Author Interviews, Education, JAMA, Race/Ethnic Diversity, Social Issues / 02.12.2019

MedicalResearch.com Interview with: Lynn Blewett, PhD Mayo Professor, Division of Health Policy and Management Director, State Health Access Data Assistance Center (SHADAC) University of Minnesota MedicalResearch.com: What is the background for this study? Response: We used a new set of questions about patient's perspectives of cultural competence of their providers that was added to the National Health Interview Survey and accessed through the Minnesota Population Center IPUMS Health Surveys.   MedicalResearch.com: What should readers take away from your report? Response: Most patients (97%) report being treated with respect by their providers. BUT we also found important disparities.  Black or Hispanic (vs White), uninsured (vs insured), and low income (vs >200% FPL) individuals reported being treated with respect less often, viewed a shared culture as more important, and saw providers who shared culture less often. (more…)
AHA Journals, Author Interviews, Gender Differences, Stroke / 30.11.2019

MedicalResearch.com Interview with: Cheryl Carcel MD Research Fellow, Stroke & Women's Health Program Conjoint Senior Lecturer, Faculty of Medicine, UNSW Sydney Associate Lecturer, Sydney Medical School, The University of Sydney The George Institute for Global Health | Australia MedicalResearch.com: What is the background for this study? Response: This study builds on previous findings of differences in the presentation, treatment and outcome for women and men who experience stroke. For this analysis, we pooled five large international, multicenter, randomized controlled trials that included the following: the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT-1 and -2 studies), the alteplase-dose arm of the Enhanced Control of Hypertension and Thrombolysis Stroke study (ENCHANTED), the Head Position in Acute Stroke Trial (HeadPoST), and the Scandinavian Candesartan Acute Stroke Trial (SCAST). (more…)
Author Interviews, Depression, JAMA / 30.11.2019

MedicalResearch.com Interview with: Karina Pereira-Lima, PhD Department of Psychiatry, University of Michigan Medical School, Ann Arbor Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil MedicalResearch.com: What is the background for this study? Response: Questions regarding the magnitude and direction of the associations between physician depressive symptoms and medical errors remain open in recent literature. By pooling data from 11 studies involving 21,517 physicians, we were able to verify that depressive symptoms among physicians were associated with increased risk of reporting medical errors (RR, 1.95; 95% CI, 1.63 – 2.33). (more…)
Author Interviews, Education, ENT, Hearing Loss, JAMA, Pediatrics / 30.11.2019

MedicalResearch.com Interview with: Dr. Carlijn M. P. le Clercq, MD Speech and Language Pathology, Pediatrics, Otolaryngology Erasmus MC, Rotterdam MedicalResearch.com: What is the background for this study? Response: Recently, more reports have been publishes about the prevalence of slight to mild hearing loss among children in the general population. These studies showed that slight hearing loss is common, also within our population-based cohort in the Netherlands. Slight hearing loss is often scored as “not relevant”. We wanted to examine if we could find associations of hearing thresholds in children with performance scores in everyday life. (more…)
Aging, Author Interviews, JAMA, Opiods / 27.11.2019

MedicalResearch.com Interview with: Yong-Fang Kuo, PhD Professor and Director, Office of Biostatistics Don W. and Frances Powell Professor in Aging Research Mukaila Raji, MD, MS, FACP Professor & Director Edgar Gnitzinger Distinguished Professorship in Aging Preventive Medicine and Population Health UTMB Health MedicalResearch.com: What is the background for this study? Response: Medicare beneficiaries who qualified because of disability constitute a growing population of patients hospitalized for opioid/heroin overdose. Although the CDC regularly generates reports of opioid overdose deaths by demographics and states, studies on policy actionable predictors of overdose mortality (e.g., clusters of medical and psychiatric conditions, types of disabling conditions) are lacking in this population.  (more…)
Author Interviews, JAMA, Opiods / 27.11.2019

