INSIDE THIS ISSUE OF JACC
Inside This Issue of JACC
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Interventional Cardiology
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Comparing the Re-Endothelialization Rates Among Different DES.
The purpose of this study was to assess trends in stent coverage with endothelium and recovery among leading polymer-based drug-eluting stents (DES). Rabbits received sirolimus- , paclitaxel- , zotarolimus- , or everolimus-eluting stents (EES) or a bare-metal stent (BMS). Endothelial coverage above and between struts was measured by morphometric analysis at 14 and 28 days using scanning electron microscopy and immunolabeling. After 14 days, the EES and BMS had more coverage of stent struts than the other DES; differences had largely resolved by 28 days. These results suggest potential disparities in arterial healing among leading DES. See page 333. See figure.
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Myocardial Infarction
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Patients With OSA More Likely to Suffer Nocturnal MIs.
Sert Kuniyoshi and colleagues studied 92 patients with myocardial infarction (MI), for whom the time of onset of chest pain was clearly identified. All patients underwent overnight polysomnography for obstructive sleep apnea (OSA). The odds of having OSA in those patients whose MI occurred between 12 AM and 6 AM was 6-fold higher than in the remaining 18 h of the day; those patients without OSA were most likely to suffer an MI between 6 AM and 12 PM. These findings suggest that OSA may be a trigger for MI and that patients having nocturnal onset of MI should be evaluated for OSA. See page 343. See figure.
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Heart Failure
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Nomogram Predicts In-Hosptial Mortality for Patients With CHF.
Abraham and colleagues used data collected from nearly 50,000 patients hospitalized for heart failure (HF) to identify risk factors for in-hospital death. Multivariable predictors of mortality on admission included age, heart rate, systolic blood pressure, serum sodium, serum creatinine, HF as the primary cause of hospitalization, and the presence/absence of systolic dysfunction. A scoring system was then developed using these 7 attributes that proved to be helpful in predicting mortality in other datasets. This nomogram is now available and should be helpful in identifying patients who may benefit from aggressive monitoring and intervention. See page 347.
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Cardiac Imaging
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CTA Screening Detects CAD in 22% of Asymptomatic Adults.
Choi and colleagues analyzed the results of computed tomography angiography (CTA) of 1,000 consecutively studied asymptomatic adults (age  50 years, 63% men) who were followed for a mean of 17 months. Atherosclerotic plaques were identified in 22% (4% soft plaque); diameter stenosis was >50% in 5% and >75% in 2% of patients (classified as low risk by the National Cholesterol Education Program [NCEP] in 25%). Cardiac events occurred in 15 patients during follow-up, and only in those with coronary artery disease (CAD) on CTA. Most events were revascularization. CTA can detect occult CAD stenoses in asymptomatic subjects, some of whom are classified as NCEP low risk. Given the radiation exposure and contrast load, the risk/benefit remains to be defined. See page 357. See figure.
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Genetics/Genomics
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2 Gene Variations Associated with Atherosclerosis.
In this issue, there are 2 studies that investigated the role of genetic variants in the susceptibility and/or progression of cardiovascular disease. In the first study, Stene and colleagues report that variants of functional promoter for the zinc finger protein 202 are associated with ischemic heart disease and with reduced transcriptional activity of the gene. In the second study, Ye and colleagues report the impact of variants in chromosome 9p21, which were associated with the presence or progression of atherosclerosis using serial carotid ultrasound imaging. An accompanying editorial addresses the use of gene-association studies to identify risk factors and potential targets for heart disease. See pages 369, 378, and
385.
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Endothelial Cell Recovery Between Comparator Polymer-Based Drug-Eluting Stents
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Predictors of In-Hospital Mortality in Patients Hospitalized for Heart Failure: Insights From the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF)
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Coronary Computed Tomography Angiography as a Screening Tool for the Detection of Occult Coronary Artery Disease in Asymptomatic Individuals
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Functional Promoter Variant in Zinc Finger Protein 202 Predicts Severe Atherosclerosis and Ischemic Heart Disease
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Gaining Insights in Coronary Disease Genomics
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Interventional Cardiology
Myocardial Infarction
