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HomeCirculationVol. 112, No. 3Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published19 Jul 2005https://doi.org/10.1161/circ.112.3.297Circulation. 2005;112:297CORTISOL, TESTOSTERONE, AND CORONARY HEART DISEASE: PROSPECTIVE EVIDENCE FROM THE CAERPHILLY STUDY, by Smith et al.There are abundant animal and human data as well as lay support for the concept that chronic stress predisposes to heart disease. However, the pathophysiological basis of the stress-heart disease connection remains poorly understood. In a prospective observational study of middle-aged men in Caerphilly, South Wales, Dr Davey Smith and colleagues examined whether elevated cortisol-to-testosterone ratio, a reputed biological marker of stress, increased the risk of ischemic heart disease. The investigators observed that there was a dose-response relation between increasing levels of cortisol to testosterone and the longitudinal development of ischemic heart disease, but no other causes of death. When the authors further adjusted for components of the insulin resistance syndrome, the relation with ischemic heart disease was significantly attenuated. The researchers acknowledged that their findings will need to be replicated in other study cohorts and with other designs. However, given that it is unlikely that chronic stress will be eliminated from modern life, understanding the biology of the stress-coronary artery disease connection will be important to facilitate the development of effective stress prevention and treatment strategies. See p 332.STATIN THERAPY MAY BE ASSOCIATED WITH LOWER MORTALITY IN PATIENTS WITH DIASTOLIC HEART FAILURE: A PRELIMINARY REPORT, by Fukuta et al.The pathophysiology and therapy of heart failure with a normal ejection fraction remain poorly understood. Fukuta et al examined the relationship between survival and the type of therapy in 137 patients with clinical heart failure and an ejection fraction ≥0.50. Although the number of deaths was small, there was a strong relationship between the use of a statin and survival, whereas no apparent relationship was found for angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or β-blockers. Serum LDL was higher in the statin-treated patients, as was the incidence of several other risk factors for heart failure, including hypertension, diabetes, and coronary artery disease. The relationship between statin use and survival persisted after adjustment for baseline clinical variables. If confirmed by controlled trials, these observations may provide a valuable new approach to the treatment of heart failure with a normal ejection fraction. See p 357.EIGHT-YEAR FOLLOW-UP OF PATIENTS WITH PERMANENT VENA CAVA FILTERS IN THE PREVENTION OF PULMONARY EMBOLISM: THE PREPIC (PRÉVENTION DU RISQUE D’EMBOLIE PULMONAIRE PAR INTERRUPTION CAVE) RANDOMIZED STUDY, by The PREPIC Study GroupApproximately 8 years ago, the initial report from the PREPIC study was published, demonstrating that permanent vena cava filters reduced the incidence of pulmonary embolism but were associated with increased deep-venous thrombosis at 2 years. The long-term effect of vena cava filters remained unknown. In this issue of Circulation, the follow-up on the 400 patients randomized to either receive a filter or be treated with medical therapy is reported. At 8 years, the investigators report that the initial observations of reduced pulmonary embolism and increased deep venous thrombosis remain; however, they now find no effect on survival. The use of vena cava filters continues to be a complicated decision, but findings such as these suggest that there is unlikely to be survival benefit in low-risk patients. See p 416.Visit http://www.circ.ahajournals.org:Cardiology Patient PageAntiphospholipid Antibodies. See p e39.Images in Cardiovascular MedicineA Nest in the Chest. See p e45.Fusion Imaging Between Myocardial Perfusion Single Photon Emission Computed Tomography and Cardiac Computed Tomography. See p e47. Download figureDownload PowerPointExtensive Subepicardial Fibrosis in a Patient With Apical Hypertrophic Cardiomyopathy With Persistent ST-Segment Elevation Simulating Acute Myocardial Infarction. See p e49.CorrespondenceSee p e51. Previous Back to top Next FiguresReferencesRelatedDetails July 19, 2005Vol 112, Issue 3 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.112.3.297 Originally publishedJuly 19, 2005 PDF download Advertisement