Giuseppe Biondi-Zoccai, MD, FSICI-GISE
Assistant Professor in Cardiology
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
During a nice dinner in Bologna, Italy, a few years ago, a colleague currently working in Cleveland once told me, with a critical yet constructive stance, that I was producing too much in my scholarly activities (ie, manuscripts). Accordingly, he was implying that the quality of my efforts was suboptimal. He thus urged me to focus on fewer and higher-quality projects.
It might seem a strange suggestion, as the typical issue with clinical researchers is that they may be too little productive. However, if you bear in mind that I am a 39-year-old interventional cardiologist with 456 articles indexed in MEDLINE/PubMed and a 53 h index as of October 24, 2013, you might also conclude that I am somewhat overdoing.[1-2]
I did not reply at the time, as this caught me off guard, but, as with any informed comment, I considered the issue thoroughly. I concede that science is a complex, time-consuming, and rarified task. However, interventional cardiologists do not necessarily need to dedicate themselves to science, if they want to improve patient care. Indeed, I have now realized that I am not sensu strictu a scientist, but rather, and much more humbly, just a researcher. I thus belong to the group of people who investigate major or minor clinical issues, but still with the ultimate goal of increasing our understanding of cardiovascular disease and improving patients’ symptoms, functional status, and life expectancy, while minimizing, if possible, costs and complications. This is not altogether different from what a Wall Street financial analyst is doing. And I sincerely hope this comparison doesn’t offend anyone.
This preamble is necessary to understand why a treasure a journal such as the Journal of Invasive Cardiology and papers similar to the one we hereby present. While papers in Nature, Science, or even the New England Journal of Medicine and Lancet shape at large medical care and our pathophysiologic paradigms, in everyday routine practice we still need detailed information to pick up the best device for a given lesion, to appropriately size a stent, or to decide if and when to administer a bolus of a given parenteral antithrombotic agent.
This time we chose to focus our scholarly energies on the comparison of patients undergoing percutaneous coronary intervention for bifurcation lesions, according to the location of the culprit lesion. We thus address the simple question that many fellows have asked us: are lesions in the left anterior descending similar or different to those in another vessel? And what about the left circumflex? While our work has many limitations, including, by definition, the lack of randomization, we believe it is inherently strong given its focus on such a tiny, yet technically specific, issue.
Without challenging the supremacy of real medical scientists, the ongoing success of sub-specialty and technical journals, rich of similar articles, is a living proof that we are right in pursuing such endeavors, and that every question, even that which appears largely trivial and obvious, may be important and fruitful to address, whenever this can be done explicitly, rigorously, and formally.
- MEDLINE/PubMed. Available at: http://www.ncbi.nlm.nih.gov/pubmed/?term=zoccai[au]+OR+biondi-zoccai[au] (last accessed on October 24, 2013).
- Google Scholar. Available at: http://scholar.google.it/citations?user=Y9HjW5oAAAAJ&hl=en (last accessed on October 24, 2013).
- Biondi-Zoccai G, Sheiban I, De Servi S, Tamburino C, Sangiorgi G, Romagnoli E. Does the target vessel impact on results of percutaneous coronary intervention for bifurcation lesions? Insights from the I-BIGIS registry. J INVASIVE CARDIOL 2013;25(12):660-665.
A selection of articles on Bifurcation Lesions, available at http://www.invasivecardiology.com:
- Ohya H, Kyo E, Tsuji T, Watanabe S, Katoh O. Impact on Clinical Outcomes of Predilatation Using the Kissing-Balloon Technique for Crossover Stenting in True Coronary Bifurcation Lesions. J INVASIVE CARDIOL 2013;25(10):512-518.
- Isaaz K, Bayle S, Lamaud M, et al. Immediate and Long-Term Results of a Modified Simultaneous Kissing Stenting for Percutaneous Coronary Intervention of Coronary Artery Bifurcation Lesions. J INVASIVE CARDIOL 2013;25(3):126-131.
- Pereira-da-Silva T, Bernardes L, Cacela D, et al. Safety and effectiveness of the Genous endothelial progenitor cell-capture stent: follow-up to 5 years. J INVASIVE CARDIOL 2013;25(12):666-669.
- Jin Z, Li L, Wang M, Zhang S, Chen Z, Shen Z. Innovative provisional stenting approach to treat coronary bifurcation lesions: balloon-stent kissing technique. J INVASIVE CARDIOL 2013;25(11):600-604.
- Williams PD, Eichhöfer J, Mamas MA, Arnous S, Fath-Ordoubadi F, Fraser D. Transradial intervention via large-bore guide catheters: a study of coronary bifurcation disease treatment using the crush technique. J INVASIVE CARDIOL 2013;25(9):455-459.