January 2008

A 54-year-old hard-working male journalist underwent 4-vessel aortocoronary bypass grafting in January 2002 after 2 myocardial infarctions.

A 55-year-old Caucasian man who had a myocardial infarction 9 months earlier was referred to our cardiology clinic.

Only 2 cases of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) pericarditis have been reported in the English literature. Over the last 15 years, CA-MRSA has emerged as an increasingly common pathogen that is genetically and epidemiologically different from hospital-acquired MRSA (HA-MRSA).

Despite the fact that prehypertension has been shown to be associated with atherosclerosis and target-organ damage, no studies evaluating coronary flow reserve (CFR) among prehypertensive patients have been done. We assessed CFR in normotensive subjects, in subjects with prehypertension, and in newly diagnosed and never-treated subjects with established hypertension. We found that CFR was decreased in prehypertensive subjects, although not as significantly as in subjects with hypertension.

Hypertension has traditionally been defined by the arbitrary criteria of systolic pressure > 140 mm Hg or diastolic pressure > 90 mm Hg.

We analyzed a subgroup of 2445 subjects with diabetes, macrovascular disease, and previous myocardial infarction (MI) from the Prospective Pioglitazone Clinical Trial in Macrovascular Events to determine the effects of pioglitazone on mortality and macrovascular morbidity. Pioglitazone was shown to decrease the occurrence of adverse cardiac outcomes, including recurrent MI, in these high-risk subjects. This additional benefit of pioglitazone in patients with diabetes and a previous MI suggests that it may be appropriate to include this medication in the management strategy of patients with MI.

Patients with type 2 diabetes have a 2- to 4-fold increased incidence of coronary artery disease than those without diabetes.

We evaluated the accuracy of the 64-slice computed tomography (CT) angiography scanner in subjects who were scheduled to undergo invasive angiography for possible stenosis in coronary artery bypass grafts. Results showed that the improved resolution of CT scanners with 64-slice technology allowed for a precise delineation of bypass graft occlusion or stenosis. It permitted an accurate noninvasive assessment of bypass grafts, even in subgroups of subjects with suboptimal scan conditions, such as those with arrhythmias or higher heart rates.

In their study, Meyer and colleagues investigated the accuracy of multislice computed tomography (MSCT) in the assessment of bypass grafts following coronary artery bypass graft (CABG) surgery.