Author Interviews, Heart Disease, JAMA, Statins / 09.03.2023

MedicalResearch.com Interview with: Myeong-Ki Hong, MD PhD Professor of Cardiology Yonsei University College of Medicine Severance Cardiovascular Hospital Seoul, Korea MedicalResearch.com: What is the background for this study? Response: The background of this study was to compare the long-term clinical outcomes between the two distinct strategies regarding statin intensity in patients with coronary artery disease (CAD). One is to titrate statin intensity to meet a target low-density lipoprotein cholesterol (LDL-C) level (treat-to-target strategy), the other is to maintain high-intensity statin without a target goal (high-intensity statin strategy). (more…)
Author Interviews, Heart Disease, Race/Ethnic Diversity / 28.02.2023

MedicalResearch.com Interview with: Dr. Muchi Ditah Chobufo MD MPH Cardiology Fellow West Virginia University MedicalResearch.com: What is the background for this study? Response: Ischemic heart diseases are a significant cause of morbidity and mortality in the USA. Also, there exists alarming ethnic disparities in mortality rates following acute myocardial infarction. To this effect, significant efforts have been deployed over the years to curb its burden and reduce extant disparities. It is in this light that we set out to analyze general and ethnic specific trends in acute myocardial infarction related age adjusted mortality rates (AAMR) in the entire USA from 1999-2020.  (more…)
Author Interviews, Cost of Health Care, Heart Disease, JACC / 26.02.2023

MedicalResearch.com Interview with: Rishi K. Wadhera, MD, MPP, MPhil Section Head, Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research Associate Program Director Cardiovascular Medicine Fellowship at Beth Israel Deaconess Medical Center Assistant Professor of Medicine, Harvard Medical School @rkwadhera MedicalResearch.com: What is the background for this study? Response: High and rising prescription drug costs in the United States contribute to medication non-adherence and financial strain among adults with cardiovascular risk factors or disease. As a result, addressing prescription drug costs in patients with chronic conditions has become a national priority. In response to these growing concerns, federal policymakers passed the Inflation Reduction Act on August 16, 2022, which aims to address high out-of-pocket drug costs for adults enrolled in Medicare Part D, by placing a $2000 annual cap on out-of-pocket prescription drug costs and expanding eligibility for full low-income subsidies to individuals that reduce deductible costs and prescription copayments (among several other provisions). It is unclear how these provisions will affect Medicare beneficiaries with cardiovascular risk factors and/or conditions. (more…)
Author Interviews, Heart Disease, JACC, Kidney Disease, Transplantation / 21.02.2023

MedicalResearch.com Interview with: Shinobu Itagaki, MD, MSc Assistant Professor Cardiovascular Surgery Icahn School of Medicine at Mount Sinai, New York, NY MedicalResearch.com: What is the background for this study? Were the transplants from a single donor? Response: The heart transplantation is the gold standard therapy for end-stage heart failure patients. As the kidney is affected by the heart function, it is common that the heart transplant candidates have some degree of kidney dysfunction as well. In these cases, the candidates are considered for simultaneous heart and kidney transplantation from a same donor. Unlike isolated heart transplantation, where the indication and benefits have been well established, simultaneous heart and kidney transplantation has less clear indication and benefits. This uncertainty is also complicated by the competing interest with isolated kidney transplantation candidates who in general wait longer on the waiting list. (more…)
Author Interviews, Biomarkers, Heart Disease, JACC, University of Michigan / 21.12.2022

MedicalResearch.com Interview with: Salim S. Hayek MD Assistant Professor Medical Director of the Frankel Cardiovascular Center Clinics University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Essentially, immune checkpoint myocarditis is a rare but deadly complication of immune checkpoint inhibitors – amazing drugs that are increasingly used for the treatment of various cancers. Most patients present late, and when they do, they’re very ill and have a 50% chance of death. Diagnosing ICI myocarditis is challenging, given there is no one test that can differentiate it from other causes of cardiac injury. It is important to diagnose it fast, early and accurately in order to start immunosuppressive therapy as soon as possible. What we did in this study was look at commonly measured biomarkers in all patients receiving ICI at the University of Michigan. What we found was that patients who developed ICI myocarditis had early signs of muscle destruction (rise in CPK) levels and hepatitis (rise in AST, ALT), and that all patients who had myocarditis with bad outcomes had rises in all of the aforementioned biomarkers. Creatinine phosphokinase was the most sensitive. (more…)
Author Interviews, Cancer Research, Duke, Heart Disease, Pediatrics / 06.12.2022

