ADHD, Author Interviews, Heart Disease, Stroke / 07.05.2024

MedicalResearch.com Interview with: Dr Anders Holt MD PhD Department of Cardiology Copenhagen University Hospital–Herlev and Gentofte Gentofte Hospitalsvej Hellerup, Denmark MedicalResearch.com: What is the background for this study? What types of ADHD treatments were in the study? Response: An increasing number of adults are being diagnosed with ADHD and subsequently treated. Taking the drugs' effect on the sympathetic nervous system into account, it seems relevant to investigate whether treatment could be associated with an elevated long-term risk of cardiovascular disease. The drugs included in the study were methylphenidate, atomoxetine, lisdexamfetamine, dexamfetamine, and modafinil. Owing to the fact that atomoxetine is not a sympathomimetic amine as the others, separate supplementary analyses were carried out for this drug, yielding similar results. (more…)
Heart Disease, Infections, Technology / 07.05.2024

MedicalResearch.com Interview with: Sarah Dräger, MD Postdoc, BRCCH Researcher Internal Medicine and ID specialist Division of Internal Medicine University Hospital Basel, Switzerland Basel   MedicalResearch.com: What is the background for this study? Response:In patients with severe infections and patients in the intensive care unit, therapeutic drug monitoring (TDM) may be used to optimize and personalize intravenous antibiotic treatment. In these patients, “conventional antibiotic dosing”, e.g. selection of the dose only considering the renal function and, if applicable, body weight, may lead to over- or underdosing due to an altered drug metabolism. This, in turn may be associated with worse clinical outcome or toxic side effects. TDM is used to monitor antibiotic blood plasma concentrations and provides guidance to the clinicians to adjust the antibiotic dosing according to the TDM results. But the collection of blood is an invasive, time- and resource-consuming sample collection technique and leads to discomfort to the patients. Additionally, turnaround time may be long (3h to 8h), and analyses may be offered only twice or three time a week. This may be too late to guide antibiotic dosing timely in patients with a very dynamic drug metabolism. Therefore, alternatives are required to overcome the limitations of current TDM. By using exhaled breath, we aim to develop an innovative therapeutic drug monitoring technique, which is non-invasive, easy to collect, not associated with discomfort to the patient, and which may allow to decrease the turnaround time, especially when combined with real-time analyses. (more…)
Author Interviews, Heart Disease, Technology / 03.04.2024

MedicalResearch.com Interview with: Dr. Janarthanan Sathananthan M.D. Chief Medical Officer for Interventional Cardiology Therapies Boston Scientific MedicalResearch.com: What is the background for this study? boston-scientificResponse: Despite significant improvements in the drug-eluting stents that are used to treat patients with coronary artery disease, 10% of the percutaneous coronary interventions (PCIs) in the U.S. today address in-stent restenosis (ISR), which is when a previously stented section of a coronary artery becomes obstructed or narrowed by plaque or scar tissue. These patients require additional intervention to avoid potential complications. In the multicenter, randomized AGENT IDE trial, we evaluated whether the AGENT™ Drug-Coated Balloon (DCB), a balloon catheter coated with anti-restenotic paclitaxel, is superior to an uncoated balloon in patients for treating ISR. The AGENT DCB is currently available in countries outside the U.S. Our goal is to bring this technology to market in the U.S. and finally provide physicians with an alternative to traditional ISR treatments, such as placing additional layers of stents or radiation, which may not provide ideal outcomes in some cases. In October 2023, at the Transcatheter Cardiovascular Therapeutics (TCT) 2023 meeting, we presented the primary endpoint data from our AGENT IDE randomized controlled trial evaluating clinical outcomes in patients with ISR undergoing treatment with the AGENT DCB or conventional balloon angioplasty. The positive results in this primary analysis cohort supported the device’s U.S. Food and Drug Administration (FDA) approval, which we announced on March 1, 2024. Just a few months later, data from the full cohort of 600 patients were published in the Journal of the American Medical Association (JAMA) and shared in a late-breaking presentation at Cardiovascular Research Technologies (CRT) 2024 meeting.  (more…)
Heart Disease, Technology / 07.03.2024

Heart disease remains a leading cause of morbidity and mortality worldwide. Despite advances in medical technology and treatment modalities, managing heart disease remains challenging. This is particularly true in remote or underserved areas with limited access to specialized healthcare. However, remote patient monitoring (RPM) has transformed the landscape of cardiac care, offering innovative solutions for proactive management and early intervention. The market for remote patient monitoring was projected to be valued at $14.0 billion in 2023, according to PR Newswire. By 2028, it is anticipated to increase to $41.7 billion. This article explores the significance of remote patient monitoring in effectively managing heart disease and its evolving role in enhancing patient outcomes. (more…)
AHA Journals, Author Interviews, Biomarkers, Brigham & Women's - Harvard, Heart Disease / 27.02.2024

