August 2008

A 10-year-old girl was brought to her primary care provider by her mother because she complained of chest pain earlier that morning. She also reported abdominal pain and nausea.

SORT OUT II trial results support our current understanding of drug-eluting stent use: (1) there is no difference in efficacy or safety among different drug-eluting stents; (2) stent thrombosis rates are highest in the first month after stent implantation; and (3) late stent thrombosis rates are low and not influenced by discontinuation of clopidogrel therapy at 12 months.

The SORT OUT II trial showed that the first generation of drug-eluting stents, Cypher® and Taxus®, exhibit similar efficacy and safety when used for percutaneous coronary intervention in everyday practice, including in a high proportion of off-label situations.

Atrial fibrillation affects over 2.2 million Americans and is estimated to affect up to 10 million by 2050.

We have seen a dramatic increase in use of ICDs along with expanded indications for these devices.

The benefits of implantable cardioverter-defibrillators (ICDs) have been shown in randomized clinical trials. The factors that affect the risk–benefit ratio in a community setting, however, have not been evaluated.

According to the World Health Organization,about 30% of deaths worldwide result from cardiovascular diseases, many of which may be preventable by modifying or treating risk factors, such as unhealthy diet, smoking, and diabetes.

Cardiovascular risk factors vary somewhat for each specific atherosclerotic cardiovascular disease event; however, there is sufficient commonality to enable crafting of a global CVD risk-assessment instrument that accurately predicts total CVD risk and the risk of its individual components.

While most patients are concerned about their risk for myocardial infarction, it is important to remember that the risk factors for death from all cardiovascular diseases, including stroke, peripheral arterial disease, and coronary artery disease, are similar.