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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 6, November/December 2017



This issue carries the first of what I hope will become a regular

feature. On page 404, McCutcheon and colleagues publish a

coronary angiogram with aggressive in-stent restenosis due

to neo-intimal hyperplasia a short while after coronary stent

implantation. The accompanying optical coherence tomographic

images demonstrate the utility of this technology. I encourage

readers to submit similar unusual or informative images.

The new oral anticoagulants remain expensive and will not

be readily available in countries with limited medical resources.

Warfarin will probably remain the agent of choice for some

time and this almost certainly applies to many countries in

Africa. Jacobs and co-workers from Tygerberg Hospital (page

346) conducted a retrospective review of patients admitted with

warfarin toxicity. They identified the causes of the toxicity and

the human and financial cost. An editorial by Blockman (page

344) points out that warfarin accounts for a significant number of

the adverse drug reactions causing admission to hospital.

In a similar vein, Awad and colleagues (page 350) report on

an investigation on medication adherence among cardiac patients

in Sudan. They determined that the top four barriers to poor

medication adherence among the study participants were the

high cost of drugs, polypharmacy, and lack of pharmacist and

physician communication with patients about their drug therapy.

There is not much individual physicians can do about the high

cost of drugs and polypharmacy is sometimes necessary, but we

should talk to our patients to explain their illnesses and the need

for adherence to medication. It is sad that this does not happen.

Balieva and co-workers report on the electrocardiographic

features found in a sub-group of patients from a larger registry

of patients in Africa with pulmonary hypertension, diagnosed

by clinical and echocardiographic features. They compared them

to ECG features found in a population known to be disease-free

following extensive cardiological evaluation (page 370).

PJ Commerford,


From the Editor’s Desk

Merry Christmas

and a

Happy New Year

The management and staff of Clinics Cardive Publishing wishes you and

your family a wonderful holiday season and a healthy and peaceful 2018.

May your holidays be filled with joy, peace and good cheer!

We take this opportunity to thank you for your loyal support during 2017

and look forward to being of service during 2018.

Please note our offices will close on 15 December and will be open from

08 January 2018.