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HomeCirculationVol. 114, No. 13Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published26 Sep 2006https://doi.org/10.1161/circ.114.13.1343Circulation. 2006;114:1343LOCALIZATION OF NA+ CHANNEL ISOFORMS AT THE ATRIOVENTRICULAR JUNCTION AND ATRIOVENTRICULAR NODE IN THE RAT, by Yoo et al.The anatomical structures, histological architecture, and electrical correlation of atrioventricular nodal function have been an area of research for over 100 years. In this issue of Circulation, Yoo and colleagues have elegantly demonstrated molecular labeling of ion channel subtypes in discrete areas of the atrioventricular conducting system in a rat model. Using immunohistochemistry techniques, they labeled several sodium channel isoform antibodies and marker proteins to molecularly illustrate the complex nature of this critical region. The authors demonstrate areas with functionally distinct cell types with electrophysiological heterogeneity, which is important clinically for understanding the development of variable conduction, dual AV nodal physiology, and reentry. See p 1360.SEX DIFFERENCES IN MAJOR BLEEDING WITH GLYCOPROTEIN IIB/IIIA INHIBITORS: RESULTS FROM THE CRUSADE (CAN RAPID RISK STRATIFICATION OF UNSTABLE ANGINA PATIENTS SUPPRESS ADVERSE OUTCOMES WITH EARLY IMPLEMENTATION OF THE ACC/AHA GUIDELINES) INITIATIVE, by Alexander et al.Randomized placebo-controlled clinical trials have demonstrated the efficacy of glycoprotein IIb/IIIa inhibitors in reducing the risk of death or myocardial infarction when administered to patients with non–ST-segment elevation acute coronary syndrome. Women have a greater predilection for bleeding, the major risk of this important therapy. In this study by Alexander et al, the real world experience from 400 hospitals participating in the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines) initiative registry is used to confirm a 2-fold higher rate of major bleeding in women compared with men with the use of glycoprotein IIb/IIIa inhibitors. Approximately a quarter of this excess bleeding can be attributed to excess dosing of women. Other important caveats about glycoprotein IIb/IIIa inhibitors use are well delineated in this clinically important article. See p 1380.BLOOD LEAD BELOW 0.48 μmol/L (10 μg/dL) AND MORTALITY AMONG US ADULTS, by Menke et al.High blood lead levels (40 μg/dL) have been associated with increased risk of death in occupational and population-based samples. The elimination of lead in gasoline and paint products has resulted in decreasing environmental lead exposure and lower adult blood lead levels over the past 3 decades. Whether more modest levels of blood lead are associated with increased mortality, however, has not been established. Menke and colleagues followed up almost 140 adult participants in the Third National Health and Nutrition Examination Survey, recruited from 1988 to 1994, to examine the relations of blood lead levels to cause-specific and all-cause mortality. The investigators observed that blood lead levels in substantively lower levels than previously reported, above only 2 μg/dL, was associated with excess death from myocardial infarction, stroke, and all causes, though not from cancer. The findings have potentially major implications for public health and the regulation of environmental lead exposures. See p 1388.Visit http://circ.ahajournals.org:Images in Cardiovascular MedicineGiant Compressive Aneurysm of the Left Auricle in a 1-Day-Old Neonate. See p e511. Download figureDownload PowerPointThe Case of a Disappearing Left Atrial Appendage Thrombus: Direct Visualization of Left Atrial Thrombus Migration, Captured by Echocardiography, in a Patient With Atrial Fibrillation, Resulting in a Stroke. See p e513.Directly to the Heart. See p e515.CorrespondenceSee p e517. Previous Back to top Next FiguresReferencesRelatedDetails September 26, 2006Vol 114, Issue 13 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.114.13.1343 Originally publishedSeptember 26, 2006 PDF download Advertisement