevan Pasupati, Karin Humphries, Christopher Thompson, Lukas Altwegg, Robert Moss, Ajay Sinhal, Ronald G. Carere, Brad Munt, Donald Ricci, Jian Ye, Anson Cheung, and Sam V. Lichtenstein
Circulation 2007 116: 755-763.
[Abstract]
[Full Text]
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