This issue of the Journal of Invasive Cardiology coincides with the 57th Annual Scientific Sessions of the American College of Cardiology and includes original research articles, a review, and articles from our Rapid Communication and Clinical Images sections. In addition, the March 2008 digital issue of the journal features case reports and selections from the 30th Anniversary of Angioplasty in conjunction with the International Andreas Gruentzig Society (found on www.invasivecardiology.com).
In the first original article, submitted by Dr. Peter Casterella and associates from Utah Heart Clinic and Cardiovascular Research Department, LDS Hospital in Salt Lake City, Utah, the authors report on their research to evaluate the real-world safety and efficacy of glycoprotein IIb/IIIa inhibitors during percutaneous coronary intervention (PCI). They showed that these agents can be used with a low incidence of major bleeding complications and can be of benefit to long-term PCI results.
Dr. Oliver Bertrand and colleagues from the Interventional Cardiology Laboratories, Laval Hospital in Québec, Canada, describe their study of clinical outcomes following multilesion PCI comparing exclusive versus selective use of drug-eluting stents (DES). They demonstrated that the selective DES strategy for lesions at higher risk for restenosis and use of bare-metal stents for other lesions was safe and effective when compared with the exclusive use of DES. Drs. Rafael Beyar and Eugenia Nikolsky have provided a commentary on this topic.
Dr. Mohammed Andron and collaborators from The Cardiothoracic Center in Liverpool, United Kingdom, present their study assessing the impact of periprocedural creatinine kinase-MB isoenzyme release on long-term mortality after PCI. They found that periprocedural myonecrosis is common with PCI and is associated with less favorable long-term mortality.
In the next original research article, Dr. Joseph Jozic and associates from the University of Kentucky at Lexington, Mayday University Hospital in Croyden, United Kingdom, Duke Clinical Research Institute, the National Human Genome Research Institute at the NIH, and the Division of Cardiovascular Disease at Scripps Clinic in La Jolla, California, present their study looking at the timing and correlates of very early major adverse clinical events following PCI. In a retrospective analysis of the CREDO trial, the investigators showed that there was a very low and constant risk of adverse events 6 hours following PCI. Next, Dr. Hamza Duygu and colleagues from the Department of Cardiology at Ege University in Izmir, Turkey, describe a study assessing the effect of mean platelet volume on postintervention coronary blood flow in patients with chronic stable angina. They found that their measure of platelet volume was associated with blood-flow parameters and may be useful in identifying patients who are at high risk for post-PCI low-reflow.
Dr. Luis Gruberg and colleagues from the Rambam Medical Center in Haifa, Israel, submitted their work on the clinical, electrocardiographic and angiographic characteristics of patients with acute coronary syndrome, increased troponin I (cTn-I) levels and normal creatine kinase levels, and found that increased cTn-I levels in the presence of rest pain and normal creatine kinase is not a spurious finding, but may actually be a marker of advanced coronary artery disease (CAD), albeit nonsignificant in some patients.
In the last original research article, Dr. Hideki Kitahara and colleagues from the Department of Cardiovascular Science and Medicine at Chiba University Graduate School of Medicine and the Divisions of Cardiology at Kimitsu Chuo and Chiba Kaihin Municipal Hospitals in Chiba, Japan, present their study to evaluate the damage to the polymer of undelivered sirolimus-eluting stents. Scanning electron evaluation demonstrated that damage may occur to the polymer when the stent is delivered through a calcified artery.
This issue of the journal also includes a selection from the Rapid Communication section. Dr. Yoriyasu Suzuki and colleagues from the Division of Cardiovascular Medicine, School of Medicine at Stanford University, present their work comparing the porcine restenosis model using thermal balloon injury with the model of stent overstretching to induce injury. They found that the thermal balloon injury model was very effective in producing stenoses and may be valuable in evaluating medical devices, PCI training and for the development of imaging modalities.
The print issue of the journal also contains two articles from the special section, Clinical Images, edited by Dr. David Rizik from the Scottsdale Heart Group at Scottsdale Healthcare Hospital in Scottsdale, Arizona. In the first, Drs. Penugonda, Mahir and Gardi from Wayne State University in Detroit, Michigan, present images from computed tomographic angiography and coronary angiograms visualizing the aberrant origin of the left anterior descending artery and quadrifurcation of coronary vessels associated with CAD. In the second article, Drs. Sayed Hussain and Saeb Khoury from the University of Cincinnati in Cincinnati, Ohio, present an unusual case demonstrating the absence of a right coronary artery.
This issue of the journal also includes Part 2 of a review article submitted by Drs. David Rizik, Kevin Klassen and James Hermiller of the Scottsdale Heart Group at Scottsdale Healthcare Hospital in Scottsdale, Arizona. This part of the review completes a very thorough discussion of current techniques and future directions in the treatment of bifurcation CAD.
This issue of the journal also includes case reports that are published directly online (click on Digital JIC on our website). The first of these, submitted by Drs. Hernandez- Antolín, Cuervo and Vicente from the Hospital Clinico San Carlos in Madrid, Spain, reports on their diagnosis and treatment of coronary stent entanglement complicated by extreme stent distortion. Next, Drs. Stevens, Kini and Sharma from the Cardiovascular Institute at Mount Sinai Hospital in New York, provide a description of an unusual patient with stenosis of an anomalous left main trunk originating from a stenosed ostial right coronary artery that was treated with kissing stents. In the next case report, Dr. Francesca del Furia and colleagues from Nuovo Ospedale San Giovanni di Dio Cardiology Unit in Florence, Italy, report on two unusual cases of anaphylaxisinduced acute STEMI treated with primary PCI.
The next case report by Drs. Menon, Rihal and Cabalka from the Department of Pediatric Cardiology at the Mayo Clinic, in Rochester, Minnesota, features a n elderly patient who developed a large distal anastomotic pseudoaneurysm after undergoing surgical repair of an abdominal aortic aneurysm that was successfully treated using a 15 mm Amplatzer® septal occluder device.
Next, Drs. Viana-Tejedor, Moreno and Moreno from La Paz University Hospital in Madrid, Spain, have provided a report on their use of an Amplatzer catheter for transcatheter closure of a postinfarction ventricular septal defect. Next, Drs. Kelly, Levy and Talwar, from Royal Bournemouth Hospital, United Kingdom, report on a case of brachial artery perforation treated successfully by the deployment of a covered stent designed for PCI. In the last of the March 2008 case reports, Drs. Aman Haider, Subhash Banerjee and Emmanouil Brilakis from the University of Texas Southwestern Medical School and the Dallas VA Medical Center, describe their successful management of a patient who developed acute pulmonary edema due to pacemaker-induced mitral regurgitation.
And finally, please see Digital JIC for several interesting talks presented during the 30th Anniversary of Angioplasty held in conjunction with the International Andreas Gruentzig Society in Zurich, Switzerland, in September of 2007. This selection from the meeting’s proceedings includes perspectives from Dr. Alfred Bollinger and Maria Schlumpf (Initial Application of Balloon Technology in Peripheral Arterial Disease), Dr. Larry S. Dean (Adjunctive Diagnostic Instruments for PCI), Dr. Richard Heuser (Renal Arteries), and Drs. Nicolas Majunkem and Horst Sievert (Atrial and Ventricular Shunt Closure).
It is my hope that the articles in this issue of the journal provide cardiovascular healthcare professionals with important and timely information that will enhance the care delivered to cardiac patients.
Richard E. Shaw, PhD, FACC, FACA
Editor- in- Chief