Editor`s Message (Nov. 2004)

Dear Readers, This issue of The Journal of Invasive Cardiology, which coincides with the American Heart Association Annual Scientific Sessions, includes original research articles, case reports, reviews, and articles from the journal’s special sections, Electrophysiology Corner, Clinical Images, and a new special section titled Adjunctive Therapy, edited by Dr. Deepak Bhatt from the Cleveland Clinic. The first research article by Dr. Efthymios Deliargyris and colleagues from the Wake Forest University School of Medicine in Winston-Salem, North Carolina, features results from a non-randomized retrospective review comparing the use of abciximab and eptifibatide during PCI. Although used in a much higher-risk group of patients, outcomes with abciximab were superior compared to those achieved with eptifibatide. In the next research article, Dr. David Holmes and associates at Saint Louis University Hospital in St. Louis, Missouri, present a paper assessing the significance of a coronary pressure (dicrotic) notch distal to a coronary stenosis and its relationship to fractional flow reserve. They found that the notch was predictive of FFR greater than or equal to 0.76, indicating that it might be used as an early non-hyperemic visual indicator of the physiologic significance of a coronary artery lesion. The research article by Drs. Koyu Sakai and Masakiyo Nobuyoshi from Kokura Memorial Hospital in Kitakyushu, Japan, reports on the use of primary angioplasty of unprotected left main coronary artery disease in patients presenting with acute anterolateral myocardial infarction. This study showed that patients presenting with left main occlusions and with cardiogenic shock have poor survival, regardless of the treatment provided. Dr. On Topaz of the journal’s editorial board has provided the accompanying commentary. In the next original research article, Chi Hang Lee from the National University Hospital and collaborators from the Thoraxcenter in Rotterdam, report on the in-hospital and long-term clinical outcomes of their patients with ST-elevation myocardial infarction and the predictors of survival. They found mortality rates higher than those reported in randomized clinical trials, with age greater than 65, cardiogenic shock, cardiac arrest, and intubation related to mortality and multi-vessel disease related to adverse events. The next research article, submitted by Dr. David Ramsdale and colleagues from The Cardiothoracic Centre Liverpool, describes their study to determine the frequency of bacteremia associated with percutaneous coronary intervention procedures. They found that nearly 18% had detectable bacteremia, but saw no negative clinical sequelae. They caution clinicians to strive for maximum sterility during PCI to avoid infective complications. Dr. Marcelo Sanmartin and associates from the Hospital Meixoeiro, present their study of the vasoreactivity of the radial artery when it is used for transcatheter catheterization. Through ultrasound and drug-induced vasodilation, the researchers determined that vasoreactivity is impaired in radial arteries following catheterization, but recovers completely by 1 month after the procedure. Drs. Barman, Chui and Ellis from the Cleveland Clinic Foundation have provided a very comprehensive commentary to accompany this article. Next, Dr. Gian Battista Danzi and collaborators from the Catheterization Laboratory at the Poliambulanza Hospital in Brescia, Italy, report the multicenter analysis of six-month clinical and angiographic outcomes of the PHANTOM IV study, an evaluation of the Tecnic Carbostent^™ coronary system. Their study showed very favorable early and late results in de novo lesions. Dr. Ramazan Akdemir and colleagues from the Abant Izzet Baysal University Duzce Medical School in Bolu, Turkey, report on the findings of their study on primary angioplasty without on-site surgical back-up utilizing a mobil catheterization laboratory facility. They demonstrated that results comparable to those reported in the literature could be achieved. Dr. Ubeydullah Deligonul of the journal’s editorial board has provided a thoughtful commentary to accompany this article. Our last original article is also this month’s article for our new Adjunctive Therapy section. We are very pleased that Dr. Deepak Bhatt, Director of the Interventional Cardiology Fellowship at the Cleveland Clinic Foundation, has agreed to edit this new special section. Dr. Bhatt