MedicalResearch.com Interview with: Amy Berkman, MD Department of Pediatrics Duke University School of Medicine MedicalResearch.com: What is the background for this study? Response: Cancer incidence in adolescents and young adults (AYAs, aged 15-39 years at diagnosis) is increasing, with approximately 90,000 new diagnoses annually in the US. Improvements in 5-year survival have led to a growing population of survivors of AYA cancer, currently estimated at >600,000 survivors. Survivors are at increased risk of treatment related chronic conditions including cardiovascular disease (CVD). We wanted to determine whether certain sociodemographic and medical history factors further increase the risk of CVD in AYA cancer survivors and also compare risk of CVD between AYA cancer survivors and the general population. (more…)
Author Interviews, Heart Disease, JACC, Supplements / 06.12.2022

MedicalResearch.com Interview with: Simin Liu MD MPH ScD Professor of Epidemiology at the School of Public Health, Professor of Medicine (Endocrinology) and Professor of Surgery at the Alpert School of Medicine Brown University MedicalResearch.com: What is the background for this study? Response: Our research team has been researching the roles of environmental and genetic determinants of chronic diseases for nearly three decades, with special emphasis on evaluating micronutrients, minerals, and trace elements in relation to cardiometabolic outcomes, and findings of which have contributed to the design of several large, randomized trials of dietary supplements in the US (Liu JAMA 1999; 2011; Diabetes Care 2005a,b; Diabetes 2006).  Several large intervention trials have consistently shown beneficial effects on clinical cardiometabolic outcomes of a diet pattern rich in micronutrients, although research on micronutrient supplementation has mainly focused on the health effects of a single or a few vitamins and minerals. We decided to take a comprehensive and systematic approach to evaluate all the publicly available/accessible studies reporting all micronutrients including phytochemicals and antioxidant supplements and their effects on cardiovascular risk factors as well as multiple CVDs. (more…)
Aging, Author Interviews, Brigham & Women's - Harvard, Dermatology, Heart Disease, Herpes Viruses, Stroke / 23.11.2022

MedicalResearch.com Interview with:| Sharon G. Curhan, MD, ScM| Director, CHEARS: The Conservation of Hearing Study Channing Division of Network Medicine Department of Medicine Brigham and Women’s Hospital Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? Response:       Herpes zoster, commonly known as “shingles,” is a viral infection that often causes a painful rash. Shingles can occur anywhere on the head or body. Shingles is caused by the varicella zoster virus (VZV), the same virus that causes chickenpox. After a person has chickenpox, the virus stays in their body for the rest of their life. Years and even decades later, the virus may reactivate as shingles. Almost all individuals age 50 years and older in the US have been infected with the varicella zoster virus and therefore they are at risk for shingles. About 1 in 3 people will develop shingles during their lifetime, and since age is a risk factor for shingles, this number may increase as the population ages. The risk is also higher among individuals of any age who are immunocompromised due to disease or treatment. A number of serious complications can occur when a person develops shingles, such as post-herpetic neuralgia (long-lasting pain), but there was limited information on whether there are other adverse long-term health implications of developing shingles. There is a growing body of evidence that links VZV, the virus that causes shingles, to vascular disease. VZV vasculopathy may cause damage to blood vessels and increase the risk of stroke or coronary heart disease. Although some previous studies showed a higher risk of stroke or heart attack around the time of the shingles infection, it was not known whether this higher risk persisted in the long term. Therefore, the question we aimed to address in this study was to investigate whether shingles is associated with higher long-term risk of stroke or coronary heart disease. To address this question, we conducted a prospective longitudinal study in 3 large US cohorts of >200,000 women and men, the Nurses’ Health Study (>79,000 women), the Nurses’ Health Study II (almost 94,000 women) and the Health Professionals Follow-Up Study (>31,000 men), without a prior history of stroke or coronary heart disease. We collected information on shingles, stroke and coronary heart disease on biennial questionnaires and confirmed the diagnoses with medical record review. We followed the participants for up to 16 years and evaluated whether those who had developed shingles were at higher risk for stroke or coronary heart disease years after the shingles episode. The outcomes we measured were incident stroke, incident coronary heart disease [defined as having a non-fatal or fatal myocardial infarction (heart attack) or a coronary revascularization procedure (CABG, coronary artery bypass graft or percutaneous transluminal coronary angioplasty)]. We also evaluated a combined outcome of cardiovascular disease, which included either stroke or coronary heart disease, whichever came first. (more…)
AHA Journals, Author Interviews, Heart Disease, Technology, Yale / 09.11.2022

