Welcome to Interventional Cardiology – Volume 4. The principal responsibility of this journal is to inform and discuss the latest developments in cardiovascular interventions. Resulting from this responsibility, the current issue includes some novel and exciting topics, such as interventions for structural heart diseases, and high-quality updates of old issues such as interventions in diabetics and carotid disease and new antithrombotic strategies.
The list of topics covered – from drug-eluting stents (DES) and thrombectomy in acute myocardial infarction to aortic and mitral valve disease treatment, carotid stenting trials and aortic aneurysm – means this publication is fully up-to-date. The range of content also confirms the need for the creation of a new rank of specialists who are able to treat nearly all cardiovascular diseases, no longer focusing only or mainly on the field of coronary artery disease.
Task forces and boards with sponsorship from the major cardiovascular medicine societies have already started a process for the definition of a pathway to clinical competence in endoluminal vascular medicine. It is not possible to predict whether in the next few years a patient with atherosclerotic disease involving more than one territory or with degenerative valvular disease and associated stroke or myocardial infarction will be routinely treated by a single vascular specialist, or if cardiovascular interventions will remain fragmented into many subspecialities. Regardless, from this point forwards all cardiologists in the interventional community will require a more complete knowledge of all cardiovascular diseases and their endoluminal treatment. This ‘global’ competence is needed to improve patient outcomes, considering that the increased risk of death in patients with clinical evidence of peripheral vascular disease is mainly driven by an unrecognised coronary artery disease that, in the majority, will be the ultimate cause of death.
Many talented cardiologists are already able to provide a global interventional approach to patients with atherosclerotic disease and cardiac and non-cardiac structural diseases, and this fact outlines the key role that cardiologists are called to play in the present and future of all cardiovascular interventions.
I hope you find the articles contained within these pages to provide a timely update on the latest developments and challenges facing the field.