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Commencing Volume 19, Issue 1, MedReviews has ceased the publication of this journal. Reviews in Cardiovascular Medicine will continue to be published by IMRPress, Ltd. (www.imrpress.com)

Volume 3, No 2 - Spring 2002

Volume 3, No 2 - Spring 2002

Table of Contents

Abciximab Readministration Treatment Update
The IIb/IIIa receptor inhibitors have been shown to improve outcomes following percutaneous coronary intervention (PCI), particularly by decreasing periprocedural myocardial necrosis. Abciximab has been subject to multiple studies, demonstrating consistent improved early and late outcomes in multiple patient populations, including a mortality advantage in diabetics, but there has been concern about the possibility of anaphylaxis, thrombocytopenia, and reduced clinical efficacy with repeat administration of abciximab. Results of the ReoPro Readministration Registry, a prospective, phase IV, multicenter registry of 500 patients undergoing PCI who were treated with abciximab at least 7 days after a previous treatment with this same drug, support the contention that abciximab readministration is both safe and clinically efficacious and that there is no significant increase in the incidence of thrombocytopenia as compared with historical controls of trials of first abciximab administration. However, profound thrombocytopenia did occur with increased frequency as compared with historical controls, suggesting a shift from mild to profound thrombocytopenia with abciximab readministration. [Rev Cardiovasc Med. 2002;3(2):67–70]
Cardiorenal Risk: An Important Clinical Intersection Treatment Update
Approximately 6 million Americans have combined chronic cardiovascular and kidney disease. This clinical intersection presents unique risks to the patient and unique challenges to the clinician. Observational studies have provided quantitative methods for estimating the risk of acute renal failure in patients undergoing percutaneous intervention and bypass surgery procedures. Fortunately, for the general cardiovascular population these risks are small. On the other hand, patients with chronic kidney disease have increased risks of accelerated atherosclerosis, nonfatal myocardial infarction, congestive heart failure, atrial and ventricular arrhythmias, and cardiac death. Chronic kidney disease presents difficult scenarios in using conventional cardioprotective therapy. However, there are increasing bodies of evidence to suggest the kidney and the heart can be targeted with lines of therapy, specifically with renin–angiotensin system antagonism, that benefit both systems with respect to reduction in the progression of disease, and the prevention of hard kidney and cardiac endpoints. This article will focus on the cardiorenal intersection and highlight innovative diagnostic and therapeutic strategies concerning this highrisk patient group. [Rev Cardiovasc Med. 2002;3(2):71–76]
Noninvasive Coronary Imaging in the New Millennium: A Comparison of Computed Tomography and Magnetic Resonance Techniques Technique Update
Until recently, visualization of the coronary arteries was the sole domain of catheterbased x-ray angiography. In an effort to detect and assess coronary artery disease noninvasively, magnetic resonance imaging, electron beam computed tomography, and multislice spiral computed tomography have emerged as potential modalities. Besides visualization of the vessel lumen, these techniques may be capable of imaging and characterizing atherosclerotic plaques. None of these techniques are yet routinely used, but considering the pace of the technical advancements, clinically reliable noninvasive coronary angiography can be expected in the coming years. [Rev Cardiovasc Med. 2002;3(2);77 –84]
Late-Breaking Trial Results Presented in Stockholm European Society of Cardiology XXIII Congress
Single Coronary Artery with an Ectopic Origin and Interarterial Course: A Case Report and Review of the Literature
A previously unreported variant of a single coronary artery arising between the aorta and pulmonary artery is presented. This variant had many high-risk features, so prophylactic coronary artery bypass grafting was recommended. [Rev Cardiovasc Med. 2002;3(2):107–110]