Circulation. 2007;116:2359
doi: 10.1161/CIRCULATIONAHA.107.187679
(Circulation. 2007;116:2359.)
© 2007 American Heart Association, Inc.
Issue Highlights
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THE COMMON LONG-QT SYNDROME MUTATION KCNQ1/A341V CAUSES UNUSUALLY SEVERE CLINICAL MANIFESTATIONS IN PATIENTS WITH DIFFERENT ETHNIC BACKGROUNDS: TOWARD A MUTATION-SPECIFIC RISK STRATIFICATION, by Crotti et al.
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Congenital long-QT syndrome is due to mutations in ion channel–encoding
genes, leading to variable clinical phenotypes of arrhythmias,
syncope, and vulnerability to sudden death. In this issue of
Circulation, Crotti and colleagues describe findings of a particularly
severe clinical presentation in patients with a relatively common
mutation in
KCNQ1. Patients with this particular mutation were
much more likely to have a longer QTc and experience cardiac
events, including sudden cardiac death, at earlier ages in childhood
as compared with other long-QT syndrome patients with different
mutations on the
KCNQ1 gene. This mutational "hot spot" causes
a more malignant phenotype, regardless of ethnic background,
even when patients were treated with β-blocker medications.
These data suggest a potential role of mutation-specific risk
stratification and therapeutic approaches. See p
2366.
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SOCIOECONOMIC POSITION, RACE/ETHNICITY, AND INFLAMMATION IN THE MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS, by Ranjit et al.
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Epidemiology studies have documented a higher prevalence of
cardiovascular disease among populations with lower socioeconomic
status. Many studies have investigated the underlying causes
of this association, but some researchers have wondered if inflammation
is the common biological process by which multiple behavioral
and psychosocial factors mediate this increased risk. Making
use of data from Multi-Ethnic Study of Atherosclerosis (MESA),
which includes a large and diverse US cohort of adults 45 to
84 years of age, Ranjit and colleagues evaluated the associations
of household income and education with various markers of inflammation.
Moreover, they determined whether the relationships were affected
by adjustment for infection, medication use, psychosocial factors,
behaviors, adiposity, and diabetes. The research has the potential
to identify the most important factors that are potentially
responsible for elevated markers of inflammation among individuals
with low socioeconomic status and thus with increased risk of
cardiovascular disease. See p
2383.
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OUTCOMES OF STENT THROMBOSIS AND RESTENOSIS DURING EXTENDED FOLLOW-UP OF PATIENTS TREATED WITH BARE-METAL CORONARY STENTS, by Doyle et al.
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Stent thrombosis (ST) is an infrequent but serious complication
of stent placement. ST occurs primarily within the first 30
days after implantation with both bare metal and drug-eluting
stents, whereas late and very late ST has been reported to be
increased with the use of drug-eluting stents. The incidence
and outcome of late and very late ST with bare metal stents,
however, have been inadequately studied. In this single center
study, 4503 consecutive patients treated with a bare metal stents
were followed for up to 10 years. The incidence of ST was 0.5%
at 30 days, 0.8% at 1 year, and 2% at 10 years. Off-label use
increased the incidence of ST. The mortality rate was markedly
increased with late and very late ST. The 10-year incidence
of clinical restenosis was 18%, and 2.1% presented with a myocardial
infarction. This study demonstrates that the incidences of ST
and myocardial infarction associated with restenosis are not
infrequent with bare metal stents during extended follow-up
and are associated with an increase in mortality rate. See p
2391.
Visit http://circ.ahajournals.org
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Images in Cardiovascular Medicine
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Corkscrew Collaterals in Thromboangitis Obliterans (Buerger’s
Disease). See p
e539.
Cardiac Magnetic Resonance Imaging of a Coronary Sinus Diverticulum Associated With Congenital Heart Disease. See p e541.
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Correspondence.
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See p
e545.
Related Articles:
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Socioeconomic Position, Race/Ethnicity, and Inflammation in the Multi-Ethnic Study of Atherosclerosis
- Nalini Ranjit, Ana V. Diez-Roux, Steven Shea, Mary Cushman, Hanyu Ni, and Teresa Seeman
Circulation 2007 116: 2383-2390.
[Abstract]
[Full Text]
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Corkscrew Collaterals in Thromboangitis Obliterans (Buerger’s Disease)
- Yuichi Fujii, Kenji Nishioka, Masao Yoshizumi, Kazuaki Chayama, and Yukihito Higashi
Circulation 2007 116: e539-e540.
[Full Text]
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Cardiac Magnetic Resonance Imaging of a Coronary Sinus Diverticulum Associated With Congenital Heart Disease
- Edythe B.C. Tham, David B. Ross, Michael Giuffre, Jeffrey Smallhorn, and Michelle L. Noga
Circulation 2007 116: e541-e544.
[Full Text]
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Letter by Golledge Regarding Article, "Sustained Benefit at 2 Years of Primary Femoropopliteal Stenting Compared With Balloon Angioplasty With Optional Stenting"
- Jonathan Golledge
Circulation 2007 116: e545.
[Full Text]
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Outcomes of Stent Thrombosis and Restenosis During Extended Follow-Up of Patients Treated With Bare-Metal Coronary Stents
- Brendan Doyle, Charanjit S. Rihal, Crochan J. O’Sullivan, Ryan J. Lennon, Heather J. Wiste, Malcolm Bell, John Bresnahan, and David R. Holmes, Jr
Circulation 2007 116: 2391-2398.
[Abstract]
[Full Text]
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The Common Long-QT Syndrome Mutation KCNQ1/A341V Causes Unusually Severe Clinical Manifestations in Patients With Different Ethnic Backgrounds: Toward a Mutation-Specific Risk Stratification
- Lia Crotti, Carla Spazzolini, Peter J. Schwartz, Wataru Shimizu, Isabelle Denjoy, Eric Schulze-Bahr, Elena V. Zaklyazminskaya, Heikki Swan, Michael J. Ackerman, Arthur J. Moss, Arthur A.M. Wilde, Minoru Horie, Paul A. Brink, Roberto Insolia, Gaetano M. De Ferrari, and Gabriele Crimi
Circulation 2007 116: 2366-2375.
[Abstract]
[Full Text]
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THE COMMON LONG-QT SYNDROME...
SOCIOECONOMIC POSITION,...