Editor's welcome to the second issue

This issue of Acute Cardiac Care provides a unique combination of review papers, original manuscripts and letters to the editor covering interesting case presentations. It reflects in a comprehensive fashion the complex care involving the acute cardiac patient. The timely paper on Stent based percutaneous coronary interventions in small coronary arteries[1] reviews the current information on treatment of small coronary vessels using stents. A third to half of all percutaneous coronary interventions involves small diameter vessels, thus it is a very frequent problem. This paper provides an update on the current status and defines the clinical utility of small vessel stenting, particularly in the era of drug‐eluting stents. The effects of abciximab in managing acute myocardial infarct interventions based on results of the Danami‐2 trial are covered in another paper [2]. In this trial, the decreased re‐infarction rates in patients receiving abciximab was offset by increased disabling stroke rates. At the same time, Abciximab in conjunction with primary PCI is associated with more pronounced partial ST‐segment resolution after 4 to 12 hours suggesting improved microvascular reperfusion. Reading this paper is a must for physicians dealing with acute myocardial infarction interventions, or for that matter any cardiologist.

Results from the Acute Coronary Syndrome Israel Survey (ACSIS) on rescue angioplasty [3] add to the picture of management of the acute patient in the intensive coronary care atmosphere. The decisions regarding rescue PCI following failed thrombolysis are of utmost importance to the management of these patients. A review paper on The eccentric lumenology[4] provides a refreshing approach to how to manage eccentric and often calcified lesions. This particular problem has been poorly dealt with in the past and adds to the field of interventional cardiology.

Is the body mass index a factor in the management of acute myocardial infarction? The paper by Iakobishvili et al [5] covers these aspects and sheds an interesting light on this issue. Acute cardiac care diagnostics is markedly enhanced by imaging. The role and accuracy of contrast enhanced Multidetector computed tomography coronary angiography is brought up by two publications on these issues [6], [7]. The development of newer non‐invasive imaging techniques to accurately detect coronary artery disease is going to enhance our ability to identify patients at an early disease phase and at the same time obtain important anatomical information that will direct us towards the type and complexity of treatment modalities.

A series of illustrative Images in cardiology and letters to the editor, with educational potential, describing unusual cases follow these articles. Images from coronary angiography in 17 years old patient with angina pectoris [8]; an image describing Large vegetations associated with implantable Cardioverter‐defibrillator lead[9]. The letters describing Ultrasound attenuation behind coronary atheroma[10]; bilateral ostial coronary artery disease[11] and late acute thrombosis after implantation of sirolimus‐eluting stent to treat in‐stent restenosis[12]. The concern of late thrombosis that can be induced by cessation of anti‐platelets agents have been growing since the wide use of drug eluting stents. Other interesting letters include unexpected result of percutaneous coronary intervention, [13]; post cardiac injury syndrome complicating radiofrequency ablation[14] and angioplasty of an occluded aberrant coronary artery[15].

Acute Cardiac Care provides a patient oriented literature coverage, original articles and description of interesting letters for the practicing cardiologist dealing with acute cardiac patients. It is the second issue of this journal in the present form and we expect it to grow and become a major venue for publications in this emerging field of research. We would like to encourage you all to submit papers to our journal and contribute to the knowledge base within this very important subject. Please turn to our journal website – http://www.tandf.no/acc – for further information and to find detailed instructions for authors.