As we march into the third issue of the journal's seventh year, we are proud to present a variety of diverse topics in interventional cardiology and vascular biology. For the last couple of years, we've been busy comparing the two approved drug-eluting stents for marketing, Cypher and Taxus. This became an ongoing debate since the industry presented studies in which they ‘cherry-picked’ data to support a stand for superiority for their particular stent. This debate has yet to be resolved; however, in my opinion, there are more important issues related to drug-eluting stents. With the dissemination of this technology across the world, we face a new reality that is less rosy than originally predicted. For example, late restenosis is occurring, and even more worrisome are the late thrombosis rates, which continue to be seen 3 and 4 years following stent implantation. This may be a wake-up call to investigators to further explore how this phenomenon can be prevented, either by designing a safer drug-eluting stent, limiting the use of these stents to patients who are at risk for restenosis, or finding antiplatelet therapy agents and regimens. You will find interesting manuscripts on these topics and more both here and in upcoming issues of Cardiovascular Revascularization Medicine.
This issue's clinical original article by Chu et al. aims to assess the safety and clinical outcomes of bivalirudin versus unfractionated heparin in patients undergoing percutaneous coronary intervention for acute myocardial infarction. In their cell therapy submission, Goodchild et al. aim to determine the potential adverse consequences of intracardiac injections of bone marrow mononuclear cells to facilitate the revascularization of an ischemic myocardium.
Four papers make up our review section. The first, by Yogaratnam et al., suggests the possible role for hyperbaric oxygen as a new drug in the arena of myocardial revascularization and cellular protection. Yan et al. aim to review the risk of drug-eluting stent thrombosis and the risk of bleeding associated with prolonged dual antiplatelet therapy. Next, Corbett et al. critically appraise the comparative data of Cypher and Taxus drug-eluting stents and examine whether the question of superiority of one stent over the other has truly been answered. Houtgraaf et al. suggest that their review be regarded as an introduction to knowledge on DNA damage, DNA damage checkpoints, and DNA repair, which has accumulated over the past 30 years.
In the first of our two vascular biology submissions, Koren et al. aim to examine the rate of transduction of primary human endothelial cells using a Gibbon ape leukemia virus pseudo-typed retroviral vector and the ability of genetically engineered cells to cover the stent surface and to secrete vascular endothelial growth factor after seeding. Then, Waksman et al. aim to test the efficacy of oral everolimus administration at a low dose for 4 weeks versus at a high dose for 7 days in inhibiting in-stent neointimal growth in rabbit iliac arteries.
Four case reports are also included in this issue. In his article, Wilson describes an approach using high-pressure inflation with a cutting balloon inside a drug-eluting stent to overcome stent underexpansion resulting from ‘napkin ring’ calcification. Movahed et al. then present a case of intermittent cessation of blood flow through stent struts during systole, with normal flow during diastole, in a previously stented ostial vein graft. Next, Ahmar et al. describe the case of a 59-year-old male with a history of tetralogy of Fallot who was noted on a full heart study to have residual Potts shunt, while Dursun et al. discuss the case of a 63-year-old man who was admitted with effort-induced angina, bradycardia, and left ventricular hypertrophy on electrocardiogram.
In our image of the issue, Rigatelli et al. present a 54-year-old man with a history of Willis polygon ectasia and previous transitory ischemic attacks who was referred for an acute inferior myocardial infarction 6 h after symptom onset.
As you may have noticed, we have increased the number of case reports appearing in the journal. It is our intention to publish a selection of these reports on the premier website (www.crtonline.org), in partnership with our journal.
Finally, I would like to thank the coeditors, reviewers, and contributors for their support, which always helps to improve the journal's contents.
FULL TEXT