MedicalResearch.com Interview with: Steven H. Woolf, MD, MPH Director Emeritus and Senior Advisor, Center on Society and Health Professor, Department of Family Medicine and Population Health C. Kenneth and Dianne Wright Distinguished Chair in Population Health and Health Equity Virginia Commonwealth University School of Medicine Richmond, Virginia 23298-0212 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Life expectancy in the US has decreased for three years in a row, the first time this has occurred in this country since the Spanish flu epidemic a century ago. Meanwhile, life expectancy in other countries continues to climb. Our study found that the trend is being driven by an increase in death rates among working-age adults (ages 25-64 years), which began as early as the 1990s. The increase has involved deaths from drug overdoses—a major contributor—but also from alcoholism, suicides, and a long list of organ diseases. We found increases in 35 causes of death. We analyzed the trends across the 50 states and discovered that the trend is concentrated in certain regions, especially the Industrial Midwest (Rust Belt) and Appalachia, whereas other regions like the Pacific states were least affected. Increases in midlife mortality in four Ohio Valley states (Ohio, Pennsylvania, Indiana and Kentucky) accounted for one third of the excess deaths between 2010 and 2017. (more…)
Author Interviews, JAMA / 27.11.2019

MedicalResearch.com Interview with: James S. Goodwin, M.D. George and Cynthia Mitchell Distinguished Chair in Geriatric Medicine University of Texas Medical Branch Galveston, TX  77555-0177James S. Goodwin, M.D. George and Cynthia Mitchell Distinguished Chair in Geriatric Medicine University of Texas Medical Branch Galveston, TX  77555-0177 MedicalResearch.com: What is the background for this study? Response: Full time hospital doctors, called hospitalists, now provide the medical care for most patients hospitalized in the US. Depending on the hospital and also the hospitalist group, the working schedules of hospitalists can have vary greatly. For example, some might work 8 AM to 5PM for seven days followed by seven days off. Others might work 24 hours on and 72 hours off. Depending on the schedule of the hospitalists proving care, a patient  might have one or two or three or more different doctors proving care during their stay. Some patients see a new doctor each day. Our goal was to see if patients who received care from hospitalists who tended to work several days in a row did better than those who were cared for many different hospitalists with intermittent schedules. (more…)
Author Interviews, JAMA, Neurology, Ophthalmology, Pain Research / 27.11.2019

MedicalResearch.com Interview with: Priv.-Doz. Dr. med. Christoph Schankin Consultant Head University Headache Clinic Department of Neurology Inselspital, Bern University Hospital University of Bern MedicalResearch.com: What is the background for this study? Response: Visual snow syndrome is a debilitating disorder with a continuous TV snow-like visual disturbance that persists over years. Patients have additional visual problems, such as severe afterimages, floaters or photophobia. The syndrome is associated with migraine and migraine aura, but the interaction between the two remains unclear. (more…)
Abbvie, Author Interviews, Rheumatology / 27.11.2019

MedicalResearch.com Interview with: Aileen Lorenzo Pangan MD Executive Medical Director AbbVie MedicalResearch.com: What is the background for this study? Response: Our ongoing commitment to advancing the standard of care for patients with rheumatic diseases is illustrated by our growing portfolio and the thirty-eight abstracts we presented at this year's ACR/ARP Annual Meeting, including results from five studies of RINVOQ in rheumatoid arthritis (RA) and primary results from our study in ankylosing spondylitis (AS). (more…)
Aging, Dermatology, JAMA / 26.11.2019

MedicalResearch.com Interview with: Christian Sell, PhD Associate Professor of Biochemistry and Molecular Biology Drexel University College of Medicine MedicalResearch.com: What is the background for this study? Response: In terms of background, the drug rapamycin targets a pathway that scientists know is critical for growth and development but is also a key regulator of lifespan in many model organisms such as worms, flies, and mice. This pathway is known as the mTOR pathway. Rapamycin is already in use clinically, it is given to people who have received organ transplants to prevent rejection and is also in trials to treat some forms of cancer, at very high doses. Many studies in mice have shown that rapamycin delays aging and prevents age-related disorders such as the decline in heart function and cognitive function. Based on this work, there is a strong expectation that these results will translate into humans, but no studies have been done due to concerns regarding potential side effects of rapamycin when the drug is given orally to prevent rejection. Our previous studies have shown that a very low dose of rapamcyin can reduce the aging of human cells and improve cell growth, while the high does used for organ transplant patients actually block cell growth.  We decided to test the impact of low dose rapamycin on aging in the skin because we could treat people safely. Previous studies have shown that the drug does not get into the blood stream when high doses were given topically to people with a rare genetic disorder, so we knew that the low doses used in our study would not get into the bloodstream and would be safe for the patients. (more…)
Author Interviews, Blood Pressure - Hypertension, JAMA / 26.11.2019

