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INSIDE THIS ISSUE OF JACC

Inside This Issue of JACC

	State-of-the-Art Paper

Top State-of-the-Art Paper Interventional Cardiology Atherosclerosis Atherosclerosis Heart Rhythm Disorders Cardiac Imaging

	Interventional Cardiology

Top State-of-the-Art Paper Interventional Cardiology Atherosclerosis Atherosclerosis Heart Rhythm Disorders Cardiac Imaging

 
Elective PCI Without Heparin: Similar Efficacy, Reduced Bleeding.  
Some studies have shown that the degree of heparin anticoagulation, as measured by the activated clotting time, does not affect the rate of ischemic events for elective percutaneous coronary intervention (PCI). Stabile and colleagues hypothesized that patients on dual antiplatelet therapy would not benefit from heparin during PCI. The study randomized 700 patients on dual antiplatelet therapy to either periprocedural heparin or saline. Those assigned to saline had lower rates of bleeding and lower rates of post-procedure creatine kinase-myocardial band elevations. This trial suggests that in some patients receiving dual antiplatelet therapy, elective PCI is safer without heparin. See pages 1293 and 1299. See figure.

	Atherosclerosis

Top State-of-the-Art Paper Interventional Cardiology Atherosclerosis Atherosclerosis Heart Rhythm Disorders Cardiac Imaging

 
Particles Released From Cell Membranes Stimulate Atherosclerotic Neovascularization.  
Although poorly understood, membrane microparticles (MPs) probably result from cell plasma membrane budding following inflammation of the vessel wall. Leroyer and colleagues studied the ability of these MPs to stimulate neovascularization. MPs were isolated from patients undergoing carotid endarterectomy. The MPs did promote neovascularization in a variety of different settings, with the pathway involving CD40. These results demonstrate that MPs can stimulate neovascularization in atherosclerotic plaques. See pages 1302 and 1312. See figure.

	Atherosclerosis

Top State-of-the-Art Paper Interventional Cardiology Atherosclerosis Atherosclerosis Heart Rhythm Disorders Cardiac Imaging

 
Increased Expression of Osteocalcin From Endothelial Progenitor Cells in Patients With CAD.   Vascular calcification occurs when osteoblasts form early bone structures in the vessel wall. Gössl and colleagues isolated endothelial progenitor cells (EPCs) from patients undergoing angiography and measured the percentage of EPCs expressing the bone-related marker osteocalcin. Compared with control subjects, subjects with endothelial dysfunction and subjects with multivessel coronary artery disease (CAD) both had higher percentages of EPCs costaining for osteocalcin. These findings will help to delineate the mechanisms of vascular calcification. See page 1314.

	Heart Rhythm Disorders

Top State-of-the-Art Paper Interventional Cardiology Atherosclerosis Atherosclerosis Heart Rhythm Disorders Cardiac Imaging

 
Novel Mutation in SCN5A Predisposes to AF.  
Mutations in SCN5A, which encodes the -subunit of the voltage-gated cardiac Na+ channels, have been associated with a variety of cardiac arrhythmias. Makiyama and colleagues studied a Japanese family with autosomal dominant hereditary atrial fibrillation (AF). Genetic analyses performed on the family revealed a novel mutation in SCN5A that was associated with AF. Further testing shows that the mutant channels display characteristics of a gain of function mutation in SCN5A that is similar to, but distinct from, the mutation in SCN5A that causes long-QT syndrome type 3. See page 1326. See figure.

	Cardiac Imaging

Top State-of-the-Art Paper Interventional Cardiology Atherosclerosis Atherosclerosis Heart Rhythm Disorders Cardiac Imaging

 
Cardiac CTA Predicts Long-Term Mortality.  
This study investigated whether cardiac computed tomographic angiography (CTA) could predict all cause mortality. Ostrom and colleagues assessed mortality during up to 12 years of follow-up in subjects referred for electron beam computed tomography (EBCT). Although the image quality for angiography using EBCT equipment is inferior to today's multidetector technology, the presence or absence of stenoses can be ascertained. CTA-diagnosed coronary artery disease was an independent predictor of mortality in a multivariable model that included cardiac risk factors and coronary artery calcium score. This study shows that CTA provides independent and incremental value for predicting mortality. See pages 1335 and 1344. See figure.

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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content Related Collections Related Articles