I would like to return to an issue that is becoming increasingly important in the image-centric society we live in: the question of central illustrations. As you are aware, this format is popular in scholarly publishing and has been adopted by many journals as a way to encapsulate the core meaning of a text without requiring in-depth reading. We could debate at length how this process of simplification may risk trivialising articles, losing sight of the critical points and, particularly, the methodological details. However, that is not the focus of today’s introduction to the table of contents of EuroIntervention. The more intriguing question at hand concerns the quality of these central figures themselves.
Journals naturally grant authors the right to exercise their creativity in arranging graphic elements as they see fit, and we lack precise guidelines for the creation of a central illustration. Nonetheless, what I have observed in recent months, not only in this Journal, is a pronounced shift towards the creation of infographics instead of central illustrations. In this context, by central illustrations, we mean figures that extract the main result from the paper; for instance, in the case of a clinical trial, an ideal central illustration would feature a graphic summarising the primary outcomes. This figure should stand on its own and be fully comprehensible even without the accompanying text.
What is increasingly common, however, is authors opting to create a kind of summary figure of the main results, accompanied by a variety of graphic elements and a few sentences summarising the key messages. This is, indeed, an infographic and a valid genre. Still, for dissemination within our Journal, we seek artwork that adheres to specific standards and this was why we updated the instructions in our Author’s centre, making them clearer and more user-friendly.
Therefore, if your idea for your next paper involves creating a central figure with various icons illustrating different outcomes such as all-cause death (over time I have seen all kinds of pictograms: tombs, skulls and bones, flat EKGs), I can already tell you that this may not be the best approach. If the paper is accepted, we will request revisiting this aspect to ensure consistency with the Journal’s content and graphics. As we strive to improve this aspect, let’s see how well we have succeeded in this edition, which I will now proceed to illustrateâ¦in words.
We open with an expert consensus from the Bifurcation Academic Research Consortium on the definitions and standardised endpoints for the treatment of coronary bifurcations. In light of the lack of standardisation applied to these lesions, Mattia Lunardi, Yoshinobu Onuma and colleagues in Europe, Asia and the USA collaborated to bring us a compendium that begins with the anatomical definitions and classifications of coronary bifurcation lesions and takes us through the different stages from diagnosis, imaging, clinical and procedural endpoints, all the way to follow-up.
We then turn to coronary interventions where the clinical research of Min Chul Kim, Youngkeun Ahn and colleagues examined whether high bleeding risk (HBR) patients are impacted differently by P2Y12 de-escalation than patients without HBR. Using data from the TALOS-AMI trial in which acute myocardial infarction patients had uniform, unguided de-escalation one month after the index PCI, the authors found that HBR status did not impact the safety and efficacy in terms of net adverse clinical outcomes, but the effect of de-escalation on reductions in the Bleeding Academic Research Consortium (BARC) bleeding type 3 or 5 was profound for patients at HBR. This article is accompanied by an editorial by Guillaume Cayla and Benoit Lattuca.
Alexandra J. Lansky, William Wijns and colleagues report the final five-year outcomes of the TARGET All Comers study in which patients were randomised to receive either the FIREHAWK biodegradable-polymer sirolimus-eluting stent or a durable-polymer everolimus-eluting stent. The 12-month primary endpoint of target lesion failure demonstrated the non-inferiority of the FIREHAWK in an all-comers population requiring stent implantation for myocardial ischaemia. The five-year results confirm the FIREHAWK’s long-term safety and efficacy. Valeria Paradies and Matteo Maurina break down the results from both clinical and technical perspectives in an accompanying editorial.
Salman S. Allana, Emmanouil S. Brilakis and colleagues analyse the use of the tip-in and rendezvous techniques in the PROGRESS-CTO registry. Although only used in a fraction of the registry’s chronic total occlusion percutaneous coronary intervention procedures, the procedural and technical success rates were similar to the more commonly used retrograde wire externalisation technique as were the in-hospital major cardiac adverse event rates. The authors additionally offer a quick primer on these techniques and situations in which they may be a useful alternative.
In a research correspondence, Sean Fitzgerald, Robert A. Byrne and colleagues share their centre’s experience of administering the European PATient Experience in the CATHeterisation Laboratory (PATCATH) survey to 100 patients undergoing either elective or in-patient coronary angiography or PCI. Developed by the EAPCI, the questionnaire explores patients’ understanding and comfort levels pre-, peri- and post-procedure. Although this was generally a positive experience, the authors suggest areas for further refinements.
Looking at interventions for valvular disease and heart failure, Masaaki Nakase, Thomas Pilgrim and colleagues investigate the prognostic value of cardiac damage staging classifications across the haemodynamic spectrum of severe aortic stenosis (AS). Patients were divided into high- and low-gradient AS groups and then classified using a modified staging scheme, according to the extent of extra-aortic valve damage. The authors discuss their findings of higher mortality in low-flow, low-gradient AS patients and that the staging system had prognostic value across all AS subtypes. This article is accompanied by an editorial by Philippe Pibarot and Lionel Tastet.
What should be done when a machine generates conflicting results? And worse, what do we do when conflicting evidence is human-generated? We bring you two viewpoints that look at the mechanism and meaning of conflicting evidence and solutions. Adil Salihu, Stephane Fournier and colleagues offer thoughts on their experience of submitting clinical vignettes to different versions of ChatGPT and Elmir Omerovic dissects the implications of two randomised trials that provide contradictory results.
Has this “illustration” of our Journal’s content intrigued you? Then, let’s now read the articles themselves.
