HomeCirculationVol. 111, No. 8Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published1 Mar 2005https://doi.org/10.1161/circ.111.8.955Circulation. 2005;111:955PLATELET-ACTIVATING FACTOR ACETYLHYDROLASE ACTIVITY INDICATES ANGIOGRAPHIC CORONARY ARTERY DISEASE INDEPENDENTLY OF SYSTEMIC INFLAMMATION AND OTHER RISK FACTORS: THE LUDWIGSHAFEN RISK AND CARDIOVASCULAR HEALTH STUDY, by Winkler et al.Inflammatory reactions are known to enhance atherosclerosis. Lipoprotein-associated phospholipase A2, also known as platelet-activating factor acetylhydrolase (PAH-AH), is a lipoprotein-bound enzyme that may play a role in atherosclerosis via its antiinflammatory actions. In this issue of Circulation, Winkler and colleagues study the association of this enzyme’s activity with angiographic cardiovascular disease from >3000 patients in the Ludwigshafen Risk and Cardiovascular Health Study. They report that PAH-AH activity is not associated with unstable coronary syndromes but is associated with angiographic cardiovascular disease independently of LDL levels. The activity of PAH-AH also was associated with select cardiovascular drugs, including (β-blockers and aspirin. Studies determining whether PAH-AH is just a marker of atherosclerosis or is actively involved in atherogenesis are ongoing. See p 980.ALISKIREN, A NOVEL ORALLY EFFECTIVE RENIN INHIBITOR, PROVIDES DOSE-DEPENDENT ANTIHYPERTENSIVE EFFICACY AND PLACEBO-LIKE TOLERABILITY IN HYPERTENSIVE PATIENTS, by Gradman et al.The renin–angiotensin system plays a pivotal role in the pathogenesis of cardiovascular diseases and has long been a key therapeutic target. Because angiotensin can be produced through a number of pathways other than the classic system, intensive interest has been paid to inhibiting its generation at the initial step of the renin–angiotensin system cascade by renin inhibitors. The clinical use of a number of agents developed in the past 20 years to inhibit the active site of renin, however, was limited because of low potency and short duration of action. Aliskiren is a recently synthesized potent nonpeptidic inhibitor with oral bioavailability. Gradman and colleagues carried out the first placebo-controlled trial to investigate the efficacy and safety of aliskiren in hypertension treatment. They clearly demonstrated that once-daily oral treatment with aliskiren lowered blood pressure effectively in patients with mild-to-moderate hypertension. Because renin has high specificity for only one substrate, side effects would be expected to be low; in fact, incidence of adverse events was shown to be comparable to that of placebo. This agent could be used for the management of a variety of cardiovascular diseases in future. See p 1012.MAINTENANCE OF LONG-TERM CLINICAL BENEFIT WITH SIROLIMUS-ELUTING CORONARY STENTS: THREE-YEAR RESULTS OF THE RAVEL TRIAL, by Fajadet et al.The introduction of sirolimus drug-eluting stents for percutaneous coronary revascularization procedures was heralded as the end of restenosis, the Achilles heel of percutaneous interventional procedures. Initial studies with sirolimus-eluting stents demonstrated nearly complete elimination of restenosis at 6 months and markedly decreased rates of associated major adverse events at 1 year when compared with conventional bare metal stents. Over time, however, it became apparent that restenosis continued to occur, albeit at rates in the single digits; coronary intravascular studies revealed that because of positive remodeling there was evidence of stent malapposition; and unexplained stent thrombosis emerged as a troubling adverse event. These events led some to question the long-term durability of sirolimus stents. In this issue of Circulation, Fajadet et al present the 3-year results of the RAVEL trial and demonstrate the continued superiority of sirolimus drug-eluting stents. See p 1040.Visit www.circ.ahajournals.org:Clinician UpdateSurgical Treatment of Atrial Fibrillation via Energy Ablation. See p e103.Images in Cardiovascular MedicineMitral Valve Prolapse Associated With Accessory Mitral Valve. See p e107.Provocable Pressure Gradient Across an Anomalous Left Main Coronary Artery: A Unique Diagnostic Tool. See p e108.Download figureDownload PowerPointCorrespondenceLetter Regarding Article by Klausen et al, “Very Low Levels of Microalbuminuria Are Associated With Increased Risk of Coronary Heart Disease and Death Independently of Renal Function, Hypertension, and Diabetes.” See p e110.Letter Regarding Article by Frigiola et al, “Pulmonary Regurgitation Is an Important Determinant of Right Ventricular Contractile Dysfunction in Patients With Surgically Repaired Tetralogy of Fallot. ” See p e112. Previous Back to top Next FiguresReferencesRelatedDetails March 1, 2005Vol 111, Issue 8 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.111.8.955 Originally publishedMarch 1, 2005 PDF download Advertisement