Circulation. 2005;112:147
(Circulation. 2005;112:147.)
© 2005 American Heart Association, Inc.
Issue Highlights
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EFFECT OF PRAVASTATIN ON RATE OF KIDNEY FUNCTION LOSS IN PEOPLE WITH OR AT RISK FOR CORONARY DISEASE, by Tonelli et al.
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Renal dysfunction is an independent risk factor for cardiovascular
disease and its associated complications. Prior studies have
suggested that lipid-lowering medications may reduce the rate
of loss of renal function. A group of investigators from three
large pravastatin studies (CARE, LIPID, and WOSCOPS) combined
their data from more than 18 thousand patients, followed up
for 5 years, either with previous coronary events or at high
risk of cardiovascular disease. In patients with moderate chronic
kidney disease, pravastatin reduced the rate of loss of renal
function by about 8% and also reduced the risk of acute renal
failure. The mechanisms of benefit are unknown but may include
the antiinflammatory effects of statins or reduction in renal
atherosclerosis. Further studies will be needed to determine
the effect of statins in patients with more severe renal dysfunction.
See p
171.
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HEREDITARY HEMOCHROMATOSIS AND RISK OF ISCHEMIC HEART DISEASE: A PROSPECTIVE STUDY AND A CASE-CONTROL STUDY, by Ellervik et al.
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The potential link between iron levels and the risk of coronary
artery disease has been termed the "iron hypothesis." Some have
speculated that the oxidation of iron produces free hydroxyl
radicals, leading to more oxidized LDL particles and subsequent
atherosclerosis. These investigators use hereditary hemochromatosis
to study the effect of iron overload on risk of ischemic heart
disease. They conducted a prospective study with long follow-up
and a case-control study to investigate the association of specific
hereditary hemochromatosis genotypes with the risk of ischemic
heart disease. They also examined the relationship of these
genotypes with oxidized LDL, transferrin saturation, and ferritin
levels. Thus, the study provides insight about the overall association
and whether it is mediated through oxidized LDL. See p
185.
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ALLOGENEIC MESENCHYMAL STEM CELL TRANSPLANTATION IN POSTINFARCTED RAT MYOCARDIUM: SHORT- AND LONG-TERM EFFECTS, by Dai et al.
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Although prior studies have demonstrated that the injection
of stem cells results in improvement in global myocardial function
after myocardial infarction, the mechanism for this beneficial
effect remains elusive. In rat hearts in which mesenchymal stem
cells were injected into the scar one week after myocardial
infarction, Dai et al compared the time courses for the improvement
in cardiac function and the expression of muscle-specific markers.
Cardiac function was improved one month after injection, at
a time when mesenchymal stem cells did not express muscle-specific
markers. In contrast, after 6 months, muscle-specific markers
were expressed, but cardiac function was no longer improved.
This study raises the possibility that improved cardiac function
in this setting is not related to contractile properties of
the implanted cells but rather may relate to a paracrine action
on preexisting myocytes. See p
214.
Visit http://www.circ.ahajournals.org:
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Clinician Update
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Management of Massive Pulmonary Embolism. See p
e28.
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Images in Cardiovascular Medicine
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Transient Occlusion of the Middle Cerebral Artery by Macroembolism
During Carotid Stenting for Traumatic Dissection of the Common
Carotid Artery. See p
e33.
Integration of 3-Dimensional Cardiac Computed Tomography Images With Real-Time Electroanatomic Mapping to Guide Catheter Ablation of Atrial Fibrillation. See p e35.
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Correspondence
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See p
e37.
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Letter Regarding Article by Adamson et al, "Continuous Autonomic Assessment in Patients With Symptomatic Heart Failure: Prognostic Value of Heart Rate Variability Measured by an Implanted Cardiac Resynchronization Device" • Response
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Circulation 2005 112: e37-e38.
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Hereditary Hemochromatosis and Risk of Ischemic Heart Disease: A Prospective Study and a Case-Control Study
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Circulation 2005 112: 185-193.
[Abstract]
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Effect of Pravastatin on Rate of Kidney Function Loss in People With or at Risk for Coronary Disease
- Marcello Tonelli, Chris Isles, Timothy Craven, Andrew Tonkin, Marc A. Pfeffer, James Shepherd, Frank M. Sacks, Curt Furberg, Stuart M. Cobbe, John Simes, Malcolm West, Chris Packard, and Gary C. Curhan
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Allogeneic Mesenchymal Stem Cell Transplantation in Postinfarcted Rat Myocardium: Short- and Long-Term Effects
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