AHA Journals, Author Interviews, Heart Disease, Menopause, University of Pittsburgh, Women's Heart Health / 23.02.2017

MedicalResearch.com Interview with: Samar R. El Khoudary, Ph.D., M.P.H. Assistant professor Department of Epidemiology University of Pittsburgh Graduate School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study revealed a previously unknown, menopause-specific indicator of heart disease risk. For the first time, we’ve pinpointed the type of heart fat, linked it to a risk factor for heart disease and shown that menopausal status and estrogen levels are critical modifying factors of its associated risk in women. My team evaluated clinical data, including blood samples and heart CT scans, on 478 women from Pittsburgh and Chicago enrolled in the Study of Women’s Health Across the Nation (SWAN). The women were in varying stages of menopause, averaged 51 years old and were not on hormone replacement therapy. In a previous study, we showed that a greater volume of paracardial fat, but not epicardial fat, after menopause is associated with a decline in the sex hormone estradiol—the most potent estrogen—in women. The higher volume of epicardial fat was tied to other risk factors, such as obesity. In the new study, we built on those findings to discover that not only is a greater paracardial fat volume specific to menopause, but—in postmenopausal women and women with lower levels of estradiol—it’s also associated with a greater risk of coronary artery calcification, an early sign of heart disease that is measured with a heart CT scan. (more…)
Author Interviews, Heart Disease, Microbiome, Nutrition, Race/Ethnic Diversity / 23.02.2017

MedicalResearch.com Interview with: Akira Sekikawa, Ph.D. Associate professor of epidemiology University of Pittsburgh Graduate School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: We found that Japanese men who are able to produce equol—a substance made by some types of “good” gut bacteria when they metabolize isoflavones (micronutrients found in dietary soy)—have lower levels of a risk factor for heart disease than their counterparts who cannot produce it. All monkeys can produce equol, as can 50 to 70 percent of people in Asian countries. However, only 20 to 30 percent of people in Western countries can. Scientists have known for some time that isoflavones protect against the buildup of plaque in arteries, known as atherosclerosis, in monkeys, and are associated with lower rates of heart disease in people in Asian countries. It was surprising when a large trial of isoflavones in the U.S. didn’t show the beneficial effects on atherosclerosis. My colleagues and I recruited 272 Japanese men aged 40 to 49 and performed blood tests to find out if they were producing equol. After adjusting for other heart disease risk factors such as high blood pressure, cholesterol, smoking and obesity as well as dietary intake of isoflavones, we found that the equol-producers had 90-percent lower odds of coronary artery calcification, a predictor of heart disease, than the equol non-producers. (more…)
Author Interviews, Heart Disease, JAMA, Testosterone, UCLA / 23.02.2017

MedicalResearch.com Interview with: Ronald S. Swerdloff, MD Chief of the Division of Endocrinology, Department of Medicine and Director of a World Health Organization Collaborative Center in Reproduction a Mellon Foundation Center for Contraceptive Development and a NIH Contraceptive Clinical Trial Center Director of the Harbor-UCLA Reproductive Program LA BioMed Lead Researcher David Geffen School of Medicine UCLA Health MedicalResearch.com: What is the background for this study? Response: While we have long known that testosterone levels decrease as men age, very little was known about the effects of testosterone treatment in older men with low testosterone until last year. Our team of researchers from LA BioMed and 12 other medical centers in the U.S., in partnership with the National Institute on Aging, conducted a coordinated group of seven trials known as The Testosterone Trials (TTrials). We studied the effects of testosterone treatment for one year as compared to placebo for men 65 and older with low testosterone. The TTrials are now the largest trials to examine the efficacy of testosterone treatment in men 65 and older whose testosterone levels are low due seemingly to age alone. The first published research from the TTrials last year reported on some of the benefits to testosterone treatment. We have now published four additional studies in the Journal of the American Medical Association (JAMA) and JAMA Internal Medicine that found additional benefits and one potential drawback. (more…)
Author Interviews, Environmental Risks, Heart Disease, Radiology / 22.02.2017

MedicalResearch.com Interview with: Alessandro Sciahbasi, MD, PhD Sandro Pertini Hospital Rome, Italy MedicalResearch.com: What is the background for this study? Response: Radiation exposure is an important issue for interventional cardiologists due to the deterministic and stochastic risks for operators, staff and patients. Consequently, it is important to know which are the determinants of operator radiation exposure during percutaneous coronary procedures in order to reduce radiation exposure. Despite different studies have already evaluated the radiation dose during percutaneous coronary procedures, most data were obtained using an indirect measure of the operator dose expressed in term of fluoroscopy time or dose area product (DAP) and only in a minority of studies dedicated operator dosimeters were used. The aim of our study was to evaluate operator radiation exposure during percutaneous coronary procedures with dedicated electronic dosimeters in a high volume center for transradial procedures. (more…)
Author Interviews, Heart Disease, JAMA, Testosterone / 21.02.2017

