Circulation. 2007;115:819
(Circulation. 2007;115:819.)
© 2007 American Heart Association, Inc.
Issue Highlights
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GENDER DIFFERENCES IN HOSPITAL MORTALITY AND USE OF PERCUTANEOUS CORONARY INTERVENTION IN ACUTE MYOCARDIAL INFARCTION: MICROSIMULATION ANALYSIS OF THE 1999 NATIONWIDE FRENCH HOSPITALS DATABASE, by Milcent et al.
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Early studies that examined the relationship between gender
and mortality rates in patients with acute myocardial infarction
found that women tend to have significantly higher in-hospital
mortality rates as compared with men. This finding has been
attributed to older age at time of presentation, smaller body
habitus, and greater prevalence of comorbid disease states among
women, suggesting that women have higher-risk clinical characteristics
compared to men. Furthermore, some studies have suggested that
revascularization procedures are used less frequently in women
compared with men. At present, the relative contribution of
each of these factors to elevated mortality rates in women with
acute myocardial infarction remains unclear. In this issue of
Circulation, Milcent et al investigated these factors using
a national database in France, which includes data from 74 389
patients hospitalized with an acute myocardial infarction. The
present study suggests that after adjustment for age, women
have higher mortality and lower use of revascularization procedures
compared with men. See p 833 (editorial p
823).
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HORMONE THERAPY AND VENOUS THROMBOEMBOLISM AMONG POSTMENOPAUSAL WOMEN: IMPACT OF THE ROUTE OF ESTROGEN ADMINISTRATION AND PROGESTOGENS: THE ESTHER STUDY, by Canonico et al.
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Use of oral estrogen in postmenopausal women has been found
to increase the rate of venous and arterial thrombotic events
including venous thromboembolism. Small studies have suggested
that route of administration might alter this risk. In the current
issue of
Circulation, Canonico and colleagues report the results
of a multicenter case-control study of postmenopausal women
that oral but not transdermal estrogen is associated with an
increased risk of venous thromboembolism. They also found that
micronised progesterone was safer in terms of thrombotic risk.
These findings suggest that further investigation is warranted
to determine if hormone replacement therapy, either by a different
form or route of administration, could be safe for women in
the management of their menopausal symptoms. See p 840 (editorial
p
820).
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INFLUENCE OF HOSPITAL PROCEDURAL VOLUME ON CARE PROCESS AND MORTALITY FOR PATIENTS UNDERGOING ELECTIVE SURGERY FOR MITRAL REGURGITATION, by Gammie et al.
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Many studies are documenting that patients who undergo surgical
procedures at higher-volume centers are more likely to have
a better outcome. The present study by Gammie et al extends
that literature by investigating this relationship for patients
undergoing mitral valve surgery, making use of the Society for
Thoracic Surgeons database. The present study provides a national
perspective on the frequency of adverse events for patients
undergoing this surgery, with attention to how the rates vary
by the volume of mitral valve surgery performed at various institutions.
In addition, the authors investigate the association between
hospital volume and the likelihood that a patient will undergo
valve repair rather than replacement. The investigators document
important and concerning variation by institution type in the
patterns of care and outcomes for this patient population. See
p
881.
Visit http://circ.ahajournals.org:
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Cardiology Patient Page
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Chronic Hypertension in Pregnancy. See p
e188.
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Images in Cardiovascular Medicine
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Constrictive Pericarditis Diagnosed by Cardiac Magnetic Resonance
Imaging in a Pacemaker Patient. See p
e191.
Giant Aneurysm of the Right Atrial Appendage in a 39-Year-Old Woman. See p e194.
Apicoaortic Double-Valved Conduit in a 40-Year-Old Woman. See p e197.
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Correspondence
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See p
e200.
Related Articles:
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Are Some Types of Hormone Therapy Safer Than Others?: Lessons From the Estrogen and Thromboembolism Risk Study
- Kathryn M. Rexrode and JoAnn E. Manson
Circulation 2007 115: 820-822.
[Extract]
[Full Text]
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Gender Differences in the Treatment for Acute Myocardial Infarction: Bias or Biology?
- R. David Anderson and Carl J. Pepine
Circulation 2007 115: 823-826.
[Extract]
[Full Text]
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Chronic Hypertension in Pregnancy
- Ellen W. Seely and Cynthia Maxwell
Circulation 2007 115: e188-e190.
[Extract]
[Full Text]
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Constrictive Pericarditis Diagnosed by Cardiac Magnetic Resonance Imaging in a Pacemaker Patient
- J. Ronald Mikolich and Edward T. Martin
Circulation 2007 115: e191-e193.
[Extract]
[Full Text]
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Giant Aneurysm of the Right Atrial Appendage in a 39-Year-Old Woman
- Andrea I. Guaricci, Giuseppe Tarantini, Cristina Basso, Francesco Corbetti, Maurizio Rubino, Riccardo Ieva, Luciano Daliento, Gino Gerosa, Angelo Ramondo, Gaetano Thiene, and Sabino Iliceto
Circulation 2007 115: e194-e196.
[Extract]
[Full Text]
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Apicoaortic Double-Valved Conduit in a 40-Year-Old Woman
- Sanjay Sarin, Anwer Qureshi, and Jamshid Shirani
Circulation 2007 115: e197-e199.
[Extract]
[Full Text]
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Letter by Del-Carpio Munoz et al Regarding Article, "Masking Inferior Infarction by Anterior Myocardial Injury"
- Freddy Del-Carpio Munoz, Robert J. Myerburg, and Agustin Castellanos
Circulation 2007 115: e200.
[Extract]
[Full Text]
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Influence of Hospital Procedural Volume on Care Process and Mortality for Patients Undergoing Elective Surgery for Mitral Regurgitation
- James S. Gammie, Sean M. O’Brien, Bartley P. Griffith, T. Bruce Ferguson, and Eric D. Peterson
Circulation 2007 115: 881-887.
[Abstract]
[Full Text]
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