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From Studying Heart Disease and Cancer Simultaneously to Reverse Cardio-Oncology
Sanne de Wit, Rudolf A. de Boer
doi : 10.1161/CIRCULATIONAHA.120.053315
Circulation. 2021;144:93–95
Ten-Year All-Cause Death According to Completeness of Revascularization in Patients With Three-Vessel Disease or Left Main Coronary Artery Disease: Insights From the SYNTAX Extended Survival Study
Kuniaki Takahashi, Patrick W. Serruys, Chao Gao, Masafumi Ono, Rutao Wang, Daniel J.F.M. Thuijs, Michael J. Mack, Nick Curzen, Friedrich-Wilhelm Mohr, Piroze Davierwala, Milan Milojevic, Joanna J. Wykrzykowska, Robbert J. de Winter, Faisal Sharif, Yoshinobu Onuma, Stuart J. Head, Arie Pieter Kappetein, Marie-Claude Morice, David R. Holmes Jr, and on behalf of the SYNTAX Extended Survival Study Investigators
doi : 10.1161/CIRCULATIONAHA.120.046289
Circulation. 2021;144:96–109
Ten-year all-cause death according to incomplete (IR) versus complete revascularization (CR) has not been fully investigated in patients with 3-vessel disease and left main coronary artery disease undergoing percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG).
Achieving Complete Revascularization for Multivessel Coronary Artery Disease
Shamir R. Mehta
doi : 10.1161/CIRCULATIONAHA.120.050379
Circulation. 2021;144:110–112
Late Outcomes of the RAPID-TnT Randomized Controlled Trial: 0/1-Hour High-Sensitivity Troponin T Protocol in Suspected ACS
Kristina Lambrakis, Cynthia Papendick, John K. French, Stephen Quinn, Andrew Blyth, Anil Seshadri, Michael J.R. Edmonds, Anthony Chuang, Ehsan Khan, Adam J. Nelson, Deborah Wright, Matthew Horsfall, Erin Morton, Jonathan Karnon, Tom Briffa, Louise A. Cullen, Derek P. Chew
doi : 10.1161/CIRCULATIONAHA.121.055009
Circulation. 2021;144:113–125
High-sensitivity troponin assays are increasingly being adopted to expedite evaluation of patients with suspected acute coronary syndromes. Few direct comparisons have examined whether the enhanced performance of these assays at low concentrations leads to changes in care that improves longer-term outcomes. This study evaluated late outcomes of participants managed under an unmasked 0/1-hour high-sensitivity cardiac troponin T (hs-cTnT) protocol compared with a 0/3-hour masked hs-cTnT protocol.
Fibroblast-Specific Proteotranscriptomes Reveal Distinct Fibrotic Signatures of Human Sinoatrial Node in Nonfailing and Failing Hearts
Anuradha Kalyanasundaram, Ning Li, Miranda L. Gardner, Esthela J. Artiga, Brian J. Hansen, Amy Webb, Michael A. Freitas, Maciej Pietrzak, Bryan A. Whitson, Nahush A. Mokadam, Paul M.L. Janssen, Peter J. Mohler, Vadim V. Fedorov
doi : 10.1161/CIRCULATIONAHA.120.051583
Circulation. 2021;144:126–143
Up to 50% of the adult human sinoatrial node (SAN) is composed of dense connective tissue. Cardiac diseases including heart failure (HF) may increase fibrosis within the SAN pacemaker complex, leading to impaired automaticity and conduction of electric activity to the atria. Unlike the role of cardiac fibroblasts in pathologic fibrotic remodeling and tissue repair, nothing is known about fibroblasts that maintain the inherently fibrotic SAN environment.
Salt Transiently Inhibits Mitochondrial Energetics in Mononuclear Phagocytes
Sabrina Geisberger, Hendrik Bartolomaeus, Patrick Neubert, Ralf Willebrand, Christin Zasada, Thomas Bartolomaeus, Victoria McParland, Dries Swinnen, Anneleen Geuzens, Andr?s Maifeld, Luka Krampert, Marion Vogl, Anja M?hler, Nicola Wilck, Lajos Mark?, Ekin Tilic, Sofia K. Forslund, Katrina J. Binger, Johannes Stegbauer, Ralf Dechend, Markus Kleinewietfeld, Jonathan Jantsch, Stefan Kempa, Dominik N. Müller
doi : 10.1161/CIRCULATIONAHA.120.052788
Circulation. 2021;144:144–158
Dietary high salt (HS) is a leading risk factor for mortality and morbidity. Serum sodium transiently increases postprandially but can also accumulate at sites of inflammation affecting differentiation and function of innate and adaptive immune cells. Here, we focus on how changes in extracellular sodium, mimicking alterations in the circulation and tissues, affect the early metabolic, transcriptional, and functional adaption of human and murine mononuclear phagocytes.