MedicalResearch.com Interview with: Brian S. Alper, MD, MSPH, FAAFP, FAMIA Board Certifications: Family Medicine, Clinical Informatics Founder of DynaMed Vice President of Innovations and Evidence-Based Medicine Development EBSCO Health  MedicalResearch.com: What is the background for this study? Response: We often use clinical practice guidelines as a “source of truth” for decision support for healthcare professionals and even as a standard of care for medical legal considerations.  However our experience evaluating guidelines for clinical reference support finds they are often inconsistent.  We picked one of the most common conditions managed in healthcare (ie hypertension, or high blood pressure) and sought out the top clinical practice guidelines that guide care around the world.   We systematically evaluated these guidelines against 70 specific recommendations to see how often the guidelines agreed or disagreed. (more…)
Author Interviews, Cancer Research, Genetic Research, Pharmaceutical Companies / 26.11.2019

MedicalResearch.com Interview with: Ambry GeneticsRachid Karam, MD PhD Director, Ambry Translational Genomics Lab Ambry Genetics MedicalResearch.com: What is the background for this study? Response: Standard DNA testing for hereditary cancer risk excludes large portions of DNA, thereby missing some mutations. In addition, DNA testing can produce inconclusive results and fail to determine that an error in our DNA increases cancer risk. These limitations impact patients and their families because doctors may not have the information needed to recommend appropriate preventive, early detection, or therapeutic steps. Additionally, relatives may not be referred for genetic testing and obtain the care they would otherwise have gotten if they had learned they had mutations. The study looked at how the addition of RNA genetic testing to standard DNA testing for hereditary cancer risk was able to increase diagnostic yield. The study looked at the first 2,500 patients that received Ambry Genetics +RNAinsight™, paired RNA and DNA genetic testing for hereditary cancer risk. The data from this study showed that the addition of RNA genetic testing to DNA testing (1) identified new mutations that would have been missed with DNA testing alone, and (2) clarified inconclusive results as disease-causing. (more…)
Author Interviews, JAMA, Osteoporosis / 26.11.2019

MedicalResearch.com Interview with: Pamela L. Lutsey, PhD Associate Professor Division of Epidemiology and Community Health University of Minnesota School of Public Health Minneapolis MedicalResearch.com: What is the background for this study? Response: Warfarin is prescribed to atrial fibrillation (AF) patients for the prevention of cardioembolic complications. However, whether it adversely impacts bone health is controversial. With the availability of alternate direct oral anticoagulant (DOAC) options, it is now possible to evaluate the comparative safety of warfarin in relation to fracture risk. (more…)
Author Interviews, Brigham & Women's - Harvard, Colon Cancer, JAMA, Omega-3 Fatty Acids / 26.11.2019

MedicalResearch.com Interview with: MINGYANG SONG, MD, ScD Assistant Professor, Epidemiology Harvard T.H. Chan School Of Public Health Assistant Professor of Medicine Clinical and Translational Epidemiology Unit Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Response: Increasing data indicate that high intake of omega-3 fatty acid may reduce the risk of colorectal cancer. Since effects of nutritional factors on risk of cancer, a slow-developing disease, typically emerge only after several years, it is useful to study the effect of preventive agents on cancer precursors such as colorectal polyps. Colorectal polyps are small growths on the lining of the colon or rectum. Most polyps are harmless, but some can become cancerous. (more…)
Author Interviews, Brigham & Women's - Harvard, Cannabis, JAMA, Pediatrics / 26.11.2019

MedicalResearch.com Interview with: Bertha K. Madras PhD Director, Laboratory of Addiction Neurobiology Psychobiologist, Substance Use Disorders Division, Basic Neuroscience Division Professor of Psychobiology, Department of Psychiatry Harvard Medical School MedicalResearch.com: What is the background for this study? Parent use of marijuana is rising, and I wondered whether this could be associated with offspring use of specific substances and across several substances
  • Several fathers have confided in me that they used marijuana to bond with their sons. They became horrified after witnessing their sons progress to using other drugs, especially heroin.
  • In general, living with a parent using substances or having substance use disorders is an explicit risk for use of substances among young offspring. Yet, few studies have directly examined whether parental marijuana use elevates the risk for opioid misuse among adolescent and young adults living with parents.  Most importantly and to the best of our knowledge, none of the existing research  simultaneously explored frequency of  parental marijuana use and whether it related to adolescent and young adult offspring’s marijuana, tobacco, alcohol use, and opioid misuse.
(more…)
Author Interviews, Ophthalmology, Thyroid Disease / 26.11.2019

