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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ahj.2009.08.021 Byline: Peter S. Munk (a)(b), Eva M. Staal (a)(b), Noreen Butt (a), Kjetil Isaksen (a), Alf I. Larsen (a)(b) Abstract: High-intensity interval training has been shown to be superior to moderate continuous exercise training in improving exercise capacity and endothelial function in patients with coronary artery disease. The objective of this study was to evaluate this training model on in-stent restenosis following percutaneous coronary intervention for stable or unstable angina. Author Affiliation: (a) Department of Cardiology, Stavanger University Hospital, Stavanger, Norway (b) Institute of Medicine, University of Bergen, Bergen, Norway Article History: Received 17 March 2009; Accepted 21 August 2009 Article Note: (footnote) ClinicalTrials.gov Identifier: NCT00469950.

Background. Growth differentiation factor-15 (GDF-15) is considered to be a cardioprotective cytokine possessing antiapoptotic and antiproliferative properties. If GDF-15 plasma levels are influenced by percutanenous coronary intervention (PCI) or regular exercise training is currently not known. Methods. After successful revascularization by PCI with stent implantation 36 consecutive patients with stable angina pectoris were randomized to an exercise training program or to a control group. Patients were followed by serial measurements of GDF-15, high-sensitivity Troponin T (hsTNT) and N-terminal pro brain natriuretic peptide (NT-proBNP) levels in peripheral blood after PCI and during six months follow-up. Results. Plasma levels of GDF-15 showed an early response to PCI with a modest, but significant increase after 30 minutes (p == 0.007) peaking three hours after PCI. Levels of hsTNT rose 5-fold from baseline to 24 hours (p < 0.001) with a normalization at seven days post PCI. Changes in plasma levels of GDF-15, hsTNT and NT-proBNP were not significantly different between the training and control group during follow-up. Conclusions. GDF-15 levels show a modest transient increase in response to coronary intervention with stent implantation. Exercise training over six months does not affect plasma levels of GDF-15, hsTNT or NT-proBNP in patients with stable coronary artery disease. [ABSTRACT FROM AUTHOR]

A correction to the article "Clinical use of optical coherence tomography to identify angiographic silent stent thrombosis" by Sonja E. Steigen and others, that was published in a 2014 issue of the journal is presented.

Background: A man in his fifties with hypertension and no other previous health problems was admitted to the hospital after frequent episodes of retrosternal squeezing chest pain, and an episode of syncope. A recent computer tomography coronary angiography demonstrated normal coronary arteries with no atherosclerosis., Case Presentation: During admission, the patient developed several episodes of chest pain lasting five to fifteen minutes followed by non-sustained ventricular tachycardia, and initially no ST elevation in the electrocardiogram (ECG). He had normal findings on ECG and magnetic resonance imaging of the heart. During hospitalisation, ST elevations in the ECG were observed in relation to chest pain. Due to ST elevation, invasive coronary angiography was performed, revealing a suspected culprit lesion in the left anterior descending artery, treated with percutaneous coronary intervention (PCI). Despite PCI, he had persistent episodes of chest pain with ST elevation and non-sustained ventricular tachycardia. Vasospastic angina was suspected., Interpretation: The clinical presentation is classical for vasospastic angina. After treatment with calcium channel blocker together with long-acting nitrate, there were no new episodes of chest pain or non-sustained ventricular tachycardia. Because of non-sustained ventricular tachycardia with haemodynamic instability and syncope, an implantable cardioverter-defibrillator was implanted.

The term unstable coronary syndromes represents a continuum of patients with unstable chest pain with or without small or large acute myocardial infarctions. There is a tendency towards an epidemiological shift to fewer large infarctions with ST elevation in the ECG (STEMI) to increased numbers of small infarctions without ST elevation (nSTEMI). Patients with unstable angina or nSTEMI should start antithrombotic medication with aspirin, heparin and clopidogrel upon arrival in hospital. Patients with medium or high risk of death or cardiac events will benefit from therapy with IIb/IIIa glycoprotein receptor inhibitors and should be referred for coronary angiography within 6-48 hours after arrival. Final therapy with percutaneous coronary intervention or coronary artery bypass surgery is indicated immediately after angiography or within a few days. Close follow-up with respect to epidemiological risk factors, diet, use of medication according to the results of large randomised studies will further reduce mortality and morbidity, in the short as well as the long term.