A Call to Action for New Global Approaches to Cardiovascular Disease Drug Solutions
Gemma A. Figtree, Keith Broadfoot, Barbara Casadei, Robert Califf, Filippo Crea, Grant R. Drummond, Jane E. Freedman, Tomasz J. Guzik, David Harrison, Derek J. Hausenloy, Joseph A. Hill, James L. Januzzi, Bronwyn A. Kingwell, Carolyn S.P. Lam, Calum A. MacRae, Frank Misselwitz, Tetsuji Miura, Rebecca H. Ritchie, Maciej Tomaszewski, Joseph C. Wu, Junjie Xiao, Faiez Zannad
doi : 10.1161/CIR.0000000000000981
Circulation. 2021;144:159–169
While we continue to wrestle with the immense challenge of implementing equitable access to established evidence-based treatments, substantial gaps remain in our pharmacotherapy armament for common forms of cardiovascular disease including coronary and peripheral arterial disease, heart failure, hypertension, and arrhythmia. We need to continue to invest in the development of new approaches for the discovery, rigorous assessment, and implementation of new therapies. Currently, the time and cost to progress from lead compound/product identification to the clinic, and the success rate in getting there reduces the incentive for industry to invest, despite the enormous burden of disease and potential size of market. There are tremendous opportunities with improved phenotyping of patients currently batched together in syndromic “buckets.” Use of advanced imaging and molecular markers may allow stratification of patients in a manner more aligned to biological mechanisms that can, in turn, be targeted by specific approaches developed using high-throughput molecular technologies. Unbiased “omic” approaches enhance the possibility of discovering completely new mechanisms in such groups. Furthermore, advances in drug discovery platforms, and models to study efficacy and toxicity more relevant to the human disease, are valuable. Re-imagining the relationships among discovery, translation, evaluation, and implementation will help reverse the trend away from investment in the cardiovascular space, establishing innovative platforms and approaches across the full spectrum of therapeutic development.
From the Literature
Tracy Hampton
doi : 10.1161/CIRCULATIONAHA.121.055993
Circulation. 2021;144:170–171
In the Heart of the Ancient Silk Road: Fever of Unknown Origin, Right Ventricular Mass, and Systemic Vasculitis
Ayelet Shapira-Daniels, Merav Ingbir, Oz M. Shapira
doi : 10.1161/CIRCULATIONAHA.121.053389
Circulation. 2021;144:172–176
Prognostic Value of Natriuretic Peptides and Cardiac Troponins in COVID-19
Jonathan W. Cunningham, Brian L. Claggett, Karola S. Jering, Muthiah Vaduganathan, Ankeet S. Bhatt, Ning Rosenthal, Scott D. Solomon
doi : 10.1161/CIRCULATIONAHA.121.054969
Circulation. 2021;144:177–179
Implantable Cardioverter-Defibrillator Eligibility After Initiation of Sacubitril/Valsartan in Chronic Heart Failure: Insights From PROVE-HF
G. Michael Felker, Javed Butler, Nasiren E. Ibrahim, Ileana L. Pi?a, Alan Maisel, Devavrat Bapat, Alexander Camacho, Jonathan H. Ward, Kristin M. Williamson, Scott D. Solomon, James L. Januzzi, and for the PROVE-HF Investigators
doi : 10.1161/CIRCULATIONAHA.121.054034
Circulation. 2021;144:180–182
Letter by Correia and Viana Regarding Article, “Myocardial Infarction in the ISCHEMIA Trial: Impact of Different Definitions on Incidence, Prognosis, and Treatment Comparisons”
Luis C.L. Correia, Mateus S. Viana
doi : 10.1161/CIRCULATIONAHA.121.054697
Circulation. 2021;144:e12–e13
Response by Chaitman et al to Letter Regarding Article, “Myocardial Infarction in the ISCHEMIA Trial: Impact of Different Definitions on Incidence, Prognosis, and Treatment Comparisons”
Bernard R. Chaitman, Harmony R. Reynolds, David J. Maron, Judith S. Hochman
doi : 10.1161/CIRCULATIONAHA.121.055296
Circulation. 2021;144:e14–e15
Mechanical Complications of Acute Myocardial Infarction: A Scientific Statement From the American Heart Association
Abdulla A. Damluji, Sean van Diepen, Jason N. Katz, Venu Menon, Jacqueline E. Tamis-Holland, Marie Bakitas, Mauricio G. Cohen, Leora B. Balsam, Joanna Chikwe, and on behalf of the American Heart Association Council on Clinical Cardiology; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Surgery and Anesthesia; and Council on Cardiovascular and Stroke Nursing See fewer authors
doi : 10.1161/CIR.0000000000000985
Circulation. 2021;144:e16–e35
Over the past few decades, advances in pharmacological, catheter-based, and surgical reperfusion have improved outcomes for patients with acute myocardial infarctions. However, patients with large infarcts or those who do not receive timely revascularization remain at risk for mechanical complications of acute myocardial infarction. The most commonly encountered mechanical complications are acute mitral regurgitation secondary to papillary muscle rupture, ventricular septal defect, pseudoaneurysm, and free wall rupture; each complication is associated with a significant risk of morbidity, mortality, and hospital resource utilization. The care for patients with mechanical complications is complex and requires a multidisciplinary collaboration for prompt recognition, diagnosis, hemodynamic stabilization, and decision support to assist patients and families in the selection of definitive therapies or palliation. However, because of the relatively small number of high-quality studies that exist to guide clinical practice, there is significant variability in care that mainly depends on local expertise and available resources.
Retraction and Replacement of: Effect of Adding Ticagrelor to Standard Aspirin on Saphenous Vein Graft Patency in Patients Undergoing Coronary Artery Bypass Grafting (POPular CABG): A Randomized, Double-Blind, Placebo-Controlled Trial
doi : 10.1161/CIR.0000000000001004
Circulation. 2021;144:e36
Correction to: Salt Transiently Inhibits Mitochondrial Energetics in Mononuclear Phagocytes
doi : 10.1161/CIR.0000000000001008
Circulation. 2021;144:e37