MedicalResearch.com Interview with: Lovedeep Singh Dhingra, MBBS Postdoctoral Research Associate Cardiovascular Data Science (CarDS) Lab Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Wearable devices are shown to have multiple health-related features, including heart rate and activity monitoring, ECG tracing, and blood pressure monitoring. In our analyses of the nationally-representative Health Information National Trends Survey (HINTS), we discovered that patients with and at risk of cardiovascular disease are less likely to use wearables. Older patients, patients with lower education, and patients with lower incomes are less likely to use wearables. Also, among adults with access to wearables, patients with cardiovascular disease use their devices less frequently as compared to the overall population. (more…)
Author Interviews, Clots - Coagulation, Heart Disease, Karolinski Institute, Kidney Disease / 06.10.2022

MedicalResearch.com Interview with: Juan Jesus Carrero Pharm PhD Professor of Epidemiology Cardio-renal Department of Medical Epidemiology and Biostatistics Karolinska Institutet, Stockholm MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Concerns on the possibility of (direct oral anticoagulants)  DOAC-related nephropathy may limit its use. In this cohort study of non-valvular AF patients from routine clinical practice, initiation of DOAC vs (vitamin K antagonists) VKA was associated with more favorable kidney outcomes, i.e., a lower risk of the composite of kidney failure and sustained 30% eGFR decline, as well as a lower risk of AKI occurrence. In agreement with trial evidence, we also showed that DOAC vs VKA treatment was associated with a lower risk of major bleeding, but a similar risk of the composite of stroke, systemic embolism or death. (more…)
Author Interviews, Heart Disease, JAMA, Primary Care, Stroke, USPSTF / 06.09.2022

MedicalResearch.com Interview with: Katrina E. Donahue, M.D., M.P.H. Professor and Vice Chair of Research Chapel Hill Department of Family Medicine University of North Carolina Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart disease and stroke are the leading causes of death in the U.S. The Task Force found that people who are 40 to 75 years old and at high risk for heart disease should take a statin to help protect their health. People in this age group who are at increased risk but not high risk should make an individual decision with their healthcare professional about whether taking a statin is right for them. There is not enough research to determine whether statins are beneficial for people 76 years and older. (more…)
Author Interviews, Heart Disease, NEJM / 30.08.2022

MedicalResearch.com Interview with: Dr Holly Morgan M.B., B.Ch. Clinical Research Fellow and REVIVED investigator King's College London MedicalResearch.com: What is the background for this study? Response: Coronary artery disease is the commonest cause of heart failure.  Whilst individually tailored pharmacological and device therapy (optimal medical therapy, OMT) is the cornerstone of management of ischemic heart failure, rates of death and hospitalization for heart failure remain unacceptably high in this population.  Given the causative relationship between coronary disease and heart failure, coronary revascularization has long been considered as a treatment option for these patients.  Whilst there is randomized evidence to support surgical revascularization with coronary artery bypass grafting (1), none previously existed for percutaneous coronary intervention (PCI) in stable ischemic left ventricular dysfunction. Despite this, patients are frequently offered PCI in this setting (particularly if unsuitable for surgery); driven by the belief that hibernating myocardium will improve in function if blood flow is restored, regardless of the revascularization method.  This approach was supported in some international guidelines, though recommendations varied. The REVIVED-BCIS2 trial aimed to establish whether revascularization with PCI in addition to OMT would improve event free survival in patients with ischemic left ventricular dysfunction, when compared to OMT alone (2).  Inclusion criteria included a left ventricular ejection fraction of ≤35%, extensive coronary artery disease (British Cardiovascular Intervention Society jeopardy score ≥6, indicating significant stenoses in the left main coronary artery, proximal left anterior descending coronary artery, dominant circumflex artery, disease in multiple vessels or a combination of these) and viability in at least four dysfunctional myocardial segments which were amenable to PCI.  The main exclusion criteria were acute myocardial infarction within 4 weeks of randomisation, angina which limited the patient’s quality of life or decompensated heart failure or sustained ventricular arrhythmia within 72 hours. The primary composite outcome was all-cause death or hospitalization for heart failure; minimum follow up was 24 months.  Key secondary outcomes included the change in left ventricular ejection fraction from baseline to follow-up at six and twelve months, myocardial infarction, unplanned revascularization and quality of life assessed with the Kansas City Cardiomyopathy Questionnaire and EQ-5D-5L. (more…)
Author Interviews, Endocrinology, Heart Disease, Kidney Stones / 10.08.2022