MedicalResearch.com Interview with: Raymond S. Douglas, MD, PhD Ophthalmology Cedars-Sinai, Los Angeles MedicalResearch.com: What is the background for this study? Response: The data presented at the American College of Rheumatology (ACR) annual meeting on November 11, 2019 are integrated, pooled efficacy data from the Phase 2 and Phase 3 clinical trials of teprotumumab for the treatment of active thyroid eye disease (TED) compared to placebo. The results support prior analyses of significant reductions in inflammation, proptosis (eye bulging) and diplopia (double vision), as well as improvements in quality of life (QoL). This presentation of the pooled analyses builds on the individual positive results of the Phase 2 and Phase 3 clinical studies.  (more…)
Author Interviews, Rheumatology / 22.11.2019

MedicalResearch.com Interview with: Professor Jianmin Fang, Ph.D. Founder, CEO & CSO RemeGen MedicalResearch.com: What is the background for this study? Response: Systemic lupus erythematosus (SLE), known more commonly as lupus, is a chronic autoimmune disease in which the immune system mistakenly attacks healthy tissue. SLE can affect tissues like the skin, joints, kidneys, brain and other organs, resulting in a wide variety of signs and symptoms. With limited treatment options for lupus and the significant unmet medical needs in the treatment of autoimmune diseases, the Phase 2b study evaluated the efficacy and safety of subcutaneous RC18 (telitacicept), a potential new medicine for the treatment of systemic lupus erythematosus (SLE) versus a placebo in combination with standard therapy in patients with SLE at 48 weeks. (more…)
Author Interviews, Thyroid Disease / 22.11.2019

MedicalResearch.com Interview with: Charit Taneja, MBBS Internal Medicine Resident Maria Brito, MD Co-Director, Mount Sinai’s Thyroid Center Assistant Professor, Medicine, Endocrinology, Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response:  There have been reports of seasonal fluctuations in thyroid function, however there are no standard guidelines for management of such fluctuations and their clinical implications. It is not a well-studied subject and there are insufficient guidelines around its clinical implications.  MedicalResearch.com: What are the main findings? Response:  Our patient had winter elevation of TSH and summer normalisation repeatedly over a course of three years, but remained largely asymptomatic despite the biochemical alterations.  (more…)
Author Interviews, Nature / 22.11.2019

MedicalResearch.com Interview with: Dr. Gary J. Nabel M.D., Ph.D. Chief Scientific Officer, Global Research and Development Sanofi MedicalResearch.com: What is the background for this study? Response: The power of T cell co-stimulation in the immune system became apparent to the immunology community from basic studies on T cell activation and T cell receptor function dating back to the 1980’s and 1990’s.  As a professor at the University of Michigan and investigator at its Howard Hughes Medical Institute in the 1990’s, I became aware of this pathway through collaborations with Carl June and Craig Thompson in the 1990s.  When we stimulated T cells by engaging CD3 (a T cell receptor activation signal e.g. signal 1) and CD28 (a survival signal e.g. signal 2), we found that the co-stimulatory effect led to exceptional T cell proliferation. After our Sanofi team developed the trispecific antibody technology, we realized that it might be possible to engage CD3 and CD28 while targeting T cells to tumors with a third arm, CD38, which is highly expressed on myelomas, all interactions mediated by this one protein.  (more…)
Author Interviews, Pediatrics, Surgical Research / 22.11.2019

MedicalResearch.com Interview with: Ben Wheeler,MB ChB(Otago) DCH PhD CCE FRACP Paediatrician, Associate Department of Women's and Children's Health (Dunedin) University of Otag MedicalResearch.com: What is the background for this study? Response: All tongues have a frenulum, which is a small band of tissue that helps connect them to the floor of the mouth. Tongue tie (or ankyloglossia) is when this frenulum causes restriction to the movement of the tongue, and can interfere with successful breastfeeding in infants. This may be improved with an operation to cut the frenulum of the tongue (frenotomy). Internationally, tongue-tie diagnosis and treatment has increased substantially (reported at over 10-15% in some locations). This has led to growing concerns of potential overtreatment. The surgical treatment is often discussed as a minor surgery with little risk, but there is growing awareness this may not be the case. There is a paucity of studies examining moderate to severe complications following frenotomy. Therefore we aimed to determine rates of moderate to severe complications of tongue tie procedures presenting to hospital-based paediatricians in New Zealand, and describe this population. (more…)
Author Interviews, Heart Disease, Surgical Research / 21.11.2019

