Circulation. 2007;115:945
(Circulation. 2007;115:945.)
© 2007 American Heart Association, Inc.
Issue Highlights
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C-REACTIVE PROTEIN AND PREDICTION OF CORONARY HEART DISEASE AND GLOBAL VASCULAR EVENTS IN THE PROSPECTIVE STUDY OF PRAVASTATIN IN THE ELDERLY AT RISK (PROSPER), by Sattar et al.
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Prospective data relating C-reactive protein (CRP) to the risk
of cardiovascular disease in the elderly are limited, with available
studies yielding conflicting results. In this issue of
Circulation,
Sattar and colleagues use data from the Prospective Study of
Pravastatin in the Elderly at Risk (PROSPER) to evaluate whether
CRP levels predict vascular events in the elderly, add to risk
prediction beyond traditional risk factors, and whether levels
correlate with the response to statin therapy. The authors report
that higher CRP was associated with increased risk of vascular
events in the PROSPER sample, but knowledge of CRP minimally
enhances cardiovascular disease prediction beyond established
risk factors as judged by the increment in the C statistic for
models with and without CRP. Moreover, CRP levels did not predict
response to statin therapy in elderly subjects at risk. These
data suggest that measurement of CRP in elderly people may have
limited clinical utility for cardiovascular disease risk stratification
or for predicting response to statin therapy. Additional studies
are warranted to confirm these observations. See p
981.
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EXPOSURE TO SECONDHAND SMOKE AND BIOMARKERS OF CARDIOVASCULAR DISEASE RISK IN NEVER-SMOKING ADULTS, by Venn and Britton
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Venn and Britton examine the association between secondhand
smoke and biomarkers of cardiovascular disease using data from
almost 8000 never-smoking adults participating in the third
National Health and Nutrition Examination Survey. The investigators
used cotinine concentrations to objectively quantify secondhand
tobacco smoke exposure. They observed that individuals with
low cotinine concentrations had significantly higher homocysteine
and fibrinogen concentrations compared with individuals with
undetectable concentrations. Of interest, the passive smoke
exposure was associated with increased biomarker concentrations
that were approximately 30% to 40% of that seen with active
smoking. Venn and Britton’s study is consistent with the
compelling growing body of literature demonstrating deleterious
effects of secondhand smoke on cardiovascular disease risk factors
and events. See p
990.
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DRUG-ELUTING STENT AND CORONARY THROMBOSIS: BIOLOGICAL MECHANISMS AND CLINICAL IMPLICATIONS, by Lüscher et al.
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Beginning with this issue, the editors of
Circulation introduce
a series of special articles devoted to the current debate about
drug-eluting stents. The report by Lüscher et al provides
an overview of the pathophysiological mechanisms and pathological
findings of stent thrombosis in drug-eluting stents. Next week,
we will continue our evaluation of this topic by framing the
issue as a Controversy in Cardiovascular Medicine, entitled
"Are Drug-Eluting Stents Associated With a Higher Rate of Late
Thrombosis than Bare Metal Stents?" Drs Patrick W. Serruys and
Joost Daemen take the position that the drug-eluting stent is
no more dangerous than the bare metal stent, while Dr Edoardo
Camenzind and colleagues suggest that patients are at greater
risk of late stent thrombosis when a drug-eluting stent is used.
Subsequently, the reader will be provided with further information
on the topic. Dr William Maisel will provide a summary of the
US Food and Drug Administration meetings held in December, as
well as provide an update for patients as part of our Cardiology
Patient Page series. Additional papers on this issue may also
be forthcoming, and we hope that you will continue to look to
Circulation as your definitive resource on the rapidly evolving
literature on drug-eluting stents. See p
1051.
Visit http://circ.ahajournals.org:
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Images in Cardiovascular Medicine
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Localized Pulmonary Edema After Blunt Chest Trauma. See p
e206.
Late Device Dislodgement After Percutaneous Closure of Mitral Prosthesis Paravalvular Leak With Amplatzer Muscular Ventricular Septal Defect Occluder. See p e208.
Westermark’s and Palla’s Signs in Acute Pulmonary Embolism. See p e211.
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Correspondence
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See p
e212.
Related Articles:
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Drug-Eluting Stent and Coronary Thrombosis: Biological Mechanisms and Clinical Implications
- Thomas F. Lüscher, Jan Steffel, Franz R. Eberli, Michael Joner, Gaku Nakazawa, Felix C. Tanner, and Renu Virmani
Circulation 2007 115: 1051-1058.
[Abstract]
[Full Text]
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Localized Pulmonary Edema After Blunt Chest Trauma
- Shougo Murakami, Michihiro Suwa, Hideaki Morita, Tomoe Murakami, Takahide Ito, Akiko Soyama, Tatsuji Kono, Yasushi Kitaura, and Takahiro Katsumata
Circulation 2007 115: e206-e207.
[Full Text]
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Late Device Dislodgement After Percutaneous Closure of Mitral Prosthesis Paravalvular Leak With Amplatzer Muscular Ventricular Septal Defect Occluder
- Gian Paolo Ussia, Salvatore Scandura, Antonio M. Calafiore, Sara Mangiafico, Rocco Meduri, Alfredo R. Galassi, and Corrado Tamburino
Circulation 2007 115: e208-e210.
[Full Text]
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Westermark’s and Palla’s Signs in Acute Pulmonary Embolism
- Shiva Sreenivasan, Sarah Bennett, and Vernon J. Parfitt
Circulation 2007 115: e211.
[Full Text]
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Letter by Calonge and Petitti Regarding Article, "The United States Preventive Services Task Force Recommendation Statement on Screening for Peripheral Arterial Disease: More Harm Than Benefit?"
- Ned Calonge and Diana Petitti
Circulation 2007 115: e212.
[Full Text]
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C-Reactive Protein and Prediction of Coronary Heart Disease and Global Vascular Events in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER)
- Naveed Sattar, Heather M. Murray, Alex McConnachie, Gerard J. Blauw, Edward L.E.M. Bollen, Brendan M. Buckley, Stuart M. Cobbe, Ian Ford, Allan Gaw, Michael Hyland, J. Wouter Jukema, Adriaan M. Kamper, Peter W. Macfarlane, Michael B. Murphy, Chris J. Packard, Ivan J. Perry, David J. Stott, Brian J. Sweeney, Cillian Twomey, Rudi G.J. Westendorp, James Shepherd for the PROSPER Study Group
Circulation 2007 115: 981-989.
[Abstract]
[Full Text]
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Exposure to Secondhand Smoke and Biomarkers of Cardiovascular Disease Risk in Never-Smoking Adults
- Andrea Venn and John Britton
Circulation 2007 115: 990-995.
[Abstract]
[Full Text]
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