MedicalResearch.com Interview with: Ashish Verma, MD Assistant Professor, Nephrology Department of Medicine Boston University MedicalResearch.com: What is the background for this study? Would you tell us a little about aldosterone? Response: “Recent randomized, controlled trials have shown that a drug called finerenone is effective in delaying CKD progression and adverse cardiovascular outcomes in patients with chronic kidney disease and diabetes. However, the role of aldosterone in this process was not directly investigated and levels of the hormone were not measured,” “Since excessive levels of aldosterone is common, yet mostly unrecognized, we hypothesized that one reason why finerenone was effective in lowering the risk of CKD progression was that it was treating unrecognized high concentrations of the hormone.” To study this we investigated the associations between aldosterone concentrations in the blood and kidney disease progression among 3680 participants in the Chronic Renal Insufficiency Cohort study, which ran in seven clinics in the US between 2003 and 2008. The participants were aged between 21 and 74 years old. Aldosterone is a steroid hormone secreted by the adrenal glands, which sit above the kidneys. Its main role is to regulate salt and water in the body, and so it plays a central role in controlling blood pressure. Too much of it can lead to high blood pressure, cardiovascular and kidney diseases. (more…)
Author Interviews, Heart Disease, JAMA, Lifestyle & Health, USPSTF / 05.08.2022

MedicalResearch.com Interview with:

Lori Pbert, Ph.D Professor, Department of Population and Quantitative Health Sciences Associate chief of the Division of Preventive and Behavioral Medicine Founder and director of the Center for Tobacco Treatment Research and Training University of Massachusetts Chan Medical School Dr. Pbert joined the U.S. Preventive Services Task Force in January 2019

MedicalResearch.com: What is the background for this study? What are the main findings?

 

Response: Heart attacks and strokes are the number one killer of adults in the United States. Based on the evidence we reviewed, the Task Force found that some people would benefit from counseling interventions to support their cardiovascular health, however the overall benefits are small. For that reason, we continue to recommend that healthcare professionals decide together with their patients who do not have cardiovascular disease risk factors whether counseling interventions on healthy diet and physical activity might help them prevent heart attacks and strokes. This is a C grade recommendation. (more…)

Author Interviews, Heart Disease, Menopause / 05.08.2022

MedicalResearch.com Interview with: Jean Shin Department of Family Medicine Korea University College of Medicine Seoul,Republic of Korea

MedicalResearch.com: What is the background for this study?

Response: Younger age at menopause is a possible risk factor for cardiovascular diseases. However, data on the association among premature menopause, age at menopause, and the risk of heart failure and atrial fibrillation are lacking. We aimed to examine the association of premature menopause and age at menopause with the risk of heart failure and atrial fibrillation.  (more…)

Author Interviews, Genetic Research, Heart Disease / 04.08.2022

MedicalResearch.com Interview with: Christine Seidman, MD Thomas W. Smith Professor of Medicine and Genetics Director, CV Genetics Center Brigham and Women’s Hospital Harvard Medical School Dept of Genetics Boston, MA 02115  MedicalResearch.com:  What is the background for this study?    Response: Heart failure is a common and incurable disorder that is known to arise from many different underlying causes.  By exploiting a new technology, single nuclear transcriptional analyses, we aimed to define molecular profiles in human hearts tissues that were obtained from patients with different genetic and non-genetic causes of heart failure. Our goal was to determine if there were distinctive signatures that could provide new opportunities to develop precise treatments, based on the specific cause of heart failure. (more…)
Author Interviews, Heart Disease, Salt-Sodium / 20.07.2022

MedicalResearch.com Interview with Weihao Liang on behalf of Professor Chen Liu Department of Cardiology, Sun Yat-sen University First Affiliated Hospital Guangzhou, Guangdong, China MedicalResearch.com:  What is the background for this study?    Response: -Salt intake restriction is frequently recommended in heart failure guidelines, but is restricting salt intake to "as least as possible" appropriate? Evidence is lacking. Besides, the effect of salt restriction on patients with heart failure with preserved ejection fraction isn’t clear as they have often been excluded from relevant studies. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lung Cancer, Supplements, USPSTF / 30.06.2022