MedicalResearch.com Interview with: Rosangela Akemi Hoshi, Ph.D. Lemann Foundation Cardiovascular Research Postdoctoral Fellowship Center for Lipid Metabolomics Divisions of Preventive and Cardiovascular Medicine Brigham and Women's Hospital Boston, MA  MedicalResearch.com: What is the background for this study? Would you describe the IgG N-glycan profile? Response: Glycans are sugar coatings of proteins, made of monosaccharide building blocks, that are involved in a variety of biological pathways.  Different sugar structures can dictate or modify the protein’s activity through specific interactions with cellular receptors. For example, proteins lacking glycans have a reduced level or a complete loss of function. Glycans are of such importance that the 2022 Nobel Prize in chemistry was awarded for glycan-based science. In this study, we examined glycans attached to Immunoglobulins G (IgG) and their link with incidence of cardiovascular disease (CVD) due to their impact on IgG inflammatory properties. Since inflammation is not only a cause, but also an aggravating factor and a mediator of a worse prognosis in cardiometabolic disorders and CVD, we investigated whether different glycan structures may characterize an at-risk phenotype for CVD development. Determining glycan profiles involved in multiple conditions can serve prognostic and diagnostic purposes. Yet, unlike other types of macromolecules, glycans are still not as much explored, characterizing a promising but underappreciated class that should be further investigated. (more…)
Author Interviews, Heart Disease, NEJM / 18.01.2024

MedicalResearch.com Interview with: John Sapp MD FRCPC FHRSHeart Rhythm, Division of Cardiology QEII Health Sciences Centre Dalhousie University MedicalResearch.com: What is the background for this study? Response: Cardiac resynchronization is a robust therapy for heart failure in patients with ventricular dysfunction, left bundle branch block and left bundle branch block. It has been shown to improve heart failure status, symptoms, survival and reduce new onset ventricular arrhythmias for appropriate candidates. The RAFT study (NEJM 2010) enrolled patients with functional class II and III heart failure, wide QRS duration on ECG and reduced left ventricular ejection fraction, and demonstrated a reduction in heart failure hospitalization and mortality during a mean follow-up of 44 months. The long-term outcomes are not known. (more…)
AHA Journals, Author Interviews, Heart Disease, Kidney Disease, Obstructive Sleep Apnea, Sleep Disorders / 15.11.2023

MedicalResearch.com Interview with: Lead Author: Rupak Desai, MBBS Atlanta Veterans Affairs Medical Center Independent Researcher, Atlanta, GA, Presenter: Vamsikalyan Borra, MD Resident Physician, Internal Medicine University of Texas Rio Grande Valley, Weslaco, TX MedicalResearch.com: What is the background for this study? Response: The relationship between sleep apnea (OSA) and chronic kidney disease (CKD) is quite complex. OSA can cause hypoxia, activation of the sympathetic nervous system, and hypertension, all of which can have negative effects on kidney function. On the other hand, in patients with end-stage renal disease (ESRD), intensifying renal replacement therapy has shown some improvement in sleep apnea severity, suggesting a bi-directional relationship between the two conditions. While there are still uncertainties, recent studies have focused on understanding the interplay between OSA and CKD. The role of CPAP therapy, a common treatment for OSA, in relation to CKD is not yet clear. Observational studies present findings regarding the impact of CPAPs on kidney function. However, researchers are actively investigating its cardiovascular benefits and its influence on the progression of CKD. The objective of this study is to analyze the trends in composite cardiovascular events in hospital encounters among geriatric patients with CKD, comparing those with and without obstructive sleep apnea. Additionally, we are also investigating sex and racial disparities in trends of major adverse cardiovascular and cerebrovascular events (MACCE) among geriatric patients with obstructive sleep apnea (OSA). Furthermore, we are assessing the impact of continuous positive airway pressure (CPAP) treatment and dependence on MACCE outcomes in OSA patients (more…)
Author Interviews, Heart Disease, Stem Cells / 13.11.2023

