Issue Highlights

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HomeCirculationVol. 116, No. 6Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published7 Aug 2007https://doi.org/10.1161/CIRCULATIONAHA.107.185625Circulation. 2007;116:585A DECADE OF SHORT-TERM OUTCOMES IN POST–CARDIAC SURGERY VENTRICULAR ASSIST DEVICE IMPLANTATION: DATA FROM THE SOCIETY OF THORACIC SURGEONS’ NATIONAL CARDIAC DATABASE, by Hernandez et al.In this issue of Circulation, Hernandez et al examined the Society of Thoracic Surgeons’ National Cardiac Database to assess the trends in the incidence of post–cardiac surgery shock requiring ventricular assist device implantation, survival rates, and risk factors for mortality. During the period 1995–2004, a total of 5735 patients had a ventricular assist device placed (0.3% cardiac surgeries). Overall survival rate to discharge following ventricular assist device placement was 54.1%. Using the earliest period (January 1995–June 1997) for reference, the mortality odds ratio declined to 0.72 (July 1998–December 2000) and eventually to 0.41 (July 2002–December 2004) (P<0.0001). The combined mortality/morbidity odds ratio also declined, to 0.84 and 0.48 over identical periods (P<0.0001). After adjustment for clinical characteristics of patients requiring mechanical circulatory support, the rates of survival to hospital discharge improved, and based upon these results, it can be concluded that the insertion of a ventricular assist device for post–cardiac surgery shock could be an important therapeutic intervention for these patients. See p 606 (editorial p 586).STATIN USE IN PATIENTS WITH EXTREMELY LOW LOW-DENSITY LIPOPROTEIN LEVELS IS ASSOCIATED WITH IMPROVED SURVIVAL, by Leeper et al.Emerging randomized controlled studies support the lowering of low-density lipoprotein (LDL) cholesterol levels to <70 mg/dL among patients with coronary heart disease, yet a plateau effect has not yet been found. In this issue of Circulation, Leeper et al provide important observational data that evaluate the safety and efficacy of statin therapy among more than 6000 high-risk patients with an LDL level <60 mg/dL. Mortality outcomes were assessed among subgroups of patients already on statins at baseline, those started on statins with LDL <60 mg/dL, those with LDL <40 mg/dL, and those without a history of coronary heart disease. Safety was assessed by evaluating the incidence of malignancy, transaminase elevation, and rhabdomyolysis. While these data need to be confirmed by randomized trials, their provocative findings provide increasing evidence to support the lowering of LDL beyond presently recommended target levels. See p 613.FAMILY HISTORY OF PREMATURE CORONARY HEART DISEASE AND CORONARY ARTERY CALCIFICATION: MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA), by Nasir et al.Family history is an established risk factor for coronary heart disease events, but how family history relates to subclinical coronary artery disease is less certain. Nasir and colleagues examined the adjusted relations of family history of premature coronary heart disease with coronary artery calcification by computed tomography in the Multi-Ethnic Study of Atherosclerosis (MESA). Although previously described in largely white, referral-based cohorts, the investigators observed that family history of premature coronary heart disease was associated with the presence (yes/no) and severity (>75th percentile) of coronary calcification accounting for coexistent risk factors. The increased risk was observed in community-based Americans of European, African, Chinese, and Hispanic descent. Of clinical interest, the association between increased risk of family history of premature heart disease and coronary calcification was observed in individuals at low and intermediate Framingham risk of heart disease, providing indirect support for the importance of family history in risk assessment. See p 619.Visit http://circ.ahajournals.org:Images in Cardiovascular MedicineMyocarditis and Sudden Cardiac Death in the Young: Extensive Fibrosis Suggested by Cardiovascular Magnetic Resonance In Vivo and Confirmed Post Mortem. See p e122. Partial Congenital Absence of the Pericardium. See p e126. Download figureDownload PowerPointBook ReviewPrinciples of Cerebrovascular Disease. See p e130.CorrespondenceSee p e132. Previous Back to top Next FiguresReferencesRelatedDetails August 7, 2007Vol 116, Issue 6 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.107.185625 Originally publishedAugust 7, 2007 PDF download Advertisement