Aspirin and clopidogrel resistance: methodological challenges and opportunities

Antiplatelet drug resistance is one of the urgent issues in current cardiovascular medicine. Many platelet function tests have been used to define responsiveness of patients with cardiovascular disease to aspirin and clopidogrel. In most studies, cut-off values of platelet function tests for defining responsiveness to antiplatelets were chosen arbitrarily. Different tests provided wide-ranging figures of the prevalence of aspirin and clopidogrel resistance, suggesting poor correlation between currently available platelet function tests. Measurement of platelet size seems to be a promising approach for monitoring antiplatelet drug therapy. This commentary highlights some limitations of studies on aspirin and clopidogrel resistance in patients undergoing coronary interventions

Familiarizing with science editors' associations

The number of science editors' associations is growing to resolve a variety of professional problems. The main objective of the associations is to educate their members by facilitating dissemination of information, publishing scholarly journals, books, networking of experts, and regular meetings. There are many science editing associations – general and specialized, traditional, and new. The article presents activities of some of these associations, which include upholding standards of science writing, editing, indexing, research reporting, peer review, editorial independence, and other editorial policies

Behçet’s Disease: an Insight from a Cardiologist’s Point of View

Behçet's disease (BD) is an enigmatic inflammatory disorder, with vasculitis (perivasculitis) underlying pathophysiology of its multisystemic affections. Venous pathology and thrombotic complications are hallmarks of BD. However, it has been increasingly recognized that cardiac involvement and arterial complications (aneurysms, pseudoaneurysms, rupture and thrombosis) are important part of the course of BD. Pericarditis, myocardial (diastolic and/or systolic dysfunction), valvular and coronary (thrombosis, aneurysms, rupture) involvement, intracardiac thrombi (predominantly right-sided) are, probably, the most frequent cardiac manifestations. Treatment of cardiovascular involvement in BD is largely empirical and aimed at suppression of vasculitis. The most challenging seems to be the treatment of arterial aneurysms and thromboses due to the associated risk of bleedings. Cardiologists should always bear in mind potential threats of (a)symptomatic cardiovascular involvement in BD

Myocardial Ischemia in Wegener’s Granulomatosis: Coronary Atherosclerosis Versus Vasculitis

Wegener’s granulomatosis (WG) is one of the most common small- and medium-sized necrotizing vasculitides that mainly affects the upper and lower respiratory tract and the kidneys. Cardiac manifestations in WG are relatively rare, and their role and place among different causes of mortality remain largely unknown. Substantially increased number of reports describing involvement of all structures of the heart, which underlie conduction disturbances, valvular disease, ischemic heart disease and other potentially serious conditions, underscores importance of comprehensive cardiovascular investigations and monitoring of patients with WG. The majority of previous reports and our current observation distinguish coronary vasculitis and thrombosis as a cause of myocardial ischemia and cardiovascular co-morbidities in WG. It seems plausible that inflammatory processes in this disease, like in some other systemic vasculitidies, do not predispose to accelerated atherogenesis. However, characteristic small- and medium-sized vasculitis still can manifest as myocardial ischemia and infarction. We overview diverse cardiac manifestations and present our own rare case of angina in the oligosymptomatic debut of WG. Importantly, in this case, coronarography failed to reveal atherosclerotic disease or thrombotic occlusion. However, magnetic resonance imaging (MRI) with adenosine test revealed subendocardial ischemia. As a result of immunosuppressive therapy with a steroid and cyclophosphamide, myocardial ischemia disappeared

Best peer reviewers and the quality of peer review in biomedical journals

Abstract Current scholarly publications heavily rely on high quality peer review. Peer review, albeit imperfect, is aimed at improving science writing and editing. Evidence supporting peer review as a guarantor of the quality of biomedical publications is currently lacking. Its outcomes are largely dependent on the credentials of the reviewers. Several lines of evidence suggest that predictors of the best contributors to the process include affiliation to a good University and proper research training. Though the options to further improve peer review are currently limited, experts are in favor of formal education and courses on peer review for all contributors to this process. Long-term studies are warranted to assess the strengths and weaknesses of this approach

Familial Mediterranean Fever as an Emerging Clinical Model of Atherogenesis Associated with Low-Grade Inflammation

Numerous inflammatory and innate immune pathways are involved in atherogenesis. Elaboration of clinical models of inflammation-induced atherogenesis may further advance our knowledge of multiple inflammatory pathways implicated in atherogenesis and provide a useful tool for cardiovascular prevention. Familial Mediterranean fever (FMF) is a chronic inflammatory disorder with profiles of inflammatory markers close to that seen in the general population. In a few recent studies, it has been shown that endothelial dysfunction, increased atherosclerotic burden and activation of platelets accompany attack-free periods of FMF. Colchicine is proved to be useful in suppression of inflammation in FMF. Preliminary basic and clinical studies suggest that this relatively safe drug may be useful for cardiovascular protection in patients with FMF and in the general population. Multinational prospective studies are warranted to further elaborate clinical model of inflammation-induced atherosclerosis associated with FMF

Best peer reviewers and the quality of peer review in biomedical journals

Abstract Current scholarly publications heavily rely on high quality peer review. Peer review, albeit imperfect, is aimed at improving science writing and editing. Evidence supporting peer review as a guarantor of the quality of biomedical publications is currently lacking. Its outcomes are largely dependent on the credentials of the reviewers. Several lines of evidence suggest that predictors of the best contributors to the process include affiliation to a good University and proper research training. Though the options to further improve peer review are currently limited, experts are in favor of formal education and courses on peer review for all contributors to this process. Long-term studies are warranted to assess the strengths and weaknesses of this approach