当前位置: 首页 > 期刊 > 《加拿大医疗协会学报》 > 2006年第4期 > 正文
编号:11119202
Imaging techniques for coronary artery disease
http://www.100md.com 《加拿大医疗协会学报》
     New cardiovascular imaging tests can be used to assess atherosclerotic plaques to allow early characterization and disease staging. Escolar and colleagues update us on the use of intravascular ultrasonography, multiple-slice coronary CT angio graphy and MRI for the visual detection of atherosclerotic coronary artery disease.

    See page 487

    Biomarkers for coronary artery disease

    Can multiple plasma biomarkers be combined to predict atherosclerosis and death, and which ones are the most useful for this? Lee and colleagues studied more than 1000 angio -graphy patients and found that elevated interleukin-6 and total homocysteine levels were the strongest predictors of death related to coronary artery disease. In a related commentary, Lowe evaluates their findings in light of the current hypothesis that inflammatory markers and homocysteine play a causal role in CAD and argues that there is insufficient evidence to support their use in routine cardiovascular risk assessment.

    See pages 461 and 479

    Bias and variation in diagnostic accuracy studies

    Studies assessing the diagnostic accuracy of tests are not subjected to the same rigour for design, reporting and review as clinical trials are. Does it matter? Rutjes and colleagues report on their findings of the effect of 15 study design features on estimates of diagnostic accuracy. In a related commentary, Furukawa and Guyatt caution physicians to pay attention to potential sources of bias in diagnostic accuracy studies and to recognize that a test is just one step in the diagnostic process, after good clinical medicine.

    See pages 469 and 481

    The human cost of nonpatentable drugs

    The pharmaceutical industry spends over US$10 billion on trials for drugs that are patentable (and profitable), yet drugs that cannot be patented are not tested, even if they answer a public health need. Calon uses omega-3 polyunsaturated fatty acids and Alzheimer's disease to highlight the social and financial costs of ignoring the possible benefits of testing nonpatentable drugs.

    See page 483

    Galanis and colleagues discuss emerging risk groups and changing epidemiology for pertussis infection (page 451). Chatterjee describes a case of bone infarcts in a woman with systemic lupus erythematosus and antiphospholipid antibody syndrome (page 455). Murray reviews challenges in global treatment and prevention efforts for HIV infection (page 457). Weinstein offers a glimpse into an unusual case of Kawasaki disease (page 459).