Acute Cardiac Care: the lifting of the veil

The title of this editorial is ambitious especially for a relatively new journal. However, the aim of the editors – to offer a different view of acute cardiac care (the subspecialty) to the readers of Acute Cardiac Care (the journal) – was clear from the first issue. The title “Acute cardiac Care: apocalypse now” [1] has been selected for the first editorial of the journal.

The Greek word “apocalypse” provoked discussions among cardiologists. The meaning of the word may vary between “writing about the future” and “predicting what will happen when the world ends” but it is also a term applied to “disclosure to privileged persons of something hidden from the mass of humankind” [2].

This issue of the journal continues the “lifting of the veil” in acute cardiac care diagnostics and treatment. Panteghini [3] reviews the importance of analytical quality specifications for biomarker assays used in acute cardiac care. “It is very important that cardiac biomarkers on which clinically relevant decisions will rest are measured with highly reliable assays”. The drive to get to the market the best diagnostic tools as soon as possible should be counteracted with appropriate quality control that assures proper and reliable techniques. Reasonable control of analytical tools that enter the market is a responsibility that must be shared among laboratories, clinicians, industry, and regulatory agencies. Obviously, regulatory control of devices and biomarker essays widely varies among different countries and some harmonization of regulatory agencies may also be helpful.

With respect to Coronary interventions Hamood et al. [4] describe the “Anchor wire technique” to improve device deliverability. This technique is based on using a second guide wire that is inserted into the non‐target artery. In this paper the authors show this technique to be useful in increasing success rates in various complex coronary interventions.

Acute coronary syndromes and heart failure are often interrelated. Iakobishvili et al. [5] studied the effect of heart failure in cases of acute coronary syndromes. While the crude mortality rates of patients admitted with acute coronary syndrome with prior heart failure are higher than in patients without heart failure, the analysis presented here indicate that the primary impact of prior heart failure is on morbidity, rather than on mortality. Heart failure is one of the major challenges in cardiology and will continue to be a major focus of this journal.

Back to interventions in acute cardiac syndromes, Bartorelli et al. [6] report the results of the RUBY study in distal embolic protection during percutaneous coronary intervention in patients with acute coronary syndromes. A thorough evaluation of the efficiency of distal protection in these patients includes major adverse cardiac events, ST‐segment resolution, myocardial blush grade and visible distal emboli. It was shown that distal protection using the GuardWire filter system was successfully achieved in nearly all patients without complications.

Guidelines are important clinical tool to induce good clinical practice worldwide. The use of the American College of Cardiology/emergency cardiac care (ACC/ ECC) guidelines in triaging patients to telemetry unit is discussed by Tiongson et al. [7]. It is shown that cardiology input using these guidelines at admission safely reduces total admissions, primarily by identifying low risk chest pain admissions.

Three interesting letters to the editor with case reports conclude this issue. Stenting left main artery in a set‐up of acute myocardial infarction and cardiogenic shock [8], a case of spontaneous coronary artery dissection [9], and a unique and novel coronary intervention in an ostial circumflex artery using 2 guiding catheters in parallel [10].

This issue of the journal covers the core elements of managing acute coronary patients. It includes diagnostics and criteria for telemetry, heart failure aspects of cardiac care, novel interventional techniques and clinical innovations. Above all, we see integration of all these interrelated fields in a Journal covering Acute Cardiac Care.

We thank the contributors and readers for their interest in this Journal. We do foresee an ever increasing role to the interrelations of the different disciplines involved in Acute Cardiac Care in cardiology. We therefore ask you to make this Journal an important venue to your publications and an interesting digest for your curiosity. We assure prompt and efficient review process and rapid publication time.