MedicalResearch.com Interview with: Chayakrit Krittanawong, MD Section of Cardiology Baylor College of Medicine Houston, TX MedicalResearch.com: What is the background for this study? Response: Transcatheter Aortic valve Implantation (TAVI) has emerged as equally effective alternative to surgical aortic valve replacement (SAVR) to treat severe aortic stenosis (AS) in all risk groups. In particular, less is known about the heart failure (HF) patients who undergo TAVI. Whether certain subtypes of HF respond differently after TAVI remains a mystery. In this study, we sought to assess and compare the incidence and predictors of in-hospital mortality among patients with heart failure with preserved ejection fraction (HFREF) versus heart failure with preserved ejection fraction (HFPEF). (more…)
Author Interviews, JAMA, Smoking, Tobacco, Tobacco Research / 21.11.2019

MedicalResearch.com Interview with: Amy L. Nyman, MA Research Associate Georgia State University, School of Public Health Atlanta, GA 30303 Coauthors: Nyman, Huang, Weaver, Eriksen MedicalResearch.com: What is the background for this study? Response: Though the negative health consequences of smoking combustible cigarettes have been well-established and widely accepted, there has been significant public debate about the health effects of Electronic Nicotine Delivery Systems (ENDS) use, and the extent to which use of ENDS may present less health risk to smokers than smoking combustible cigarettes. Many tobacco control researchers and scientists believe that ENDS use is safer than combustible cigarette smoking, though recent news of an expansive outbreak of vaping-related lung illnesses and deaths has led to continued speculation. A prior study of perceived comparative harm of combustible cigarettes and ENDS revealed the proportion of US adults perceiving ENDS to be as harmful as, or more harmful than combustible cigarettes increased substantially between 2012 and 2017. Given recently proposed regulations and the escalating focus on the impact of ENDS use on youth in the past few years, our study assessed changes in perceived comparative harm of combustible cigarettes and ENDS among US adults since the prior study, between 2017 and 2018.  (more…)
Author Interviews, Biogen / 20.11.2019

MedicalResearch.com Interview with: Aaron Deykin MD Vice President, Late Stage Clinical Development Biogen  MedicalResearch.com: What data support the U.S. Food and Drug Administration’s (FDA) approval of VUMERITY™ (diroximel fumarate)? Response: The FDA approval of VUMERITY was based on a New Drug Application (NDA) submitted under the 505(b)(2) filing pathway. It included data from pharmacokinetic bridging studies comparing VUMERITY and TECFIDERA® (dimethyl fumarate) to establish bioequivalence, and relied, in part, on the FDA’s findings of safety and efficacy for TECFIDERA. The NDA submission also included interim exposure and safety findings from EVOLVE-MS-1, an ongoing, Phase 3, single-arm, open-label, two-year safety study evaluating VUMERITY in patients with relapsing-remitting multiple sclerosis (MS). Interim results from EVOLVE-MS-1 at the time of NDA submission included a low overall rate of VUMERITY treatment discontinuation due to adverse events (6.3 percent), and a rate of less than one percent of patients who discontinued VUMERITY treatment due to gastrointestinal (GI) adverse events. Additional exploratory efficacy endpoints in the ongoing EVOLVE-MS-1 study showed changes in clinical and radiological measures compared to baseline. (more…)
Author Interviews, Heart Disease / 20.11.2019

MedicalResearch.com Interview with: Matthew Budoff MD Professor of Medicine, UCLA Endowed Chair of Preventive Cardiology Lundquist Institute Torrance, CA 90502 MedicalResearch.com: What is the background for this study? Response: We present the nine-month interim analysis results from the EVAPORATE mechanistic study of Icosapent Ethyl, after benefits were seen with the REDUCE-IT Trial, demonstrating 25% event reduction. This trial was a serial multi-detector computed tomographic (MDCT) study to look at plaque progression between icosapent ethyl (4 gm/day) and matching placebo.  (more…)
Author Interviews, Cancer Research, HPV / 20.11.2019

MedicalResearch.com Interview with: Ashish Deshmukh, PhD, MPH Assistant Professor UTHealth School of Public Health Houston MedicalResearch.com: What is the background for this study? Response: Anal cancer is one of the six human papillomavirus associated cancers.  Rates of anal cancer are increasing in the US, but no prior study quantified the contemporary trends (i.e., increase in rates over time) in anal cancer incidence. It was unknown whether the rise is real or driven by increased screening in some high-risk populations. Incidence trends according to age and stage at diagnosis was also never comprehensively studied. Furthermore, it was unknown whether the rise in incidence has led to a rise in mortality. Our objective was to answer these questions. (more…)
Accidents & Violence, Author Interviews, PTSD, Surgical Research / 20.11.2019

