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…)
AHA Journals, Author Interviews, Heart Disease, Social Issues, UCSD / 03.02.2022

MedicalResearch.com Interview with: Natalie Golaszewski, PhD Herbert Wertheim School of Public Health and Human Longevity Science University of California, San Diego La Jolla, CA 92093 MedicalResearch.com:  What is the background for this study?  Response: Social isolation and loneliness are growing public health concerns as they are associated with health conditions that increase the risk of cardiovascular disease including obesity, smoking, physical inactivity, poor diet, high blood pressure and high cholesterol. (more…)
Author Interviews, Heart Disease, JAMA, NYU, USPSTF / 02.02.2022

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: Atrial Fibrillation (AFib) is the most common type of irregular heartbeat and a major risk factor for stroke, and it often goes undetected. For this recommendation, the Task Force evaluated whether screening adults over the age of 50 who do not have any signs or symptoms of AFib can help prevent strokes. In its evidence review, Task Force expanded its scope to include a search for studies on portable and wearable devices such as smartphones and fitness trackers in addition to electrocardiography (ECG). Despite this consideration, the Task Force found insufficient evidence to recommend for or against screening for AFib. This is consistent with the Task Force’s 2018 recommendation. (more…)
Author Interviews, CDC, COVID -19 Coronavirus, Emory, Heart Disease, JAMA / 25.01.2022

MedicalResearch.com Interview with: Matthew Oster, MD, MPH CDC COVID-19 Response CDC Center on Birth Defects and Developmental Disabilities Pediatric Cardiologist, Sibley Heart Center, Children’s Healthcare of Atlanta Emory University School of Medicine Emory University Rollins School of Public Health MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: More than 192 million people ages 12 years and older in the U.S. received at least one dose of mRNA COVID-19 vaccines from December 2020 through August 2021. From this population, VAERS (the Vaccine Adverse Event Reporting System) received 1,991 reports of myocarditis,  1,626 of which met the case definition of myocarditis. Rates of myocarditis were highest following the second dose of an mRNA vaccine among males aged 12–15 years (70.7 per million doses of Pfizer), 16-17 years (105.9 per million doses of Pfizer), and 18–47 years (52.4 and 56.3 per million doses of Pfizer and Moderna, respectively). Of those with myocarditis, the median age was 21 years and the median time from vaccination to symptom onset was two days. Males accounted for 82% of patients for whom sex was known. Approximately 96% were hospitalized, 87% of whose symptoms had gone away by the time they were discharged from the hospital. Non-steroidal anti-inflammatory drugs (589/676, 87%) were the most common treatment. (more…)
Alzheimer's - Dementia, Author Interviews, Clots - Coagulation, Heart Disease / 23.11.2021

MedicalResearch.com Interview with: Bruno Caramelli MD PhD Associate Professor of Medicine University of Sao Paulo, Brasil Director, Interdisciplinary Medicine in Cardiology Unit Chairman of the PhD program in Medical Sciences at the University of Sao Paulo, Brazil. President of the Department of Clinical Cardiology at the Brazilian Society of Cardiology FESC: Fellow of the European Society of Cardiology MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation is the most common cardiac arrhythmia in older adults, and it is associated with an increased risk of stroke, cognitive impairment, and dementia. Stroke can occur when a blood clot blocks blood flow to the brain, and oral anticoagulants, such as dabigatran and warfarin, are typically prescribed to prevent stroke. Dabigatran has been found to be comparable to warfarin for the prevention of stroke and also has a lower risk of major bleeding complications. Previous research has shown that people with atrial fibrillation taking oral anticoagulation therapy have a lower risk of dementia, however, the mechanism involved in this benefit is unknown, and previous clinical trials have not evaluated cognitive and functional impairment outcomes among patients. It’s possible that cognitive decline is related to the formation of small blood clots in the brain, which is treated by effective medications that prevent blood clots. Since dabigatran offers a more stable anticoagulation status, we investigated whether it would be more effective than warfarin for the prevention of cognitive decline in patients with atrial fibrillation. Previous studies were retrospective and observational studies and considered tests that evaluate global cognitive function in a generic, global, and non-specific way. In that way its not possible to exclude different causes of dementia as Alzheimer's disease and others making it difficult to establish an effect directly related to atrial fibrillation or the anticoagulation treatment. (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, University of Pennsylvania / 18.11.2021

MedicalResearch.com Interview with: Ashwin Nathan, MD, MSHP Assistant Professor, Medicine, Perelman School of Medicine Interventional Cardiologist Hospital of the University of Pennsylvania and at the Corporal Michael C. Crescenz VA Medical Center in Philadelphia Penn Cardiovascular Outcomes, Quality & Evaluative Research Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: We found that the rates of TAVR were lower in areas with higher proportions of Black, Hispanic and socioeconomically disadvantaged patients. Inequities in access in areas with higher proportions of Black and Hispanic patients existed despite adjusting for socioeconomic status. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lipids / 16.11.2021

