Chris’s Corner: Personal Reflections on Valentin Fuster

By Christopher P. Cannon, MD

It is with great excitement and anticipation that I look forward to working with Valentin Fuster, MD, PhD, when he takes the post as the next editor-in-chief of JACC. He has been one of the reasons I went into cardiology in my early years of medicine, and continues to inspire me (and many others) to discover what is possible in CV medicine.

I should note that I was part of the selection committee for the next JACC editor-in-chief—one of a group of 15 charged with sifting through the many applications to find someone capable of filling some of the biggest shoes at the ACC (those of our trusted and admired leader, Tony DeMaria, MD). In the past 6+ years since I have been an editor at CardioSource, I have so cherished my time with Tony. He has led JACC to greatness, and we have forged many cross collaborations with online and electronic media. Who could we possibly find to do as good a job?

There were great candidates, many of whom could do a terrific job at JACC, but Dr. Fuster stood out as a leader who can continue JACC's rise and expand its important role in the field of cardiology.

My first "introduction" to Dr. Fuster was though his writings. The concept of acute coronary syndromes was just emerging, and one paper I had in my pile in my call room was "Anatomic-physiologic links between acute coronary syndromes" by Drs. Gorlin, Fuster, and Ambrose from Mt. Sinai. As I look at it today, it is amazing that the term was used back in 1986, since it took more than a decade for the term to come into greater use. This has become the field I ended up devoting myself to.

There were other papers, including many articles by Drs. Fuster and Chesebro on platelets and clotting, actual visualization of clots with angioscopy in unstable angina patients by Dr. Forrester and colleagues, platelets and unstable disease by Dr. Willerson and colleagues, and the classification of unstable angina by Dr. Braunwald. The idea that what was thought to be "atherosclerosis" (or hardening of the arteries, as my father would explain to me when I was growing up) was very dynamic, and opened up the whole field of antithrombotic and thrombolytic therapy. This is where I really dived into cardiology!

Later, I would listen to Dr. Fuster's talks at plenary sessions, always detailed and fresh new looks at the pathophysiology of coronary disease: he developed a classification of plaques as they evolve, from rupture to healing; a focus on the "hot" plaques, the "hot" blood; from "unstable plaques" to "unstable patients." He was always challenging us to move forward in our thinking, and to think more broadly.

Indeed, his vision is one of his most admirable strengths. He was AHA president in 1998-1999, the year that the AHA set a goal to reduce CV morbidity and mortality by 25% in the next 10 years. How bold and important. And in January 2008 came the announcement: government statistics showed that goal had been met!

Back in 1999, I had the great privilege of participating in a program at the Heart House, "How to Become a Cardiovascular Investigator," that Dr. Fuster still leads. It is here where many young investigators could be inspired to engage in academics—a wonderful service he brings to us all. The following year, I joined him on a program he also continues to chair, "The Cardiology Show" on, a roundtable of highlights from cardiology meetings. I loved participating with him, along with Michael Weber, MD, and Terry Ferguson, MD, as he picked out the most important trials and asked our thoughts.

His enthusiasm is contagious, and his energy boundless! He sees patients many days a week, runs institutes both in Spain and at Mt. Sinai, performs cutting-edge research, leads clinical trials (like FREEDOM), and leads the ACC's Annual New York Cardiovascular Symposium (now held on three continents). He has already built up one journal from scratch to be #6 (Nature Reviews Cardiology); I can't wait to see the direction in which he takes JACC.

Starting next July he will become editor-in-chief of JACC, bringing with him all his vision and energy, with the goal of positioning JACC as a vehicle to engage clinicians on CV disease worldwide. He said his focus would be to ensure all articles relate in some way to the patient—either direct management or new biologic understanding that helps understand a patient's disease or treatment. I look forward to being part of the team that makes JACC a multimedia experience, exploring all possible avenues on CardioSource and in electronic communications to spread the word and encourage participation on an international level. All of us collaborators want the same thing: a dynamic journal that will help us improve the CV care of our patients. It will be a wonderful ride!

Christopher P. Cannon, MD, is a professor of medicine at Harvard Medical School in Boston, Massachusetts. He is also the Editor-in-Chief of CardioSource Science and Quality.

Keywords: Thrombolytic Therapy, Acute Coronary Syndrome, Atherosclerosis, Angioscopy

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