MedicalResearch.com Interview with: Michael J. Barry, M.D Director of the Informed Medical Decisions Program Health Decision Sciences Center Massachusetts General Hospital. Professor of medicine at Harvard Medical School Dr. Barry was appointed as Vice Chair of USPSTF in March 2021. He previously served as a member from January 2017 through December 2020.   MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: The Task Force looked at the use of vitamin and mineral supplementation specifically for the prevention of heart disease, stroke, and cancer. We found that there is not enough evidence to recommend for or against taking multivitamin supplements, nor the use of single or paired nutrient supplements, to prevent these conditions. However, we do know that you should not take vitamin E or beta-carotene for this purpose. (more…)
Annals Internal Medicine, Author Interviews, Brigham & Women's - Harvard, Diabetes, Heart Disease / 07.06.2022

MedicalResearch.com Interview with: HoJin Shin, BPharm, PhD Postdoctoral Research Fellow Division of Pharmacoepidemiology and Pharmacoeconomics Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston, Massachusetts MedicalResearch.com:  What is the background for this study?  Response: The public health burden of cardiovascular disease has been increasing in people with diabetes along with the burden of diabetes itself.
  •  Cardiovascular disease affects approximately one-third of the population with type 2 diabetes and accounts for     50%–80% of their mortality
  • 1 in 10 people in the US has diabetes
Since 2008, the US FDA has recommended post-approval cardiovascular outcome trials to ensure the safety of new glucose-lowering drugs responding to this growing burden of cardiovascular disease in type 2 diabetes and the potential increase in cardiovascular risk with certain existing glucose-lowering drugs (e.g., rosiglitazone). Notably, SGLT-2i have demonstrated superiority to placebo in reducing the risk of cardiovascular events, including hospitalization for heart failure. Consequently, beginning in 2018, clinical guidelines in the US have recommended SGLT-2i as a preferred second-line treatment for patients with type 2 diabetes and cardiovascular disease. As the paradigm of second-line pharmacological treatment for type 2 diabetes has shifted to include the management of cardiovascular risk in addition to glycemic control, this further raised the question of whether SGLT-2i should be advanced to first-line treatment. Since 2019, SGLT-2i have been recommended as a first-line agent for patients with type 2 diabetes and cardiovascular disease by the European guidelines (the European Society of Cardiology and the European Association for the Study of Diabetes). In the absence of head-to-head RCTs, non-randomized studies using real-world data could provide information on whether SGLT-2i may have greater cardiovascular benefits over metformin more timely than randomized clinical trials among both patients with and without existing CVD. Therefore, we evaluated the risk for cardiovascular events among adults with T2D who initiated treatment with first-line SGLT-2i versus metformin in clinical practice. (more…)
Author Interviews, Heart Disease, JACC, Statins / 17.05.2022

MedicalResearch.com Interview with: Dr. Raffaele Bugiardini, UNIBO Professor & MD Clinical cardiologist Full Professor of Cardiology at the University of Bologna MedicalResearch.com:  What is the background for this study?  Response: Questions about the evidence base for primary prevention with statins continue to emerge from many quarters. It has been argued that prior estimates of statin effects were mainly based on information from both individuals with and without pre-existing cardiovascular disease, which may overestimate the true benefits of statins. Some investigators attempted to quantify the impact of statins on outcomes of women versus men and reported significantly different effect estimates. Others have questioned the benefits of statins in adults 76 years and older as this age group was poorly represented in the randomized trials for primary prevention of cardiovascular disease. There is little or no information on concomitant preventive medications in prior work. Thus, how large is the incremental benefit of statin, added to other standard preventive interventions? and is cholesterol a reliable surrogate endpoint to guide prevention of cardiovascular disease? (more…)
Author Interviews, Heart Disease, JAMA / 04.05.2022

MedicalResearch.com Interview with: Gbenga Ogedegbe, MD, MPH Dr. Adolph & Margaret Berger Professor of Population Health Director, Division of Health & Behavior Director Center for Healthful Behavior Change Department of Population Health NYU Langone Health NYU School of Medicine Member of the U.S. Preventive Services Task Force MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Heart disease and stroke are the leading causes of mortality in the United States, accounting for more than one in four deaths. Taking a daily aspirin may help prevent a first heart attack or stroke in some people, but it can also cause some harm, like internal bleeding. The decision on whether or not to start taking a daily aspirin should be based primarily on age, but cardiovascular disease risk, a person’s chances of bleeding, and other factors should also be taken into account. (more…)
AHA Journals, Author Interviews, Fertility, Heart Disease / 27.04.2022