MedicalResearch.com Interview with: Michael A. Vella, M.D., M.B.A. Assistant Professor of Surgery Division of Acute Care Surgery and Trauma University of Rochester School of Medicine and Dentistry MedicalResearch.com: What is the background for this study? Response: There is a lot of (appropriate) focus on the mortality statistics related to gun violence, but sometimes we forget about the large number of survivors of gunshot wounds.  We wanted to specifically look at the long term physical and mental health outcomes in this patient population. (more…)
Author Interviews, Heart Disease, Omega-3 Fatty Acids, Prostate Cancer / 20.11.2019

MedicalResearch.com Interview with: Jeffrey L. Anderson, MD FAHA FACC MACP Distinguished Research Physician Professor of Medicine with Tenure University of Utah School of Medicine MedicalResearch.com: What is the background for this study? Response: Omega-3 supplements are widely used for cardiovascular prevention. However, a study published in the Journal of the National Cancer Institute (105:1132, 2013) reported as an incidental finding in a plasma bank study that the risk of prostate cancer increased with increasing levels of docosahexaenoic acid (DHA) and trended to increase with eicosapentaenoic acid (EPA). (more…)
Author Interviews, OBGYNE / 19.11.2019

MedicalResearch.com Interview with: Cynthia Gyamfi-Bannerman, MD, MSc Vice Chair for Faculty Development Ellen Jacobson Levine and Eugene Jacobson Professor of OBGYN Director, Maternal-Fetal Medicine Fellowship Program Co-Director, CUMC Preterm Birth Prevention Center  MedicalResearch.com: What is the background for this study? Response: ​Delayed cord clamping (DCC) at delivery has been associated with neonatal benefit.  Specially, it decreases the likelihood of anemia.  It became widely recommended as a practice for all deliveries even though the literature showing benefit to the neonates was largely only for low risk women with vaginal deliveries.  In theory, DCC could result in increased blood loss during a cesarean due to the blood loss encountered when cutting into a gravid uterus. (more…)
Author Interviews, CMAJ, Thyroid Disease / 18.11.2019

MedicalResearch.com Interview with: Dr. Richard Birtwhistle, Professor Departments of Family Medicine and Community Health and Epidemiology Director of the Centre for Studies, Primary Care, Department of Family Medicine Queen’s University MedicalResearch.com: What is the background for this study? Response: Testing for thyroid dysfunction is a commonly done by primary care practitioners. While the Thyroid stimulating hormone (TSH) test is an easy blood test to perform results outside the normal range are often found and will revert to normal over time without treatment in patients without symptoms. We wanted to see if there was any clinical benefit to patients by screening for thyroid dysfunction.  (more…)
Author Interviews, Lipids, NEJM, Neurological Disorders, Stroke / 18.11.2019

MedicalResearch.com Interview with: Pierre Amarenco, MD Professor and Chairman Paris University, Paris, France INSERM Department of Neurology and Stroke Centre Bichat Hospital Paris, France MedicalResearch.com: What is the background for this study? Response: The rationale of the Treat Stroke to target trial was that after we published the SPARCL trial in 2006 (atorvastatin 80 mg/day vs placebo in patients with stroke) which showed a 16% relative risk reduction of recurrent stroke, we performed several pre specified and post hoc analyses, showing that in SPARCL patients randomized with "atherosclerotic disease" the risk reduction for the primary endpoint was much higher (33%), and in in patients achieving a LDL cholesterol of less than 70 mg/dL as compared to those achieving a LDL cholesterol 100 mg/dL or higher, the risk reduction was 28%. Therefore to confirm this findings, we designed the TST trial, which was an investigator initiated trial funded by the french ministry of health,  and enrolled patients with an ischemic stroke due to atherosclerotic stenosis and randomized them to either a target LDL cholesterol of less than 70 mg/dL or a target LDL cholesterol of 90 to 110 mg/dL. To achieve these goals, the investigators could use any statin available on the market, and titrate the dosage of the statin to get to the assigned target. They could also use ezetimibe on top of statin therapy if a high dosage of statin was not sufficient to get to the target level assigned by randomization. (more…)