May-05

Dear Readers, This issue of the Journal of Invasive Cardiology includes original research articles, case reports and case reports with brief reviews, as well as articles from the journal’s special sections Adjunctive Therapy and Interventional Pediatric Cardiology, and part 2 of discussions from the proceedings of the 8th Biennial International Andreas Gruentzig Society meeting held in January of 2004. The first research article, submitted by Dr. Bharathi Upadhya and colleagues compared outcomes between patients with prior stroke and those without stroke that were undergoing percutaneous coronary angioplasty. They found that patients with prior stroke were at higher risk for complications following PCI compared to patients without a history of stroke. In the next original article, Dr. Michael Lee and collaborators studied the effect of different dosing regimens for heparin in patients with and without diabetes. They showed that diabetics treated with a higher heparin dose had similar ACTs to non-diabetics on a lower heparin dose. Dr. Mouaz Al-Mallah and colleagues present their research on the relationship of time from admission to coronary angiography to long-term outcomes in patients presenting with non-ST-segment elevation acute coronary syndrome. They found that patients undergoing late angiography (> 2 days) had higher 3-year mortality rates compared with patients who underwent angiography earlier in their hospitalization. In the next original research article, Dr. Deepak Jain and associates present a simple classification scheme based on lesion length and reference diameter to predict differential outcome following intracoronary radiation therapy. They found that longer lesions and shorter lesions with wider reference diameters had worse in-hospital and late outcomes compared to shorter lesions with a normal reference diameters. For the last original article, we have selected a paper which is also a part of our special section of Interventional Pediatric Cardiology, edited by Dr. P. Syamasundar Rao. In this article, Dr. Mario Zanchetta and colleagues present their study of the feasibility and effectiveness of treating perforated secundum septal defects using transcatheter closure. They found that by using intracardiac echocardiography they were able to successfully guide the placement of devices and monitor therapy as it was delivered. In the first case report with review of the literature, Dr. Paul Poommipanit and colleagues describe their approach to diagnosing and treating a patient who presented with eosinophilic arteritis. In the second case report with literature review, Drs. Porto and Banning describe a patient who received a drug-eluting stent but experienced persistent in-stent restenosis that required a second, different type of drug-eluting stent to be placed. Late follow-up showed continued patency in the second stent. The first case report by Dr. Mauricio Cohen demonstrates the use of a novel renal catheter used to infuse fenoldopam through both renal arteries to successfully perform cardiac catheterization in a patient with severe heart failure. In the next case report, Dr. Angela Hoye and colleagues describe a patient who presented with total occlusion of the ostial portion of the left anterior descending artery. Using a new radiofrequency ablation wire in this patient allowed the placement of a drug-eluting stent as definitive treatment. In the last case report, Dr. Turgay Celik and colleagues present a patient who developed late thrombosis in a drug-eluting stent that occurred when the patient returned for evaluation with stress testing. The authors discuss the whether this event was precipitated by the stress test or related to inadequate placement of the initial stent. The special section, Adjunctive Therapy, edited by Dr. Deepak Bhatt, features the proceedings from a roundtable discussion led by Dr. Bhatt. The roundtable participants consider the issues involved in deciding whether to administer or to withhold clopidogrel in acute coronary syndrome patients, balancing the proven efficacy of this therapeutic approach for these patients with the increased risk of bleeding associated with surgical revascularization in the presence of this drug. Finally, this issue offers the second in a series of discussions from the 8th Biennial International Andreas Gruentzig Society meeting held in January of 2004. The discussion featured in this issue is entitled Acute Myocardial Infarction: Early Strategies to Optimize Results. We are happy to bring you these excellent articles and hope that they will offer you the timely and reliable information you require to give optimal care to your patients.