MedicalResearch.com Interview with: Prof. Dr. Wolfram-Hubertus Zimmermann Director, Institute of Pharmacology and Toxicology University Medical Center Göttingen Georg-August University Göttingen, Germany   MedicalResearch.com: What is the background for this study? Response: Involvement in research and development in the field of tissue engineered heart repair since 25+ years. Bench-to-bed translation of our research. MedicalResearch.com: How are the stem cell obtained? Response: We make use of induced pluripotent stem cells as starting material to obtain heart muscle cells for the engineering of Engineered Human Myocardium (EHM) and its use as Biological Ventricular Assist Tissue (BioVAT). (more…)
Author Interviews, Heart Disease / 06.11.2023

MedicalResearch.com Interview with: Prakriti Gaba, MD Cardiovascular Medicine Fellow Brigham and Women's Hospital Deepak L. Bhatt MD MPH Director of Mount Sinai Fuster Heart Hospital Dr. Valentin Fuster Professor of Cardiovascular Medicine Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study?  Response: Accurate classification of acute myocardial infarction is instrumental for the appropriate diagnosis and effective management of patients suffering from this widely prevalent cardiovascular condition. In the past, there have been a variety of clinical scores published to advise clinicians on the best classifications schemes for patients with acute MI. These have included the Thrombolysis in Myocardial Infarction (TIMI) risk score, the HEART score, and the Killip classification. The strength of these traditional scores includes their practicality, as they can be implemented at the bedside to rapidly assist with prognostication. Nonetheless, as technologic advancements have made imaging and tissue identification more accessible, national and international committees are looking to revise traditional classification schemes of acute MI with novel ones leveraging multimodal approaches. (more…)
Heart Disease, Pediatrics / 06.10.2023

If you’re a worried or concerned parent looking to learn more about vascular ring, the following guide has information you need. This includes:
  • Vascular ring definition
  • Causes and symptoms
  • How the treatment of vascular ring works
By the end, you’ll be feeling much calmer with your new knowledge.

What Is Vascular Ring?

Vascular ring is a heart defect that’s present from birth. A part of the body’s main artery forms a small ring around the trachea (windpipe) or esophagus (the pipe that connects the throat to the stomach). In some cases, the ring can occur around both the trachea and the esophagus, but this is less common. Compared with other congenital heart defects, vascular ring is one of the rare ones. As of today, vascular rings are incredibly rare and occur in less than 1% of babies. (more…)
Author Interviews, Dermatology, Diabetes, Heart Disease, Weight Research / 28.08.2023

MedicalResearch.com Interview with: Dr. Alexis Elias Malavazos Endocrinology Unit Clinical Nutrition and Cardiovascular Prevention Service, IRCCS Policlinico Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy   MedicalResearch.com: What is the background for this study? Response: Psoriasis is a systemic inflammatory disease often associated with obesity and type-2 diabetes (T2D). The inflammatory process of psoriasis can target adipose tissue depots, particularly those surrounding the heart and the coronary arteries, exposing them to an increased risk of cardiovascular disease. (more…)
Author Interviews, General Medicine, Health Care Systems, Heart Disease, JAMA / 26.06.2023

MedicalResearch.com Interview with: Dan P. Ly, MD, PhD, MPP Physician and an Assistant Professor Division of General Internal Medicine and Health Services Research David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? Response: Cognitive biases, or ways of thinking that may deviate from rationality, are thought to influence physician decision-making, but there has been little large-scale evidence of their existence clinically. There is some large-scale evidence of the availability heuristic, under which the likelihood of an event is affected by how easily it comes to mind, but there’s little large scale evidence of other cognitive biases affecting physicians.  (more…)
Author Interviews, Heart Disease, JACC, Surgical Research / 22.05.2023

MedicalResearch.com Interview with: Aloke V. Finn MD Medical Director/Chief Scientific Officer CVPath Institute Inc. Gaithersburg, MD 20878   MedicalResearch.com: What is the background for this study? Response:Transcatheter left atrial appendageal closure (LAAC) has become an established therapeutic approach for prevention of stroke in subjects with non-valvular atrial fibrillation who are ineligible for long-term oral anticoagulation.  Device-related thrombus (DRT), developing after LAAO procedures occurs in a small proportion but patients receiving these devices but is associated with critical embolic events such as ischemic stroke. Thrombogenicity and delayed endothelialization of fabric play a role in the development of DRT.  Fluorinated polymers are known to have thromboresistant properties which may favorably modify blood biomaterial interactions of a LAAO device. In this study we compared the thrombogenicity and endothelial coverage (EC) after left atrial appendage occlusion (LAAO) between a novel fluoropolymer-coated Watchman (FP-WM (Watchman FLX PRO) and the conventional uncoated Watchman FLX (WM). (more…)
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…)