(Vol.6 No.5 --- July 2001)


Ischemic heart disease is the second commonest cause of death in Hong Kong. With our aging population and more westernized life-style, it is expected that the importance of ischemic heart disease will further increase in the future. Over the past few decades, one has seen important advances both in the diagnosis as well as management of this important disease entity. The most outstanding of these is the discovery of percutaneous transluminal coronary angioplasty with its first successful clinical application in September 1977 by Dr. Andreas Gruentzig in Zurich in a 37 years old insurance salesman with severe angina pectoris and high grade stenosis of the proximal left anterior descending coronary artery. Since then a lot of exciting developments occurred in the field of percutaneous coronary intervention and it has now become one of the most widely practised treatment modality worldwide. In the Special Feature Section of this issue of the Medical Diary, I shall give a brief summary of the diagnosis of ischemic heart disease and its treatment by percutaneous coronary intervention.

Also included in the Special Feature Section is an article on "Advances in Anti-thrombotic Treatment". Thrombolytic treatment is another breakthrough in the management of acute myocardial infarction. Since then many anti-thrombotic agents have been developed like the GP IIb/IIIa inhibitors, new anti-platelet agents like ticlopidine and clopidogrel as well as the direct antithrombins and low molecular weight heparin. In this article, advances in anti-thrombotic treatment will be detailed.

The last article included in the Special Feature Section is "Women at Cardiovascular Risk: Does Gender Alter Therapy?". In this article detailed discussion of the cardiovascular risk factors in women will be given and the role of hormone replacement therapy after the findings of the Heart and Estrogen-progestin Replacement Study (HERS) will be explained.

In the Medical Bulletin Section I have selected a number of interesting papers presented in the Ninth Annual Scientific Congress of the Hong Kong College of Cardiology which covered important area like hypertension treatment by calcium channel blockers and low dose combination therapy, management of hypertension in diabetic patients, roles of ACE inhibitors, angiotensin II receptor blockers and beta-blockers in treatment of heart failure patients and devices versus drug management in arrhythmia in heart failure.

I hope that these papers will refresh the memories of our readers and to bring to their attention some recent advances in the field of Cardiology.

Dr. Chiang Chung Seung