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(Circulation. 2004;110:2277.)
© 2004 American Heart Association, Inc.
Issue Highlights |
SELECTING PATIENTS WITH ATRIAL FIBRILLATION FOR ANTICOAGULATION: STROKE RISK STRATIFICATION IN PATIENTS TAKING ASPIRIN, by Gage et al.
Quantifying a patient’s precise risk of ischemic stroke in atrial fibrillation is important for determining whether he or she would have a greater benefit from warfarin or aspirin. Gage and colleagues studied data from >2500 participants with nonvalvular atrial fibrillation who were entered into one of 6 large multicenter trials and determined the predictive accuracy of 5 distinct stroke risk stratification schemes. They found that all of the methods stratified the risk of stroke better than chance but that they varied widely in the number of patients who were identified as being at low or high risk. Although all of the schemes adequately identified the low-risk patients, success was variable for identification of the high-risk schemes. The authors conclude that a patient’s risk of stroke can be reliably identified and that this can guide the choice of antithrombotic agent. See p 2287.
STATIN-INDUCED CHOLESTEROL LOWERING AND PLAQUE REGRESSION AFTER 6 MONTHS OF MAGNETIC RESONANCE IMAGING–MONITORED THERAPY, by Lima et al.
In vivo monitoring of atherosclerosis regression has been challenging, as invasive imaging methods often have been used in the past. More recently, it has been demonstrated that magnetic resonance imaging can depict plaque area and volume, quantify lumen area, and allow an interrogation of plaque components. In this issue of Circulation, Lima and colleagues use a novel magnetic resonance technique combining standard magnetic resonance with an esophageal probe to obtain high-resolution images of the aortic wall and lumen. They demonstrate that plaque regression can be seen with 6 months of statin therapy and that the magnitude of plaque regression is related to the change in LDL cholesterol. This technique will enhance the ability to study the vascular changes that occur with aggressive lipid-lowering therapy and to delineate their time course. See p 2336.
ASSOCIATIONS OF PARENTAL, BIRTH, AND EARLY LIFE CHARACTERISTICS WITH SYSTOLIC BLOOD PRESSURE AT AGE 5: FINDINGS FROM THE MATER-UNIVERSITY STUDY OF PREGNANCY AND ITS OUTCOMES, by Lawlor et al.
Childhood blood pressure is likely to influence adult blood pressure and cardiovascular disease risk. In a cohort of 3864 children followed up prospectively from their mother’s first antenatal assessment to age 5 years, Lawlor and colleagues have shown that important determinants of blood pressure at age 5 years include body mass index of all family members, maternal age, maternal smoking during pregnancy, breastfeeding, and birth order. Because childhood blood pressure tracks into adulthood, interventions aimed at early-life risk factors, such as cessation of smoking during pregnancy and breastfeeding for at least 6 months, may be important for lowering blood pressure in the population and thus reducing cardiovascular disease risk. See p 2417.
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Cardiology Patient Page
Prevention of Deep Vein Thrombosis and Pulmonary Embolism. See p e445.
Images in Cardiovascular Medicine
Thrombosis of a Coronary Artery Aneurysm in a Young Man Presenting With Acute Myocardial Infarction. See p e448.
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Hypertrophic Cardiomyopathy with Apical Aneurysm. See p e450.
Related Articles:
Circulation 2004 110: 2417-2423.
Circulation 2004 110: 2336-2341.
Circulation 2004 110: 2287-2292.
Circulation 2004 110: e445-e447.
Circulation 2004 110: e448-e449.
Circulation 2004 110: e450.
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