HomeCirculationVol. 113, No. 13Issue Highlights Free AccessIn BriefPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessIn BriefPDF/EPUBIssue Highlights Originally published4 Apr 2006https://doi.org/10.1161/circ.113.13.1633Circulation. 2006;113:1633CLINICAL FEATURES OF ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA/CARDIOMYOPATHY ASSOCIATED WITH MUTATIONS IN PLAKOPHILIN-2, by Dalal et al.andPLAKOPHILIN-2 MUTATIONS ARE THE MAJOR DETERMINANT OF FAMILIAL ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA/CARDIOMYOPATHY, by van Tintelen et al.Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) may be challenging to diagnose because of variable expressivity and penetrance. There are multiple gene mutations responsible for the disease, with overlapping clinical phenotypes, analogous to other inherited cardiac diseases with arrhythmia vulnerability. Most of the genes associated with ARVD/C encode for desmosomal proteins involved in cell-to-cell adhesion. In this issue of Circulation, 2 reports by Dalal et al and van Tintelen et al sought to determine the prevalence and clinical expression of mutations in the plakophilin-2 gene (PKP2) in ARVD/C patients. Both groups found a high frequency of PKP2 mutations in patients with familial ARVD/C. Dalal and colleagues found that patients with PKP2 mutations presented earlier in life. However, neither study could identify distinguishing clinical features associated with PKP2 mutations compared with other (non-PKP2) patients with ARVD/C. They conclude that molecular genetic testing for PKP2 mutations may allow presymptomatic identification of ARVD/C and may refine treatment strategies. See pp 1641 and 1650 (and editorial on p 1634).EFFECT OF CLOPIDOGREL PREMEDICATION IN OFF-PUMP CARDIAC SURGERY: ARE WE FORFEITING THE BENEFITS OF REDUCED HEMORRHAGIC SEQUELAE? by Kapetanakis et al.Dual antiplatelet therapy with aspirin and clopidogrel reduces major adverse cardiovascular events after unstable angina, enhances infarct-related artery patency after thrombolytic therapy in ST-elevation myocardial infarction, and decreases post--percutaneous coronary intervention thrombotic complications after both elective and urgent stenting procedures. However, the enhanced efficacy of dual antiplatelet therapy is associated with an increased risk of bleeding that is particularly troublesome for patients requiring surgical revascularization because of the irreversible nature of clopidogrel action. In this issue of Circulation, Kapetanakis and colleagues report on their retrospective study of 1572 patients undergoing isolated off-pump coronary artery bypass surgery (OPCAB) to evaluate the effect of preoperative clopidogrel administration on bleeding. Risk-adjusted logistic regression and matched pair propensity score analyses demonstrated that clopidogrel preadministration increased the risk for hemostatic reoperation and blood transfusion requirements during and after OPCAB surgery. The findings of this nonrandomized, nonblinded retrospective analysis add to the controversy surrounding the optimal timing of clopidogrel administration given the nonsignificant trends for only modest increases in bleeding observed in patients who continued clopidogrel within 5 days before surgery in prospective, double-blind, randomized trials (Clopidogrel in Unstable Angina to Prevent Recurrent Events [CURE] and Clopidogrel as Adjunctive Reperfusion Therapy [CLARITY]-Thrombolysis in Myocardial Infarction [TIMI] 28). See p 1667.MAGNESIUM INTAKE AND INCIDENCE OF METABOLIC SYNDROME AMONG YOUNG ADULTS, by He et al.The metabolic syndrome is defined as a constellation of risk factors that appear to directly promote the development of atherosclerotic cardiovascular disease. Owing to its potential to adversely affect cardiovascular health, much attention is now focused on strategies that may prevent and treat this condition. Prior studies suggest that increased magnesium intake is associated with a more favorable lipid profile and a lower risk of hypertension and diabetes. Accordingly, these data prompt the question of whether there is a relationship between dietary magnesium and the development of metabolic syndrome. In this issue, He and colleagues report the results of their carefully conducted observational study to assess the association of dietary magnesium and the incidence of metabolic syndrome among 4637 young adults, who were followed up for 15 years. Their provocative results suggest a promising role for dietary magnesium intake that can only be verified by the future performance of randomized controlled trials. Whether taking magnesium supplements can provide similar benefits requires further study as well. See p 1675.Visit http://circ.ahajournals.org:Cardiology Patient PageCatheter Ablation of Atrial Fibrillation. See p e666.Images in Cardiovascular MedicineAcute Myocardial Infarction Caused by Extension of a Proximal Aortic Dissection Flap Into the Right Coronary Artery: An Intracoronary Ultrasound Image. See p e669. Download figureDownload PowerPoint“Shock Advised”: Inappropriate Public Access Defibrillation. See p e672.Magnetic Resonance Imaging and Computed Tomography Findings in Arrhythmogenic Right Ventricular Cardiomyopathy. See p e673.CorrespondenceSee p e676. Previous Back to top Next FiguresReferencesRelatedDetailsCited By Joondeph B Federalism, the Rehnquist Court, and the Modern Republican Party, SSRN Electronic Journal, 10.2139/ssrn.1019648 April 4, 2006Vol 113, Issue 13 Advertisement Article InformationMetrics https://doi.org/10.1161/circ.113.13.1633 Originally publishedApril 4, 2006 PDF download Advertisement