Heart Journal Focuses On Cardiovascular Interventions

Ruzanna Harutyunyan's picture
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A system for assessing patients’ risk of in-hospital death after angioplasty is validated in the premier issue of Circulation: Cardiovascular Interventions.

The journal, which highlights progress in the rapidly growing sub-specialty of interventional cardiology, is the fourth of six new specialized journals of Circulation: Journal of the American Heart Association.

“Interventional cardiology, perhaps more than other fields of cardiology, has realized tremendous growth,” said David P. Faxon, M.D., editor of the new journal and vice chair of medicine of Integrated Clinical Services in the Department of Medicine at Brigham and Women’s Hospital in Boston.

Percutaneous coronary intervention (PCI), which involves inserting and inflating tiny balloons into vessels to widen narrowed arteries, is the most-often-performed heart revascularization procedure in the United States. Doctors performed more than 1.3 million PCIs in 2005, the most recent year for which statistics are available.

Interventional cardiology now encompasses PCI in arteries throughout the body and heart valves plus valve replacement for structural and congenital heart disease. As a result of the increased use of PCI, researchers published more than 5,300 articles and conducted 245 randomized trials in 2007 in some 65 different journals, Faxon said. With only three journals dedicated to invasive or interventional cardiology, he said, “the need to establish a premier journal that would focus on the large and growing field of interventional cardiology has been too long in coming.”

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The core of the new journal will be “original experimental and clinical investigations that provide new and important contributions that will lead to improvement in care of patients,” Faxon said.

Each bi-monthly issue of Circulation: Cardiovascular Interventions will feature reviews by recognized leaders in the field on topics including advances, controversies and images in interventional cardiology.

Full issues of the specialty journals will be published every other month, and papers from each issue will be published online ahead of print as they become available.

Here is a summarized report of one of the articles from the first issue:

New study validates scoring system as a useful model for assessing PCI patients’ risk.

Mayo Clinic researchers said they’ve now confirmed that their scoring system provides a clear blueprint for assessing patients’ risk of dying while being hospitalized for percutaneous coronary intervention (PCI), which encompasses procedures used to clear blocked coronary arteries with a tiny balloon and prop the vessel open with a stent. Using seven simple clinical and non-invasive variables, the Mayo Clinic Risk Score (MCRS) provides a model for predicting in-hospital death after PCI. In their new evaluation, the Mayo physicians sought to validate the risk score’s efficacy in a review of data on 309,351 patients who had PCI between 2004 and 2006.

Using the MCRS equation, the researchers assigned “predicted probabilities of death” to each patient. Their analysis indicated “excellent” predictions overall and in patient subgroups according to gender, age, diabetes, renal failure, low ejection fraction and multi-vessel disease. “Ninety-seven percent of patients undergoing PCI had a MCRS below 10 indicating low to intermediate risk,” the investigators reported. The MCRS model initially slightly under-predicted event rates but was corrected after recalibration, thus validating data from the large patient database, they said. “Seven variables can be combined into a convenient risk scoring system before coronary angiography is performed to predict in-hospital mortality following PCI,” the scientists said. “This model may be useful in providing patients with individualized, evidence-based estimates of procedural risk as part of the informed consent process before PCI.”

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