Editor`s Message (June 2003)

Dear Readers, This issue of the Journal of Invasive Cardiology includes original research articles, expert commentary, case reports, a CME offering, and an article from the Journal special section called “The Electrophysiology Corner”. The first two original articles explore the problem of contrast-induced nephropathy. In the first article, submitted by Dr. Vitor Gomes and colleagues from the Department of Cardiology and Nephrology at the Hospital Sao Lucas, Pontificia Universidade Catolica in Porto Alegre, Brazil, the authors provide a comprehensive review highlighting the current understanding of the pathogenesis and treatment of contrast-medium-induced nephropathy. In the second original research article, Dr. George Tadros and associates from the Departments of Cardiology, Internal Medicine and Clinical Research at the Geisinger Medical Center in Danville, Pennsylvania present their research using N-acetylcysteine to prevent acute renal dysfunction in patients undergoing coronary angiography. The researchers demonstrated that N-acetylcysteine was effective in preventing renal dysfunction, especially in patients who had a baseline creatinine greater than 2 mg/dl. Dr. Joseph Carver, a member of the editorial board from the Abramson Cancer Research at the University of Pennsylvania Cancer Center in Philadelphia, Pennsylvania has provided a commentary, providing further guidance in deciding what approach to take in preventing contrast-induced nephropathy. Drs. Fernando Boccalandro and H. Vernon Anderson from the University of Texas Health Science Center in Houston Texas provide an additional commentary about this dangerous complication that has become increasingly frequent as the treatment population ages. In the third original research article, Dr. Mahmoud Suleiman and collaborators from the Division of Invasive Cardiology at the Rambam Medical Center and the Technion-Israel Institute of Technology in Haifa, Israel present their study comparing eptifibatide and abciximab in patients undergoing percutaneous coronary interventions. They found that the 2 groups had similar rates of in-hospital major adverse events, but reported that the abciximab patients were more likely to develop thrombocytopenia. Dr. Steve Goldberg of the editorial board has provided a commentary to accompany the Suleiman et al. article. He has presented a very thought-provoking article discussing the use of reduction in the elevations of cardiac enzymes as the proof of benefit for GP IIb/IIIa drugs and its relationship to the current study. In the next original research article, Dr. Christiana Schannwell and collaborators from the Clinic of Cardiology, Pneumology and Angiology at Heinrich-Heine University in Duesseldorf, Germany present their analysis of diastolic dysfunction comparing stent treatment with conventional balloon angioplasty. They found that in comparison to balloon angioplasty, stent implantation resulted in significantly better improvement in left ventricular diastolic function 48 hours after treatment. The fifth original research article, submitted by Dr. David Allie and colleagues from the Cardiovascular Institute of the South, Lafayette and Houma, Louisiana, Columbia Medical Center of Southwest Louisiana and Opelousas General Hospital in Opelousas, Louisiana, presents their research using bivalirudin as an anticoagulant in the treatment of renal and iliac arterial narrowings with percutaneous peripheral interventions. When compared to an historical control group that had received heparin, the group receiving bivalirudin had shorter sheath removal time, shorter time to ambulation and decreased length of stay. The last original research article, submitted by Dr. Ehtisham Mahmud and associates from the Division of Cardiology at the Veteran’s Administration Medical Center and the University of California, San Diego School of Medicine in San Diego, California describes their approach to identifying patients who are at low risk for periprocedural myocardial infarction following percutaneous coronary intervention. They showed that identifying selected clinical and angiographic factors following PCI can identify those patients at low risk for periprocedural myocardial infarction. This issue of the Journal also includes several interesting clinical case reports. The first case report is a multiple case report submitted by Dr. Ping-Han Lo and colleagues from the Section of Cardiology at China Medical College Hospital in Taichung, Taiwan and the Dong-A Medical College in Pusan, South Korea. They report their approach to treating patients with double-orifice mitral valve incomplete bridge-type using balloon valvuloplasty. In the next case report, Drs. Silver, Bauman and Berkovitz from the Northeast Ohio University College of Medicine in Akron, Ohio describe their approach to successfully treating a severe coronary perforation using a dual-catheter covered stent technique. The third case report, from Drs. Abu-Ful, Benharroch, and Henkin, from the Cardiology Department and Pathology Institute, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel, describes their approach to treating occurrences of total extraction of the radial artery during sheath removal. In the last case report, submitted by Drs. George Moukarbel and Habib Dakik from the Division of Cardiology and Department of Internal Medicine at the American University of Beirut in Beirut, Lebanon diffuse coronary artery spasm was induced by the introduction of a guidewire and was resolved by administration of intracoronary nitrates. An additional case report from Vimal Nanavati and his colleagues from Redding Medical Center in Redding, California completes this section with a case in which a patient who has a totally occluded right coronary artery presents with a normal electrocardiogram. In the special Journal section on electrophysiology, edited by Dr. Todd Cohen of the Department of Cardiology at Winthrop-University Hospital in Mineola, New York, Dr. Ronald Lo and associates from the Division of Cardiology and Department of Medicine at Winthrop present an unusual case presenting with third degree AV block that was due to Lyme disease. This issue of the Journal is completed with a special CME offering. In the article, Drs. Pramod Kuchulakanti, Robert Lew, and Ron Waksman from the Division of Cardiology at Wasington Hospital Center inWashington, DC, discuss edge effect as being one of the limitations of vascular brachytherapy. Edge effect is due to inadequate radiation coverage of the edges following VBT, and may be overcome by confining injury to the lesion segment and extending the radiation sources by a few millimeters from the injured segment. It is my hope that all of the articles in this issue of the Journal provide healthcare professionals with valuable information that is useful in the daily care of patients with valuable information that is useful in the daily care of patients with cardiovascular disease. Richard E. Shaw, PhD, FACC Editor-in-Chief