A Selection of Significant Papers from the Past Year as Recommended by the European Cardiolovascular Disease 2006 Advisory Panel

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Incremental cost-effectiveness of drug-eluting stents compared with a third - generation bare-metal stent in a real-world setting: randomised Basel Stent Kosten Effektivitats Trial (BASKET)

Kaiser C, Brunner-La Rocca H P, Buser P T, Bonetti P O, Osswald S, Linka A, Bernheim A, Zutter A, Zellweger M, Grize L, Pfisterer ME; BASKET Investigators

Lancet (2005);366(9489): pp. 921-929.

No prospective trial-based data are available for incremental cost-effectiveness of drug-eluting stents (DES) compared with bare-metal stents (BMS) in unselected patients, as treated in everyday practice. In a real-world setting, use of DES in all patients is less cost effective than in studies with selected patients. Use of these stents could be restricted to patients in high-risk groups.

Hypersensitivity cases associated with drug-eluting coronary stents: a review of available cases from the Research on Adverse Drug Events and Reports (RADAR) project

Nebeker J R, Virmani R, Bennett C L, et al.

J Am Coll Cardiol (2006);47(1): pp. 175-181

Six months after the approval of the first DES, the Food and Drug Administration (FDA) reported 50 hypersensitivity reactions after stent placement. We undertook the review of all available cases of hypersensitivity reactions after placement of a DES and classified potential causes. The FDA reports and autopsy findings suggest that DES may be a cause of systemic and intrastent hypersensitivity reactions that, in some cases, have been associated with late thrombosis and death.

Resistin is secreted from macrophages in atheromas and promotes atherosclerosis

Jung H S, Park K H, Cho Y M, Chung S S, Cho H J, Cho S Y, Kim S J, Kim S Y, Lee H K, Park K S

Cardiovascular Research, Volume 69, Issue 1, 1 January 2006, Pages 76-85

It was examined to discover if if resistin was secreted from macrophages locally in atheromas and if it affected vascular cell function in human. Resistin secreted from macrophages may contribute to atherogenesis by virtue of its effects on vascular endothelial cells and smooth muscle cells in humans.

Concurrent coronary and carotid artery surgery: factors in fluencing perioperative outcome and long-term results

Kolh, P H, Comte, L, Tchana-Sato, V, Honore, C, Kerzmann, A, Mauer, M and Limet, R

Eur Heart J (2006);27(1): pp. 49-56.

The assessment of risk factors for early and late outcome after concurrent carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) reviewed records from 311 consecutive patients having concurrent CEA and CABG. Concurrent CEA and CABG can be performed with acceptable operative mortality and morbidity, and good long-term freedom from coronary and neurologic events. Atheromatous aortic disease is a harbinger of poor operative and long-term outcome.

Cardiac mast cell-derived renin promotes local angiotensin formation, norephinephrine release and arrhythmias in ischaemia/reperfusion

Mackins C J, Kano S, Seyadi N, Schafer U, Reid A, Machida T, Silver R B, Levi R

JCI (2006);116: pp. 1,063-1,070.

Having identified renin in cardiac mast cells, it was assessed whether its release leads to cardiac dysfunction. Mast cell-derived renin may be a useful therapeutic target for hyperadrenergic dysfunctions, such as arrhythmias, sudden cardiac death, myocardial ischemia, and congestive heart failure.

Engineered heart tissue grafts improves the systolic and diastolic function in infarcted rat hearts

Zimmerman W H, Melnycheko I, Wasmeier G, et al.

Nature Medicine (2006);12: pp. 452-458.

The concept of regenerating diseased myocardium by implantation of tissue-engineered heart muscle is intriguing, but convincing evidence is lacking. Large, force-generating engineered heart tissue were created from neonatal rat heart cells. This study provides evidence that large contractile cardiac tissue grafts can be constructed in vitro, can survive after implantation and can support contractile function of infarcted hearts.

The use of Tissue Doppler Imaging for the assessment of changes in myocardial structure and function in inherited cardiomyopathies

De Backer J, Matthys D, Gillebert T C, De Paepe A, De Sutter J

Eur J Echocardiogr (2005);6(4): pp. 243-250

Although there is still a long way to go, our understanding of the genetic basis of cardiomyopathies has significantly improved over the past decade. The new era of cardiogenetics has raised some questions. In an attempt to address these questions, there is a need for sensitive and non-invasive screening technique. In recent years Tissue Doppler Imaging (TDI) has emerged as a well-suited technique for these purposes. This paper reviews the findings from TDI in several forms of inherited cardiomyopathy. The implementation of the technique still requires some fine-tuning, but the results of this study are hopeful and TDI is likely to be complementary to other established screening tools such as ECG and conventional echocardiography.