MedicalResearch.com Interview with: Pensée Wu, MBChB, MD(Res) Senior Lecturer, Honorary Consultant Obstetrician Subspecialist in Maternal Fetal Medicine School of Medicine, Keele University Staffordshire, UK MedicalResearch.com:  What is the background for this study? What are the main findings? Response: We looked at outcomes in pregnancies conceived with assisted reproductive technology and compared those with pregnancies that were conceived naturally. Using a hospital admissions database in the U.S. called the National inpatient sample between 2008 and 2016, we included >100,000 pregnancies conceived with assisted reproductive technology and 34 million naturally conceived pregnancies. We found that women with assisted reproductive technology-conceived pregnancies had doubled the risk of acute kidney injury and arrhythmias (irregular heart beats). These women also had a 1-3-1.6-fold risk of preterm birth, Caesarean delivery and placental abruption (placenta separating from the womb). We concluded that women should be informed of these risks during pre-pregnancy counselling.  (more…)
Heart Disease, Technology / 19.04.2022

Ken Londoner, MBA Founder, Chief Executive Officer, Chairman, and Director BioSig Technologies MedicalResearch.com: Would you briefly describe the condition of Atrial fibrillation (AFib)? Whom does AFib primarily affect and how common is it?  What are the potential complication of AFib?  Response: Atrial Fibrillation, or Afib—the most common heart rhythm disturbance—affects over 33 million people across the globe. Afib is caused by faulty electrical signals in the upper chambers of the heart (the atria) that cause it to beat too fast or irregularly—often more than 400 beats per minute.*  The condition can lead to serious health consequences, including stroke, blood clots, or sudden cardiac arrest. Stroke is among the most serious health concerns for Afib patients, with research suggesting a Afib carries a 5-fold increased risk of stroke— especially when Afib is left untreated. With a lifetime risk of more than 20 percent*, Afib can affect anyone. However, the condition is most common in those 65 years and older.  Individuals with underlying health complications, including heart disease, high blood pressure, thyroid problems, or excessive alcohol use are also at a greater risk of developing Afib.* (more…)
Author Interviews, Brigham & Women's - Harvard, Fertility, Heart Disease, JACC / 19.04.2022

MedicalResearch.com Interview with: Emily Lau, MD, MPH Cardiologist Instructor in Medicine, Harvard Medical School Director, Menopause, Hormones & Cardiovascular Disease Clinic Massachusetts General Hospital MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Emerging data suggest that a woman’s reproductive history influences her future risk of heart disease. Infertility is a reproductive risk factor that affects ~14% of women but has not been rigorously studied with respect to its relationship with cardiovascular disease risk. We studied over 38,000 women enrolled in the Women’s Health Initiative and found that infertility was associated with greater risk of heart failure. In particular, we found that the association was driven by greater risk of heart failure with preserved ejection fraction, a form of heart failure that is far more common among women. (more…)
Author Interviews, Gender Differences, Heart Disease, JACC, Surgical Research / 06.04.2022

MedicalResearch.com Interview with: Mario F.L. Gaudino, M.D. PhD Attending Cardiac SurgeonDepartment of Cardiothoracic Surgery Antonino Di Franco, MD Adjunct Clinical Assistant Professor of Cardiothoracic Surgery Weill Cornell Medicine   MedicalResearch.com:  What is the background for this study?  What is the aim of this review?  Response: Biological and socio-cultural differences between men and women are complex and likely account for most of the variations in the epidemiology and treatment outcomes of coronary artery disease (CAD) between the two sexes. Despite the growing recognition of sex-specific determinants of outcomes, representation of women in clinical studies remains low, and sex-specific management strategies are generally not provided in guidelines. We summarized the current evidence on sex-related differences in patients with CAD, focusing on the differential outcomes following medical therapy, percutaneous coronary interventions, and coronary artery bypass surgery. (more…)
Author Interviews, Genetic Research, Heart Disease, Technology / 17.03.2022

