Issue Highlights

Abstract

HomeCirculationVol. 112, No. 20Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published15 Nov 2005https://doi.org/10.1161/circ.112.20.3025Circulation. 2005;112:3025OPTIMAL TIMING OF INTERVENTION IN NON–ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROMES: INSIGHTS FROM THE CRUSADE (CAN RAPID RISK STRATIFICATION OF UNSTABLE ANGINA PATIENTS SUPPRESS ADVERSE OUTCOMES WITH EARLY IMPLEMENTATION OF THE ACC/AHA GUIDELINES) REGISTRY, by Ryan et al.An early invasive strategy for patients with non–ST-segment elevation acute coronary syndromes has been shown to improve outcomes in most (but not all) recent studies. The optimal timing of intervention has not been determined. Should patients be triaged, as with primary angioplasty for ST-segment elevation, and have a door-to- balloon time of <90 minutes, or should “passivation” of the plaque with intensive antithrombotic therapy be administered for a period of perhaps 12 to 24 hours before angioplasty? In this issue of Circulation, Ryan et al report findings from the CRUSADE Registry, where they compared outcomes of patients presenting on weekends, who experienced a delay to angiography of 46.3 hours, to patients presenting during the week, who experienced a delay to angiography of 23.4 hours. Increased delay was not associated with adverse outcomes. Thus, increasing access to invasive therapy on weekends across the community may not improve population outcomes. See p 3049.AMBIENT AIR POLLUTION IS ASSOCIATED WITH INCREASED RISK OF HOSPITAL CARDIAC READMISSIONS OF MYOCARDIAL INFARCTION SURVIVORS IN FIVE EUROPEAN CITIES, by von Klot et al.Air pollution is increasingly recognized as a risk factor for cardiovascular events. In a European study, investigators determined the risk of ambient nitrogen dioxide, carbon monoxide, ozone, and mass of particles <10 μm on the risk of recurrent events in individuals who had survived an acute myocardial infarction. The study sample included 22 006 patients from Augsburg, Barcelona, Helsinki, Rome, and Stockholm from 1992 to 2000. The authors report how daily pollution levels affect risk of cardiac readmissions. See p 3073.CONTINUOUS AORTIC FLOW AUGMENTATION: A PILOT STUDY OF HEMODYNAMIC AND RENAL RESPONSES TO A NOVEL PERCUTANEOUS INTERVENTION IN DECOMPENSATED HEART FAILURE, by Konstam et al.Despite therapy with inotropic and vasodilator agents, some patients continue to have left ventricular failure such that they have hemodynamic instability. Intra-aortic balloon counter-pulsation and left ventricular assist devices are options in many such patients. Konstam et al report the early clinical experience with a new hemodynamic support device that uses a magnetically levitated and driven centrifugal pump to remove blood from the femoral artery and return it to the thoracic aorta. This initial report demonstrates that the external pump causes reductions in systemic vascular resistance and pulmonary capillary wedge pressure associated with an increase in cardiac output. Future clinical trials will be needed to determine the clinical value of these hemodynamic effects and the overall safety profile of this new device. See p 3107.Visit http://circ.ahajournals.org:Cardiology Patient PageLearn, Take Action, and Live: A Guide to Using Online Tools to Prevent and Manage Heart Disease and Stroke. See p e318.Images in Cardiovascular MedicineMultislice Computed Tomography for Preinterventional Mapping of Complicated Coronary Artery Injury. See p e320.Transient Giant Negative T Waves Associated with Cardiac Involvement of Diffuse Large B-Cell Lymphoma. See p e322.Systemic Complications of Infective Endocarditis. See p e324.Download figureDownload PowerPointCorrespondenceSee p e325. Previous Back to top Next FiguresReferencesRelatedDetails November 15, 2005Vol 112, Issue 20 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.112.20.3025 Originally publishedNovember 15, 2005 PDF download Advertisement