Vol 5, No 4 (August 2015): Cardiovascular Diagnosis and Therapy



CDT coverVol 5, No 4
Cover story

In PubMed


CDT will exhibit in the American College of Surgeons (ACS) Clinical Congress 2015 in Chicago. Our booth “AME Publishing Company” stands at No.1140 in the exhibition hall. More
Original Article
survival curve

Evaluation of prolonged safety and efficacy of biodegradable polymer coated sirolimus-eluting coronary stent system: 1-year outcomes of the INDOLIMUS Registry» Durgaprasad Rajasekhar and others

The study evaluates prolonged safety and efficacy of the Indolimus coronary stent system in high risk patients with complex coronary lesions…
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inflammatory cells

Preclinical evaluation of a novel abluminal surface coated sirolimus eluting stent with biodegradable polymer matrix» Prakash Sojitra and others

Currently, Lebanon is at a stage of technically working to reduce the sodium content in the major sources of sodium, namely local bread and bread-like products…
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Four-year clinical follow-up of the first-in-man randomized comparison of a novel sirolimus eluting stent with abluminal biodegradable polymer and ultra-thin strut cobalt-chromium alloy: the INSPIRON-I trial» Marcos Danillo Peixoto Oliveira and others

The study evaluates the long-term clinical outcomes of patients treated with this novel sirolimus-eluting stent enrolled into the INSPIRON-I trial…
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bar graph

Prevalence of metabolic syndrome in the clinical practice of general medicine in Italy» Giuliano Tocci and others

Using this sample of outpatients followed by general practitioners in Italy, the study reports a relatively high prevalence of metabolic syndrome and a high prevalence of associated additional cardiovascular and…
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Review Article


Inflammation, plaque progression and vulnerability: evidence from intravascular ultrasound imaging» Yu Kataoka, Rishi Puri, Stephen J. Nicholls

The review provides evidences illustrating the relationship of inflammation with atherosclerotic plaque…
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MR images

Cardiac MR imaging: current status and future direction» Maythem Saeed and others

It can be concluded that MRI has revolutionized cardiac imaging. MR-guided intervention is another young and rapidly evolving field…
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Brief Report
country-level collaborations

Institution-level collaboration in cardiovascular research in sub-Saharan Africa» Remare R. Ettarh

This study focuses on mapping the linkages between institutions in this region using co-authorship of publications in cardiovascular research from 2005 to 2014…
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European Heart Journal: Expert position paper on air pollution and cardiovascular disease.



Air pollution has wide-ranging and deleterious effects on human health and is a major issue for the global community. The Global Burden of Disease study has described the worldwide impact of air pollution with as many as 3.1 million of 52.8 million all-cause and all-age deaths being attributable to ambient air pollution in the year 2010.1 Moreover, ambient air pollution ranked ninth among the modifiable disease risk factors, being listed above other commonly recognized factors, such as low physical activity, a high-sodium diet, high cholesterol, and drug use. Finally, air pollution accounts for 3.1% of global disability-adjusted life years, an index that measures the time spent in states of reduced health.1

Although it is intuitive that air pollution is an important stimulus for the development and exacerbation of respiratory diseases, such as asthma, chronic obstructive pulmonary disease, and lung cancer, there is generally less public awareness of its substantial impact on cardiovascular disease. Historically, the 1952 Great Smog of London led to an increase in cardiovascular death as well as deaths due to respiratory disease. Subsequent studies in the 1990s, such as the Harvard Six Cities2 and American Cancer Society cohort studies,2,3 established an enduring positive association between long-term exposure to air pollution and total and cardiovascular mortality, mainly due to coronary artery disease.4 In Europe, the first study that supported this association between long-term exposure and mortality was the Netherlands Cohort Study on Diet and Cancer.5 Associations with cardiovascular morbidity and mortality are also seen with short-term (e.g. day-to-day fluctuations) pollutant exposures of residents in large urban areas worldwide, including the United States of America6 and Europe.7,8 Among multiple pathways linking air pollution to cardiovascular morbidity and mortality, the most relevant are the induction of oxidative stress, systemic inflammation, endothelial dysfunction, atherothrombosis, and arrhythmogenesis.9

Here, we present an expert consensus document on behalf of the European Society of Cardiology that explores the mechanisms and relationships between ambient air pollution and cardiovascular disease. The purpose of this document is to highlight and raise awareness of the importance and wide-ranging impact of air pollution on cardiovascular disease. It will also provide guidance to society, patients, and healthcare professionals on the potential health impacts of air pollution, and make recommendations for future public health and research priorities to manage and mitigate this avoidable cause of death and disease.

NEJM: Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy



The natural history, management, and outcome of takotsubo (stress) cardiomyopathy are incompletely understood.


The International Takotsubo Registry, a consortium of 26 centers in Europe and the United States, was established to investigate clinical features, prognostic predictors, and outcome of takotsubo cardiomyopathy. Patients were compared with age- and sex-matched patients who had an acute coronary syndrome.


Of 1750 patients with takotsubo cardiomyopathy, 89.8% were women (mean age, 66.8 years). Emotional triggers were not as common as physical triggers (27.7% vs. 36.0%), and 28.5% of patients had no evident trigger. Among patients with takotsubo cardiomyopathy, as compared with an acute coronary syndrome, rates of neurologic or psychiatric disorders were higher (55.8% vs. 25.7%) and the mean left ventricular ejection fraction was markedly lower (40.7±11.2% vs. 51.5±12.3%) (P<0.001 for both comparisons). Rates of severe in-hospital complications including shock and death were similar in the two groups (P=0.93). Physical triggers, acute neurologic or psychiatric diseases, high troponin levels, and a low ejection fraction on admission were independent predictors for in-hospital complications. During long-term follow-up, the rate of major adverse cardiac and cerebrovascular events was 9.9% per patient-year, and the rate of death was 5.6% per patient-year.


Patients with takotsubo cardiomyopathy had a higher prevalence of neurologic or psychiatric disorders than did those with an acute coronary syndrome. This condition represents an acute heart failure syndrome with substantial morbidity and mortality. (Funded by the Mach-Gaensslen Foundation and others; ClinicalTrials.gov number,NCT01947621.)http://www.nejm.org/doi/full/10.1056/NEJMoa1406761?query=featured_home