December 2007

A 62-year-old man presented with a 3-day history of intermittent episodes of central chest discomfort and associated dyspnea, culminating in a 20-minute episode occurring at rest, with marked diaphoresis and associated anguor animi.

The patient was a 44-year-old woman who had been obese for 20 years (height, 5'3"; weight, 194.8 lb; body mass index, 32.7 kg/m2; waistline, 42").

A 63-year-old man with type 2 diabetes and hypertension presented to the outpatient clinic with atypical symptoms.

We evaluated 100 subjects who underwent multislice computed tomography (MSCT) to assess the presence and severity of coronary artery disease (CAD) and to determine the occurrence of coronary events (including cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, and revascularization) over a follow-up period of 16 months.

We developed a set of equations to predict the risk or probability of developing coronary artery disease (CAD) in 10 years among American Indians. The equations are based on the significant risk factors identified in the Strong Heart Study, a longitudinal study of cardiovascular disease in American Indians. The equations can be used in patient education and to evaluate the efficacy of CAD prevention and intervention programs.

The risk calculator reported in the Lee et al paper was developed to predict the 10-year cardiovascular (CV) disease probability in an American Indian population.

Diabetic patients with acute coronary syndromes are at higher risk for mortality, even if they have ST-segment elevation myocardial infarction. Diabetic patients with unstable angina/non–Q-wave infarction have impaired platelet responsiveness to nitric oxide, a physiological anti-aggregating autocoid. The extent of this impairment depends on the degree of hyperglycemia. Rapid correction of hyperglycemia with infused insulin restores responsiveness to nitric oxide, thus ameliorating platelet dysfunction.

Glucose-insulin-potassium (GIK) was initially advocated as a treatment of acute myocardial infarction (MI) to promote electrical stability.

To evaluate the interactions between the weight loss drug, sibutramine, and different antihypertensive treatments, we randomly assigned 171 subjects taking 3 antihypertensive treatment regimens to receive sibutramine or placebo. Our study showed for the first time that combination therapy with an angiotensin-converting enzyme inhibitor and a calcium channel blocker is more advantageous than a ß blocker/diuretic-based-regimen with regard to supporting the weight-reducing actions and metabolic changes induced by sibutramine.

Obesity is a growing epidemic in the United States and around the world.

The study presented in this issue of Cardiology Review by Schuijf and colleagues investigated various aspects of what is rapidly becoming an accepted imaging modality for the assessment of coronary artery disease.