MedicalResearch.com Interview with: Ali Torkamani, Ph.D. Director of Genomics and Genome Informatics Scripps Research Translational Institute Professor, Integrative Structural and Computational Biology Scripps Research La Jolla, CA 92037 MedicalResearch.com:  What is the background for this study?  Response: Prior research has shown that people with higher polygenic risk for coronary artery disease achieve greater risk reduction with statin or other lipid lowering therapy. In general, adherence to standard guidelines for lipid lowering therapy is low - about 30% of people who should be on lipid lowering therapy are, with no correlation to their genetic risk. We set out to see whether communicating personalized risk, including polygenic risk, for coronary artery disease would drive the adoption of lipid lowering therapy. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, Chocolate, Heart Disease, Supplements / 16.03.2022

MedicalResearch.com Interview with: Howard D. Sesso, ScD, MPH Associate Professor of Medicine Division of Preventive Medicine Brigham and Women's Hospital MedicalResearch.com:  What is the background for this study? How does the amount of flavanols in the study arm compare to what might be obtained in a typical diet? Response: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a randomized, double-blind, placebo-controlled clinical trial that tested the effects of two promising dietary supplements on cardiovascular disease (CVD) and cancer in 21,442 older adults. Cocoa flavanols have been shown to have favorable vascular effects in small and short-term clinical trials. The 500 mg/day flavanols tested in COSMOS exceeds that readily obtained in the diet typically from cocoa, tea, grapes, and berries. Of note, flavanol content in not typically listed on food labels. COSMOS also tested a multivitamin, the most common dietary supplement taken by US adults and previously linked with a potential modest reduction in cancer in a previous long-term trial of men conducted by our research group at the Division of Preventive Medicine at Brigham and Women’s Hospital. (more…)
Author Interviews, Exercise - Fitness, Heart Disease, JNCI / 03.03.2022

MedicalResearch.com Interview with: Fiona Bartoli PhD Leeds Institute of Cardiovascular and Metabolic Medicine University of Leeds  MedicalResearch.com:  What is the background for this study?  Response: Physical activity improves our health and reduces the risk of developing cardiovascular disease, diabetes, depression or even cancer. However, sedentary lifestyles are increasing, and people fail to exercise enough, for reasons such as illnesses, injuries, or computer usage. This puts people at more risk of disease. During physical exercise, the heart beats faster so more blood is pumped through the body. The very large protein called Piezo1 is found in the lining of blood vessels and acts as an “exercise sensor” by detecting the change in blood flow during exercise and acting accordingly. (more…)
Author Interviews, Biomarkers, Heart Disease, NEJM / 03.03.2022

MedicalResearch.com Interview with: PJ Devereaux MD PhD Professor of Medicine, and of Health Research Methods, Evidence and Impact McMaster University President of the Society of Perioperative Research and Care  MedicalResearch.com:  What is the background for this study?  Response: More than 1 million patients undergo cardiac surgery in the United States and Europe annually. Although cardiac surgery has the potential to improve and prolong a patient’s quality and duration of life, it is associated with complications. Prognostically important heart injury – detected by an elevated blood concentration of either cardiac troponin or creatine kinase myocardial MB isoform (CK-MB) – is one of the most common complications after cardiac surgery and is associated with increased mortality. Although elevated CK-MB was historically used to define heart injury after cardiac surgery, this assay is no longer available in many hospitals worldwide, and consensus statements have recommended high-sensitivity cardiac troponin assays as the preferred biomarker. Based on expert opinion, the Fourth Universal Definition of Myocardial Infarction suggested that a cardiac troponin concentration >10 times the upper reference limit, in patients with a normal baseline measurement, should be the threshold used in the diagnosis of heart attack along with evidence of ischemia (e.g., ischemic ST changes on an ECG) in the first 48 hours after coronary artery bypass grafting (CABG). Although the Academic Research Consortium-2 Consensus stated there was no evidence-based threshold for cardiac troponin after CABG, they endorsed a threshold for the diagnosis of heart attack of ≥35 times the upper reference limit together with new evidence of ischemia, based on expert opinion. They also defined a threshold of ≥70 times the upper reference limit as a stand-alone criterion for clinically important periprocedural myocardial injury. Globally, many hospitals now use high-sensitivity cardiac troponin assays; however, limited data are available to define a prognostically important degree of myocardial injury after cardiac surgery based on these assays. We undertook the Vascular Events in Surgery Patients Cohort Evaluation (VISION) Cardiac Surgery Study to examine clinical outcomes after cardiac surgery. A primary objective was to determine the relationship between postoperative levels of high-sensitivity cardiac troponin I and the risk of death 30 days after cardiac surgery.  (more…)