MedicalResearch.com Interview with: Nicholas A. Marston, MD, MPH Thrombolysis in Myocardial Infarction (TIMI) Study Group Brigham and Women’s Hospital Harvard Medical School Boston, Massachusetts MedicalResearch.com: What is the background for this study? Response: There has been recent debate about how much of lipid-associated cardiovascular risk is from LDL cholesterol versus triglycerides. However, genetic studies suggest that apolipoprotein B is actually the primary driver of atherosclerotic risk. Since there is exactly one apoB lipoprotein on each lipid particle (LDL, IDL, VLDL), its measurement is a surrgate for the total number of apoB-containing lipoproteins. So in this study, we asked the question: Do common measures of cholesterol concentration, triglyceride concentration, or their ratio carry predictive value for cardiovascular risk beyond the number of apo-B containing lipoproteins? (more…)
Author Interviews, Coffee, Heart Disease, JAMA, OBGYNE / 09.11.2021

MedicalResearch.com Interview with: Stefanie N. Hinkle, PhD Assistant Professor Department of Biostatistics Epidemiology and Informatics Perelman School of Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: Over 80% of U.S. women of reproductive age consume caffeine daily.While most women decrease consumption after becoming pregnant, many continue to consume caffeine throughout pregnancy. The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women limit their caffeine consumption to <200 mg/d out of an abundance of caution due to potential associations with pregnancy loss and fetal growth restriction at higher intakes. There remains limited data on associations with maternal cardiometabolic outcomes in pregnancy.   (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA, Technology / 05.10.2021

MedicalResearch.com Interview with: Pinar Zorlutuna, PhD Sheehan Family Collegiate Professor of Engineering Aerospace and Mechanical Engineering Chemical and Biomolecular Engineering (Concurrent) Bioengineering Graduate Program University of Notre Dame  MedicalResearch.com: What is the background for this study? Response: Acute myocardial infarction (AMI) is the primary cause of death among cardiovascular diseases. The current clinical standard of diagnosis combines echocardiogram (ECG) and several circulating protein biomarkers from plasma. In their current state, both are incapable of distinguishing between patients with and without complete coronary occlusion, unless additional invasive testing is implemented, and both have significant false positive rates. MicroRNAs (miRNAs) have shown great potential as rapid and discriminating biomarkers for acute myocardial infarction (AMI) diagnosis. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Stroke / 30.09.2021

MedicalResearch.com Interview with: Daniel E. Singer, MD Professor of Medicine, Harvard Medical School Professor in the Department of Epidemiology Harvard T.H. Chan School of Public Health Division of General Internal Medicine Massachusetts General Hospital Boston, MA, 02114 MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) raises the risk of ischemic stroke 4-5-fold and this risk is largely reversible by oral anticoagulants (OAC). These facts are part of the core knowledge of internal medicine and the basis of multiple guidelines. They are based on studies of patients with persistent or predominantly “heavy burden” paroxysmal AF completed in the 1990s. More recent studies using cardiac implantable devices (CIEDs: implantable defibrillators, pacemakers, etc) which have the capacity to monitor heart rhythm continuously have found that many older patients have brief, often undiagnosed, episodes of AF. Several of these studies have found that strokes occur during periods of sinus rhythm temporally distant from a preceding episode of AF. This has led to a widespread suspicion that AF is not a direct causal risk factor but a risk “marker” indicating the presence of other truly causal features like a diseased left atrium (atrial myopathy). If the risk marker hypothesis is correct, then long-term anticoagulation is needed even for brief and rare episodes of AF (assuming the patient’ s CHA2DS2-VASc score is high enough). The key problem with prior prospective studies using CIEDs was that only a small number of strokes were observed leading to inadequate statistical power. Our study addressed this power problem by linking the very large Optum electronic health record database which could identify ischemic strokes with the Medtronic CareLink database of long-term, continuous heart rhythm records of patients with CIEDs. We ended up studying 891 individuals who had an ischemic stroke and had 120 days of continuous heart monitoring prior to the stroke. (more…)
Aging, Author Interviews, Exercise - Fitness, Heart Disease, JAMA / 07.09.2021

MedicalResearch.com Interview with: Amanda Paluch, PhD Assistant Professor University of Massachusetts Amherst Department of Kinesiology Institute for Applied Life Sciences Life Science Laboratories Amherst, MA 01003 MedicalResearch.com: What is the background for this study? Response: We wanted to understand the association of total steps per day with premature mortality among middle-aged, Black and White women and men.  This study included 2110 adults; age 38-50 years old at the start of this study.  These adults wore a step counting device for one week and then followed for death from any cause over the next 10 years. (more…)
Author Interviews, Heart Disease, NEJM, Salt-Sodium, Stroke / 03.09.2021

MedicalResearch.com Interview with: Maoyi TIAN PhD Program Head, Digital Health and Head, Injury & Trauma Senior Research Fellow The George Institute MedicalResearch.com: What is the background for this study? Response: There is clear evidence from the literature that sodium reduction or potassium supplementation can reduce blood pressure. Reduced blood pressure can also lead to a risk reduction for cardiovascular diseases. Salt substitute is a reduced sodium added potassium product combined those effects. Previous research of salt substitute focus on the blood pressure outcome. There is no evidence if salt substitute can reduce the risk of cardiovascular diseases or pre-mature death. This study provided a definitive evidence for this unaddressed question. MedicalResearch.com: What are the main findings? The main findings of the research were:
  • The salt substitute reduced the risk of stroke by 14%
  • The salt substitute reduced the risk of major adverse cardiovascular events by 13%
  • The salt substitute reduced the risk of pre-mature death by 12%
(more…)