Author Interviews, Biomarkers, Heart Disease, JAMA, Technology / 05.10.2021
Portable Device Screens for MicroRNAs to Rapidly Detect Heart Attack
MedicalResearch.com Interview with:
[caption id="attachment_58206" align="alignleft" width="200"] Dr. Zorlutuna[/caption]
Pinar Zorlutuna, PhD
Sheehan Family Collegiate Professor of Engineering
Aerospace and Mechanical Engineering
Chemical and Biomolecular Engineering (Concurrent)
Bioengineering Graduate Program
University of Notre Dame
MedicalResearch.com: What is the background for this study?
Response: Acute myocardial infarction (AMI) is the primary cause of death among cardiovascular diseases. The current clinical standard of diagnosis combines echocardiogram (ECG) and several circulating protein biomarkers from plasma. In their current state, both are incapable of distinguishing between patients with and without complete coronary occlusion, unless additional invasive testing is implemented, and both have significant false positive rates.
MicroRNAs (miRNAs) have shown great potential as rapid and discriminating biomarkers for acute myocardial infarction (AMI) diagnosis.
Dr. Zorlutuna[/caption]
Pinar Zorlutuna, PhD
Sheehan Family Collegiate Professor of Engineering
Aerospace and Mechanical Engineering
Chemical and Biomolecular Engineering (Concurrent)
Bioengineering Graduate Program
University of Notre Dame
MedicalResearch.com: What is the background for this study?
Response: Acute myocardial infarction (AMI) is the primary cause of death among cardiovascular diseases. The current clinical standard of diagnosis combines echocardiogram (ECG) and several circulating protein biomarkers from plasma. In their current state, both are incapable of distinguishing between patients with and without complete coronary occlusion, unless additional invasive testing is implemented, and both have significant false positive rates.
MicroRNAs (miRNAs) have shown great potential as rapid and discriminating biomarkers for acute myocardial infarction (AMI) diagnosis.
Dr. Frost[/caption]
Holly Frost, MD
Assistant Professor Pediatrics
University of Colorado Anschutz School of Medicine
[caption id="attachment_58185" align="alignleft" width="150"]
Dr. Singer[/caption]
Daniel E. Singer, MD
Professor of Medicine, Harvard Medical School
Professor in the Department of Epidemiology
Harvard T.H. Chan School of Public Health
Division of General Internal Medicine
Massachusetts General Hospital
Boston, MA, 02114
MedicalResearch.com: What is the background for this study?
Response: Atrial fibrillation (AF) raises the risk of ischemic stroke 4-5-fold and this risk is largely reversible by oral anticoagulants (OAC). These facts are part of the core knowledge of internal medicine and the basis of multiple guidelines. They are based on studies of patients with persistent or predominantly “heavy burden” paroxysmal AF completed in the 1990s.
More recent studies using cardiac implantable devices (CIEDs: implantable defibrillators, pacemakers, etc) which have the capacity to monitor heart rhythm continuously have found that many older patients have brief, often undiagnosed, episodes of AF. Several of these studies have found that strokes occur during periods of sinus rhythm temporally distant from a preceding episode of AF. This has led to a widespread suspicion that AF is not a direct causal risk factor but a risk “marker” indicating the presence of other truly causal features like a diseased left atrium (atrial myopathy). If the risk marker hypothesis is correct, then long-term anticoagulation is needed even for brief and rare episodes of AF (assuming the patient’ s CHA2DS2-VASc score is high enough). The key problem with prior prospective studies using CIEDs was that only a small number of strokes were observed leading to inadequate statistical power.
Our study addressed this power problem by linking the very large Optum electronic health record database which could identify ischemic strokes with the Medtronic CareLink database of long-term, continuous heart rhythm records of patients with CIEDs. We ended up studying 891 individuals who had an ischemic stroke and had 120 days of continuous heart monitoring prior to the stroke.
Helen Trottier Ph.D
Assistant Professor, Department of Social and Preventive Medicine,
Researcher, CHU Sainte-Justine Research Center
Université de Montréal
Montréal, Québec, Canada
MedicalResearch.com: What is the background for this study?
Response: We know that HPV infection can have serious consequences such as the development of cancerous lesions in the cervix. HPV infection is also very prevalent in young women of childbearing age but the possible consequences of HPV in pregnancy have been poorly studied. Some population registers around the world have shown a reduction in the risk of preterm birth with HPV mass vaccination, but we must be careful with this kind of ecological correlation.
We have set up a large cohort study in pregnant women to study the association between HPV in pregnancy and preterm birth by targeting certain HPV genotypes and the duration of the infection.
Dr. Ezhkova[/caption]
Elena Ezhkova, PhD
Professor, Department of Cell, Developmental, and Regenerative Biology
Professsor, Dermatology
Lab Head,The Black Family Stem Cell Institute
Icahn School of Medicine at Mount Sinai
New York
[caption id="attachment_58115" align="alignleft" width="125"]
Dr. Li[/caption]
Meng-Yen Li, PhD
Postdoctoral Fellow
The Black Family Stem Cell Institute
MedicalResearch.com: What is the background for this study?
Response: The epidermis is the primary barrier and the first line of defense to combat environmental stressors. The sun's ultraviolet (UV) is one of the main environmental stressors that our body is exposed to daily. UV produces DNA damage in epidermal cells and is a leading cause of skin cancers.
To protect from the damaging effects of UV, epidermal cells become pigmented by melanocytes, pigment-producing cells. Taken up by epidermal cells, the melanin pigment absorbs UV light and reduces DNA damage. How the epidermis senses UV and how it leads to epidermal pigmentation is poorly understood.
Dr. Cole[/caption]
Megan B. Cole, PhD, MPH
Assistant Professor | Dept. of Health Law, Policy, & Management
Co-Director | BU Medicaid Policy Lab
Boston University School of Public Health
Boston, MA 02118
MedicalResearch.com: What is the background for this study?
Response: Under the Affordable Care Act, states were given the option to expand Medicaid eligibility to nonelderly adults with incomes up to 138% of the federal poverty level, where in January 2014, 25 states plus Washington, DC expanded eligibility, with 13 additional states expanding thereafter. State Medicaid expansion decisions were particularly consequential for federally qualified health centers (FQHCs), which serve nearly 30 million low-income, disproportionately uninsured patients across the US.
We know from earlier work that in the shorter-term, Medicaid expansion was associated with improvements in quality of care process measures and FQHC service capacity. However, we conducted the first known nationally representative study to examine how Medicaid expansion impacted key chronic disease outcome measures at FQHCs over the longer-term by looking at changes five years after implementation, including changes by race/ethnicity.
