Jun-04

Dear Readers, This issue of The Journal of Invasive Cardiology includes original research articles, case reports, case reports with brief literature reviews, and articles from the journal’s special sections “Electrophysiology Corner,” “Clinical Decision Making” and “Clinical Images.” In the first original research article, Dr. Christian Witzke and associates from the Cardiac Catheterization Laboratory at the Massachusetts General Hospital in Boston, Massachusetts, present their analysis of the changing pattern of coronary perforation in the era of new coronary devices, indicating that the rate continues to be low but is most often associated with debulking devices. They also offer valuable insights into the management of patients who develop perforation. Drs. Antonio Colombo and Goran Stankovic have provided a commentary to accompany the Witzke et al. article. In the second original research article, Dr. Vishal Gupta and colleagues from the Department of Cardiology at Michigan State University and Borgess Heart Institute in Kalamazoo, Michigan, report on their study comparing the rate of subacute thrombosis between patients receiving drug-eluting stents versus those receiving standard, bare metal stents. They observed much less subacute thrombosis in the heparin-coated stent group compared to the bare metal stent group. In the next original research article Dr. Brett Faulknier and colleagues from the West Virginia University and Charleston Area Medical Center in Charleston, West Virginia, present an evaluation of the effect of IVUS-guided stent employment on 6-month clinical and angiographic outcomes. They concluded that IVUS-guided stent placement did not offer any advantage over non-IVUS placement. In the next original research article, Dr. Mark Eisenberg from the Jewish General Hospital in Montreal, Quebec, Canada, and associates from multiple centers representing the investigators of the Routine versus Selective Exercise Treadmill Testing after Angioplasty (ROSETTA) study, present the results of this multicenter evaluation of routine functional testing after coronary angioplasty. Their study showed that patients undergoing routine functional testing had fewer follow-up clinical events, due either to early identification and treatment or to clinical differences between those who are referred for routine versus selective functional testing. Dr. Howard Cohen of the editorial board has provided a commentary to accompany the ROSETTA study article. The final original research article submitted by Dr. Dominick Angiolillo and collaborators from the Interventional Cardiology Unit and Cardiovascular Institute at San Carlos University Hospital in Madrid, Spain, research is presented comparing the use of a 300 mg clopidogrel loading dose at the time of intervention versus pre-treatment 48 hours prior to stenting in inhibiting platelet function after coronary stenting. They found that platelet inhibition at baseline and 4 hours post-stenting were significantly more effective in the pre-treatment group, but at 24 hours, the groups were equivalent, suggesting that a higher loading dose used at the time of stenting is warranted. This issue of the Journal also includes case reports and case reports with brief reviews of the literature. In the first case report, Dr. James Orford and colleagues from the Mayo Clinic in Rochester, Minnesota, present a rare yet serious complication of alveolar hemorrhage associated with eptifibatide use. Next, Dr. Colombo and colleagues from the Cardiology Department at the Luigi Sacco Hospital in Milan, Italy, present a case providing angiographic demonstration of resolution of a thrombus using eptifibatide in a patient presenting with acute coronary syndrome. In the final case report, Drs. Rajbir Sangha and Peter Hui, from the Department of Cardiology at the California Pacific Medical Center in San Francisco, California, present their evaluation and successful treatment of a patient who developed occlusion of the circumflex artery following mitral valve replacement. In the first case report with brief review, Dr. Umesh Arora and colleagues from the University of South Florida in Tampa and the Baylor College of Medicine in Houston, discuss their approach in using multivessel PCI with bivalirudin in a patient with severe hemophilia A. Drs. Moukarbel and Alam from the Division of Cardiology and the Department of Medicine at the American University of Beirut in Beirut, Lebanon, present a patient who had spontaneous coronary artery dissection that was successfully treated by coronary stenting. In the last case report with brief literature review, Drs. Marcus St. John and Alan Heldman from the Johns Hopkins Hospital, describe a successful approach for preventing thrombosis during the treatment of saphenous vein grafts utilizing distal protection, thrombectomy and adenosine prior to reperfusion. This issue of the Journal also includes selections from three of the special journal sections. In the first special section, “Clinical Decision Making,” edited by Dr. Michael Sketch from Duke University, Dr. Sketch has selected a case from Dr. Mario Zanchetta and colleagues from the Department of Cardiovascular Disease, Cittadella General Hospital in Padua, Italy, presenting the question of whether posterior fossa lesions can be a place for preventive patent foramen ovale transcatheter closure. A number of perspectives concerning this approach are provided from Dr. Steven Goldberg, Drs. John Young and Joseph Choo, and Drs. Ashraf Nagm and P. Syamasundar Rao. In the next special section, “Clinical Images,” edited by Dr. David Rizik from Scottsdale Heart Group at Scottsdale Healthcare Hospital in Scottsdale, Arizona, Dr. Muhammad Mustafa, from Newark Beth Israel Medical Center, presents a case and images with hypertrophic obstructive cardiomyopathy. In the last special journal section, the “Electrophysiology Corner,” edited by Dr. Todd Cohen of the Department of Cardiology at Winthrop-University Hospital in Mineola, New York, Dr. Stelios Paraskevaidis and colleagues from the Ahepa University Hospital in Thessaloniki, Greece, present a case illustrating inappropriate ICD therapy from electrical interference due to external alternating current leakage. It is my hope that the articles in this issue of the Journal provide cardiovascular specialists with new perspectives to solve the issues they face in the daily management of patients with cardiovascular disease.