Circulation. 2007;115:1333
doi: 10.1161/CIRCULATIONAHA.107.182496
(Circulation. 2007;115:1333.)
© 2007 American Heart Association, Inc.
Issue Highlights
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ASSOCIATION OF PLASMA NATRIURETIC PEPTIDE LEVELS WITH METABOLIC RISK FACTORS IN AMBULATORY INDIVIDUALS, by Wang et al.
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The metabolic syndrome, comprising obesity, glucose intolerance,
dyslipidemia, hypertension, and insulin resistance, is associated
with a high risk of cardiovascular disease. Several studies
have shown that obesity is associated with low levels of B-type
natriuretic peptides (BNP), which, in turn, have been shown
to be an adverse risk factor in a number of cardiac conditions.
In this issue of
Circulation, Wang and colleagues show, in 3333
Framingham subjects without heart failure, that BNP levels were
inversely associated with all components of the metabolic syndrome
except hypertension. Although these data cannot determine which
came first, the low BNP or the metabolic syndrome, the authors
suggest that low BNP levels could predispose to insulin resistance
and affect lipid and fatty acid metabolism as well as increase
inflammation. They also raise the possibility that metabolic
traits should be taken into account when interpreting BNP levels.
See p
1345.
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SIX-MONTH OUTCOME OF EMERGENCY PERCUTANEOUS CORONARY INTERVENTION IN RESUSCITATED PATIENTS AFTER CARDIAC ARREST COMPLICATING ST-ELEVATION MYOCARDIAL INFARCTION, by Garot et al.
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The role of percutaneous coronary intervention in patients who
are resuscitated from cardiac arrest following an acute ST-elevation
myocardial infarction is unclear, and the outcome of these patients
is poorly defined. The study by Garot et al retrospectively
collected the data from 186 consecutive patients undergoing
emergency percutaneous coronary intervention after resuscitated
cardiac arrest complicating acute myocardial infarction from
5 centers. Most of the patients were resuscitated out of the
hospital by mobile medical care units. Shock was present on
admission in 52%. Percutaneous coronary intervention was successful
in 87% of the patients. Six-month survival rate was 54%. The
multivariable predictors of survival were a short duration between
the onset of arrest and the arrival of the first responder and
the return of spontaneous circulation and the absence of diabetes.
The study supports the use of early revascularization in these
patients and reaffirms the importance of prehospital management
and early resuscitation. See p
1354.
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GLUCOSE LEVELS PREDICT HOSPITALIZATION FOR CONGESTIVE HEART FAILURE IN PATIENTS AT HIGH CARDIOVASCULAR RISK, by Held et al.
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The augmented risk of major adverse cardiovascular events in
patients with diabetes mellitus is consistent across epidemiological
and clinical trial databases. Held and colleagues explored the
baseline testing glucose levels of over 30 000 patients in the
ONTARGET (Ongoing Telmisartan Alone and in Combination With
Ramipril Global Endpoint Trial) and TRANSCEND (Telmisartan Randomized
Assessment Study in ACE Intolerant Subjects With Cardiovascular
Disease) trials and found an association between elevated glucose
levels and risk of being hospitalized for heart failure. The
significance of this association persisted after adjusting for
other risk factors, including the diagnosis of diabetes. Petrie
and McMurray underscore the novel data of an association with
dysglycemia and heart failure risk in patients not characterized
as having diabetes in their accompanying editorial. See p 1371
(editorial on p
1334).
Visit http://circ.ahajournals.org:
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Images in Cardiovascular Medicine
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Multiphoton Microscopy for 3-Dimensional Imaging of Lymphocyte
Recruitment Into Apolipoprotein-E–Deficient Mouse Carotid
Artery. See p
e326.
Contrast-Enhanced Echocardiography in Spindle Cell Sarcoma of the Pericardium. See p e329.
Precordial Thump in the Catheterization Laboratory: Experimental Evidence for Commotio Cordis. See p e332.
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Correspondence
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See p
e333.
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