Issue Highlights

Abstract

HomeCirculationVol. 111, No. 12Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published29 Mar 2005https://doi.org/10.1161/circ.111.12.1455Circulation. 2005;111:1455RISK OF CARDIOVASCULAR DISEASE BY HYSTERECTOMY STATUS, WITH AND WITHOUT OOPHORECTOMY: THE WOMEN’S HEALTH INITIATIVE OBSERVATIONAL STUDY, by Howard et al.It has long been appreciated that women who have undergone hysterectomy with or without oophorectomy have excess cardiovascular disease morbidity and mortality. Investigators have speculated that the deficiencies in endogenous hormones produced by the uterus and ovaries as well as alteration in iron stores might contribute to the unfavorable outcome. To gain further insights into factors that contribute to cardiovascular disease in women after hysterectomy, researchers analyzed the geographically diverse Women’s Health Initiative Observational database of almost 90 000 women. The investigators confirmed the observation that hysterectomy predicted a risk of cardiovascular disease events and total mortality; however, they noted that black, Hispanic, and American Indian women had higher hysterectomy rates than their white counterparts. In addition, women who had undergone hysterectomy had an unfavorable risk factor profile, including a higher prevalence of hypertension, diabetes, obesity, and high cholesterol and lower education, income, and physical activity levels. Of note, the apparent increased risk of hysterectomy was significantly reduced after adjusting for race/ethnicity and cardiovascular risk factors. Although observational in design, the present study may help reassure patients that hysterectomy per se may not markedly alter cardiovascular risk. One possible clinical implication of the present study is that patients and clinicians might view the advent of hysterectomy as an opportunity to review cardiovascular disease risk factor burden and pursue risk factor modification when appropriate. See p 1462.RISK OF WORSENING RENAL FUNCTION WITH NESIRITIDE IN PATIENTS WITH ACUTELY DECOMPENSATED HEART FAILURE, by Sackner-Bernstein et al.Nesiritide is a commonly used treatment for patients with acute decompensated heart failure in whom renal function is an identified prognostic factor. Sackner-Bernstein et al examined public records from US Food and Drug Administration files to determine whether treatment with nesiritide was associated with changes in renal function. In data from 5 randomized trials involving 1269 patients with heart failure, they found that, as compared with control subjects, patients who received nesiritide had a significant risk of increasing the serum creatinine by ≥0.5 mg/dL. This effect was not associated with a greater need for dialysis. This study suggests that further evaluation of the effects of nesiritide and its impact on outcomes may be warranted. See p 1487.IN VIVO CHARACTERIZATION OF CORONARY ATHEROSCLEROTIC PLAQUE BY USE OF OPTICAL COHERENCE TOMOGRAPHY, by Jang et al.Optical coherence tomography (OCT) is a high-resolution catheter-based imaging technique that can provide detailed in vivo tomographic assessment of coronary arterial plaques. Previous studies have established the validity of the image findings to define plaque components, as well as the feasibility of performing OCT during catheterization and percutaneous coronary intervention procedures. In this issue of Circulation, Jang and colleagues deploy the OCT technique in patients undergoing cardiac catheterization after presenting with acute myocardial infarction, unstable angina, or stable angina, and they define syndrome-specific differences in the minimum thickness of the fibrous cap as well as in the prevalence of thin cap fibroatheroma. These exciting data move the field another step forward toward a goal of online high-resolution detailed assessment of coronary plaque during cardiac catheterization and enable the potential for differential treatment strategies based on plaque morphology. See p 1551.Visit www.circ.ahajournals.org:Images in Cardiovascular MedicineA “Mickey Mouse” Coronary Anomaly: Aorto-Left Atrial Fistula With Aneurysm. See p e162. Download figureDownload PowerPointCorrespondenceLetter Regarding Articles by Kereiakes and Willerson, Mehran et al, and Kaplan et al, “Mini-Review: Expert Opinion.” See p e164.Letter Regarding Article by Khan et al, “Predictive Adaptive Responses to Maternal High-Fat Diet Prevent Endothelial Dysfunction but Not Hypertension in Adult Rat Offspring.” See p e166.Letter Regarding Article by Vita et al, “Serum Myeloperoxidase Levels Independently Predict Endothelial Dysfunction in Humans.” See p e167. Previous Back to top Next FiguresReferencesRelatedDetails March 29, 2005Vol 111, Issue 12 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.111.12.1455 Originally publishedMarch 29, 2005 PDF download Advertisement