This Week in JAMA FREE

A JAMA THEME ISSUE

Edited by Eric D. Peterson, MD, MPH, and J. Michael Gaziano, MD, MPH

In a randomized trial of 398 patients with elevated low-density lipoprotein cholesterol (LDL-C) or low high-density lipoprotein cholesterol (HDL-C) levels, Nicholls and colleagues found that 12 weeks' treatment with evacetrapib, a cholesteryl ester transfer protein inhibitor, administered as monotherapy or in combination with statin therapy was associated with greater increase in HDL-C and decrease in LDL-C levels than what was achieved with statin monotherapy or placebo. In an editorial, Cannon discusses the counterregulatory role of HDL-C in atherosclerosis and emerging drug therapies that increase HDL-C levels.

ArticleArticle  (AUTHOR VIDEO INTERVIEW)

Intracoronary infusion of autologous bone marrow mononuclear cells (BMCs) within 1 week of acute myocardial infarction has been associated with improved left ventricular (LV) function. In a randomized trial of 87 patients with an LV ejection fraction of 45% or less following successful primary percutaneous coronary intervention, Traverse and colleagues found that compared with placebo infusion, intracoronary infusion of autologous BMCs administered 2 to 3 weeks after percutaneous coronary intervention was not associated with improvement in global or regional LV function at the 6-month assessment. In an editorial, Hare discusses cell-based therapy for myocardial injury.

ArticleArticle  (AUTHOR AUDIO INTERVIEW)

In an analysis of data from 542 008 patients with incident acute myocardial infarction (MI) included in the community-based National Registry of Myocardial Infarction (1994-2006), Canto and colleagues examined the association between the number of coronary heart disease (CHD) risk factors (specifically, hypertension, smoking, dyslipidemia, diabetes, and family history of CHD) and risk of acute MI–related mortality. The authors report that inpatient mortality was inversely related to the number of CHD risk factors present at hospital admission.

The association of coronary computed tomographic (CT) angiography with subsequent health care utilization and expenditures among patients with suspected coronary artery disease (CAD) is not known. In an analysis of 2005-2008 Medicare claims data from 282 830 beneficiaries who underwent initial outpatient evaluation for CAD by either CT angiography or stress testing, Shreibati and colleagues found that compared with patients who underwent stress testing, patients having CT angiography were more likely to undergo invasive cardiac procedures and have higher CAD-related spending in the subsequent 6 months.

Ovbiagele and colleagues examined the relationship between maintenance of systolic blood pressure (SBP) levels within the normal range and risk of recurrent stroke in a post hoc analysis of data from 20 330 patients with recent ischemic stroke who participated in a recurrent stroke prevention trial. Patients were categorized according to their mean SBP level during follow-up. The authors found that compared with mean SBP in the high-normal range (130-139 mm Hg), SBP levels lower than 120 mm Hg and higher than 140 mm Hg were associated with an increased risk of recurrent stroke.

“[E]ach day I stand before your door on rounds. Secretly wanting to just keep walking.” From “Tall Buildings.”

Proponents of statin therapy for primary prevention of cardiovascular disease say it benefits patients; skeptics say the evidence is not robust enough for such claims.

Cardiovascular science and national strength

Preventing cardiovascular disease and stroke

Rational dispersion of transcatheter aortic valve replacement

The cardiovascular biomarker conundrum

Cardiology in 2011

How would you manage an 86-year-old woman with upper gastrointestinal bleeding who is anticoagulated and receiving antiplatelet therapy? Go to www.jama.com to read the case. Submit your response by December 4 for possible online posting.

For your patients: Information about heart failure.