has provided an introductory article highlighting the importance of adjunctive therapy in the era of contemporary interventional cardiology. To commence this special section, Dr. Bhatt has included the report on in-hospital and 30-day outcomes from the APPROVE registry. This original paper is from Dr. David Allie of the Cardiovascular Institute of South in Lafayette, Louisiana, and collaborators from Genesis Heart Institute in Davenport, Iowa, William Beaumont Hospital in Royal Oak, Michigan, and the Washington Hospital Center in Washington, D.C., in which the authors report on in-hospital and 30-day outcomes from the APPROVE registry looking at the use of Angiomax in percutaneous peripheral vascular procedures. They found that Angiomax was associated with a very high success rate and low bleeding rates, indicating that it is a useful adjunct in peripheral interventions. Two of our other special sections are featured in this issue of the journal. In the first of these, Clinical Images, edited by Dr. David Rizik from Scottsdale Heart Group at Scottsdale Healthcare Hospital in Scottsdale, Arizona, Dr. Srihari Naidu and colleagues from the Hospital of the University of Pennsylvania, present an interesting set of images showing the unprotected left main “kissing” stent implantation with a percutaneous ventricular assist device in use. In the Electrophysiology Corner, edited by Dr. Todd Cohen of the Department of Cardiology at Winthrop-University Hospital in Mineola, New York, Drs. Duong, Hui and Mailhot from the Division of Cardiology at the California Pacific Medical Center in San Francisco, California, present an unusual case with acute right artery occlusion after radiofrequency catheter ablation of a posteroseptal accessory pathway that was successfully treated with balloon angioplasty. This issue of the journal also includes case reports on interesting topics, as well as case reports with brief reviews of the literature. In the first case report, Dr. Peter Engel and associates from the Ohio Heath Health Center and Lindner Center for Research and Education in Cincinnati, Ohio, describe a case of severe pulmonary hypertension which regressed during treatment with intravenous prostacyclin therapy, demonstrating that regression can occur regardless of medical therapy. In the next case, Drs. Benedict Glover and Mazhar Khan from the Royal Victoria Hospital, report on the novel use of a covered stent in the management of a left internal mammary artery-to-pulmonary vasculature fistula. In the next case, Drs. Ashish Pershad and Jon Stevenson from the Heart and Vascular Center of Arizona, present a case demonstrating distal protection of the LAD utilizing the EX Filter Wire during the treatment of an acute coronary syndrome. In the final case report, Drs. Ashar, Niccoli and Porto from John Radcliffe Hospital, present a patient with spasm of a saphenous vein graft that was successfully treated with nitrates and diltiazem both during the procedure and long-term with use of oral versions of these drugs. In the first case report with brief review, Drs. Shigenori Ito and colleagues from the Division of Cardiovascular Medicine, Toyohashi Heart Center, report three cases where they used IVUS and histological findings to determine that advanced atherosclerotic plaque-generating atheroemboli cause no-reflow in elective PCI. In the next case report, Dr. Jeffrey Lorin and colleagues from the New York University School of Medicine and VA Medical Center, describe the management of a patient with coronary artery dissection during PCI of a chronic total occlusion using the LuMend Frontrunner catheter. The patient returned seven weeks after the initial hospitalization and had successful therapy of the healed dissection. In the next report, Dr. Mariano Ledesma and associates from Hospital Star Medica Morelia in Morelia Michoacan, Mexico, collaborating with Dr. Ted Feldman from Evanston Northwestern Healthcare in Evanston, Illinois, describe their approach to an unusual case of Lutembacher syndrome which was successfully treated with balloon mitral valvuloplasty and percutaneous ASD closure. In the last case report with brief literature review, Drs. Singh, Turner and Forbes from Children’s Hospital of Michigan and Wayne State University, present a case of nickel allergy in a patient referred for transcatheter closure of secundum atrial septal defect. 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 cardiovascular disease.