Marie-Claude Morice.

Stenting: Clinical Implications of the SYNTAX Trial. Commenting closes March 4, 2009.. Patrick W. Serruys, M.D., Ph.D., Marie-Claude Morice, M.D., A. Pieter Kappetein, M.D., Ph.D., Antonio Colombo, M.D., David R. Holmes, M.D., Michael J. Mack, M.D.D., Ted E. Feldman, M.D., Marcel van den Brand, M.D., Eric J. Bass, B.A., Nic Van Dyck, R.N., Katrin Leadley, M.D., Keith D. Dawkins, M.D., and Friedrich W. Mohr, M.D., Ph.D. For the SYNTAX Investigators: Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Serious Coronary Artery Disease Coronary-artery bypass grafting was introduced in 1968 and rapidly became the standard of look after symptomatic individuals with coronary artery disease.1 Developments in coronary surgery have reduced morbidity, mortality, and prices of graft occlusion.2-6 Percutaneous coronary intervention was introduced in 1977.7 Experience with this approach, coupled with improved technology, has made it possible to treat progressively complex lesions and sufferers with a past history of clinically significant cardiac disease, risk factors for coronary artery disease, coexisting circumstances, or anatomical risk elements.8,9 Several trials evaluating PCI involving bare-metal stents with CABG in patients with multivessel disease showed similar survival rates but higher revascularization rates among sufferers with bare-steel stents at 5 years.Shah, M.D., M.P.H., Rodney H. Falk, M.D., Brian Claggett, Ph.D., Dalane W. Kitzman, M.D., Thomas H. Mosley, Ph.D., Kenneth R. Butler, Ph.D., Eric Boerwinkle, Ph.D., and Scott D. Solomon, M.D.: The Amyloidogenic V122I Transthyretin Variant in Elderly Dark Americans Amyloid cardiovascular disease leads to an increase in ventricular wall thickness and stiffness of the heart.1 Abnormalities of transthyretin, a transport proteins synthesized by the liver mainly, may lead to hereditary transthyretin-related amyloidosis.2 This disorder can be caused by any one greater than 100 stage mutations in the transthyretin gene ; the V122I variant, in which isoleucine is substituted for valine at placement 122, is the most typical mutation and happens in 3 to 4 percent of black Americans.3-5 V122I reduces the stability of transthyretin tetramers, causing cardiac deposition of misfolded transthyretin monomers and leading to an autosomal dominant cardiomyopathy that typically occurs during or after the sixth decade of lifestyle, with a penetrance believed to be as high as 80 percent among men.6-9 The variant offers been associated with increased risks of heart death and failure.