Circulation. 2007;116:879
doi: 10.1161/CIRCULATIONAHA.107.185627
(Circulation. 2007;116:879.)
© 2007 American Heart Association, Inc.
Issue Highlights
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INDEPENDENT IMPACT OF GOUT ON MORTALITY AND RISK FOR CORONARY HEART DISEASE, by Choi and Curhan.
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Gout is the most common inflammatory arthritis in men, yet data
on the impact of gout on risk of death and cardiovascular disease
are limited. Prior studies have investigated the risks associated
with hyperuricemia but have not focused specifically on long-term
outcomes in patients with clinical gout. In this issue of
Circulation,
Choi and Curhan describe prospective data about the impact of
gout on risk of death in the >51 000 male participants of
the Health Professionals Follow-Up Study. The authors note that
over a follow-up period of 12 years, men with gout had a 28%
higher risk of death from all causes than men without prior
coronary heart disease (CHD) or gout. Among men without preexisting
CHD, the increased mortality risk was due to elevated risk of
cardiovascular disease deaths, particularly CHD deaths. These
associations were independent of established risk factors, including
age, body mass index, smoking, family history of myocardial
infarction, use of diuretics and aspirin, dietary risk factors,
diabetes, hypercholesterolemia, and hypertension. These observational
data support aggressive management of cardiovascular risk factors,
including hypertension, dyslipidemia, and lifestyle factors,
in patients with gout. See p 894 (editorial p
880).
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SERIAL ANGIOSCOPIC EVIDENCE OF INCOMPLETE NEOINTIMAL COVERAGE AFTER SIROLIMUS-ELUTING STENT IMPLANTATION: COMPARISON WITH BARE-METAL STENTS, by Awata et al.
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Neointimal coverage after implantation of drug-eluting stents
is recognized to be delayed as compared with bare-metal stents.
Serial angioscopy allows assessment of neointimal formation
and subclinical thrombosis after drug-eluting stent implantation.
In the study in this issue by Awata et al, angioscopy was performed
serially at 3.6±1.1 months, 10.5±1.5 months, and
21.2±2.2 months after implantation in 17 patients who
received a sirolimus-eluting stent (SES) and in 11 who received
a bare-metal stent (BMS). According to a grading system for
neointimal coverage (grades 0 through 3), SES had an average
grade of 1.3±0.5 at the third follow-up exam, as compared
with 3.0±0.0 for BMS. Thrombosis correlated with the
lower grade of neointimal coverage. Yellow plaques were seen
in the majority of the SES and infrequently with BMS. Little
change was noted among the 3 follow-up exams. The findings demonstrate
a significant difference in vascular healing after SES implantation
that persists up to nearly 2 years after implantation. See p
910.
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AORTIC ARCH ATHEROMA PROGRESSION AND RECURRENT VASCULAR EVENTS IN PATIENTS WITH STROKE OR TRANSIENT ISCHEMIC ATTACK, by Sen et al.
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Previous studies have demonstrated that aortic atheroma and
progression of carotid plaques each predict vascular events,
but little is known about the prognosis of aortic atheroma progression.
In a unique study, Sen and colleagues examined 125 consecutive
patients with stroke and transient ischemic attacks who agreed
to serial transesophageal echocardiograms at 1 year. In blinded
readings, the investigators observed that 28% of aortic atheroma
lesions progressed and 14% regressed. The researchers report
that aortic atheroma progression was associated with increased
patient age, neutrophil count, homocysteine concentrations,
and complex mobile plaques on the index transesophageal echocardiography.
Notably, the investigators report that progression of aortic
atheroma lesions was associated with an adjusted 4-fold increased
risk of vascular events. The study highlights the importance
of research into how to treat aortic atheroma and prevent aortic
atheroma progression. See p
928.
Visit http://circ.ahajournals.org:
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Images in Cardiovascular Medicine
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Pseudomitral Intraventricular Valve. See p
e306.
Papillary Muscle Infarction After Cardiopulmonary Resuscitation. See p e308.
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Correspondence
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See p
e310.
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Pseudomitral Intraventricular Valve
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Circulation 2007 116: e306-e307.
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Letter by Wetzels Regarding Article, "Renal Insufficiency Following Contrast Media Administration Trial (REMEDIAL): A Randomized Comparison of 3 Preventive Strategies"
- Jack F.M. Wetzels
Circulation 2007 116: e310.
[Full Text]
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Serial Angioscopic Evidence of Incomplete Neointimal Coverage After Sirolimus-Eluting Stent Implantation: Comparison With Bare-Metal Stents
- Masaki Awata, Jun-ichi Kotani, Masaaki Uematsu, Takakazu Morozumi, Tetsuya Watanabe, Toshinari Onishi, Osamu Iida, Fusako Sera, Shinsuke Nanto, Masatsugu Hori, and Seiki Nagata
Circulation 2007 116: 910-916.
[Abstract]
[Full Text]
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Aortic Arch Atheroma Progression and Recurrent Vascular Events in Patients With Stroke or Transient Ischemic Attack
- Souvik Sen, Alan Hinderliter, Pranab K. Sen, Jennifer Simmons, James Beck, Steven Offenbacher, E. Magnus Ohman, and Stephen M. Oppenheimer
Circulation 2007 116: 928-935.
[Abstract]
[Full Text]
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INDEPENDENT IMPACT OF GOUT...
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