MedicalResearch.com Interview with: T. Craig Cheetham, PharmD, MS Southern California Permanente Medical Group Department of Research & Evaluation Pasadena, CA 91101 MedicalResearch.com: What is the background for this study? Response: Concerns have been raised about the cardiovascular safety of testosterone replacement therapy. Patient selection criteria may have been a factor in the findings from studies reporting an increased cardiovascular risk with testosterone replacement therapy. Many men who were receiving testosterone replacement therapy don’t fall into the categories of ‘frail elderly’ or ‘high cardiovascular risk’. We therefore studied testosterone replacement therapy in a population of androgen deficient men within Kaiser Permanente Northern and Southern California. (more…)
Author Interviews, Cost of Health Care, Heart Disease, JAMA / 17.02.2017

MedicalResearch.com Interview with: James E. Udelson, MD Chief, Division of Cardiology Director, Nuclear Cardiology Laboratory Professor, Tufts University School of Medicine   MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are millions of stress tests done every year in the United States and many of them are normal,” said James Udelson, MD, Chief of the Division of Cardiology at Tufts Medical Center and the senior investigator on the study. “We thought that if we could predict the outcome of these tests by using information we already had from the patient before the test, we could potentially save the health care system money and save our patients time and worry.”   We were able to get a strong prediction of the possibility of having entirely normal testing and no clinical events such as a heart attack, by developing a risk prediction tool using ten clinical variables that are commonly available to a physician during an evaluation” (more…)
AHA Journals, Author Interviews, Cost of Health Care, Geriatrics, Heart Disease / 15.02.2017

MedicalResearch.com Interview with: Olga Khavjou RTI International MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cardiovascular disease (CVD) is the leading cause of death in the United States and is one of the costliest chronic diseases. As the population ages, CVD costs are expected to increase substantially. To improve cardiovascular health and control health care costs, we must understand future prevalence and costs of CVD. In 2015, 41.5% (more than 100 million people) of the U.S population was estimated to have some form of CVD. By 2035, the number of people with CVD is projected to increase to over 130 million people, representing a 30% increase in the number of people with CVD over the next 20 years. Between 2015 and 2035, real total direct medical costs of CVD are projected to more than double from $318 billion to $749 billion and real indirect costs (due to productivity losses) are projected to increase from $237 billion to $368 billion. Total costs (medical and indirect) are projected to more than double from $555 billion in 2015 to $1.1 trillion in 2035. (more…)
Author Interviews, Heart Disease, JACC, Pharmacology / 15.02.2017

MedicalResearch.com Interview with: Gavin Y Oudit, MD, PhD, FRCPC Associate Professor, Department of Medicine, University of Alberta Clinician-Scientist Mazankowski Alberta Heart Institute Canada Research Chair in Heart Failure Division of Cardiology Edmonton, Alberta Heart specialist Gavin Oudit and his research team discovered a molecule — angiotensin converting enzyme 2 (ACE2)—that works to restore balance to the pathways responsible for chronic and acute heart failure, including in hearts from patients with advanced heart failure who underwent heart transplants. In developing the new drug, Oudit and his team discovered to an extent not seen before how the renin-angiotensin system (RAS), which regulates the body’s sodium balance, fluid volume, and blood pressure, is at play in both acute and chronic heart failure. In collaboration with Dr. Oudit, recombinant human ACE2 was made by Apeiron Biologics, purchased by GlaxoSmithKline, and has recently completed phase II clinical trial. (more…)
Author Interviews, Environmental Risks, Gender Differences, Heart Disease / 14.02.2017

MedicalResearch.com Interview with: Nathalie Auger MD MSc FRCPC Montréal, Québec MedicalResearch.com: What is the background for this study? Response: Snow shoveling is a challenging cardiovascular activity. Some studies suggest a link between snowfall and myocardial infarction, but use aggregate data which are limited. We used health data for individuals in the province of Quebec, Canada to analyze the association between snowfall and likelihood of hospital admission or death due to myocardial infarction. (more…)
AHA Journals, Author Interviews, Columbia, Heart Disease, Immunotherapy, Lipids / 13.02.2017

MedicalResearch.com Interview with: Henry N. Ginsberg, MD Irving Institute for Clinical and Translational Research Columbia University Columbia College of Physicians and Surgeons New York, NY MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies in mice and cells have identified increased hepatic low density lipoprotein (LDL) receptors as the basis for LDL lowering by PCSK9 inhibitors, but there have been no human studies characterizing the effects of PCSK9 inhibitors on lipoprotein metabolism, particularly effects on very low density lipoproteins (VLDL), intermediate density lipoproteins (IDL) or LDL metabolism. This study in 18 healthy subjects, found that alirocumab decreased the number of IDL and LDL particles in the circulation, and their associated cholesterol and apoB levels by increasing efficiency of the clearance of IDL and LDL. There were not effects on VLDL metabolism. The increased clearance of IDL meant that less LDL was produced from IDL, which is the precursor of LDL. Thus, the dramatic reductions in LDL cholesterol resulted from both less LDL being produced and more efficient clearance of LDL. These results are consistent with increases in LDL receptors available to clear IDL and LDL from blood during PCSK9 inhibition. (more…)
Author Interviews, Heart Disease, JAMA, Neurological Disorders, Stroke / 13.02.2017

  Christopher Chen, FRCP Department of Pharmacology Yong Loo Lin School of Medicine Memory Aging and Cognition Center National University Health System Singapore Saima Hilal, PhD Department of Pharmacology, National University of Singapore Department of Radiology, Epidemiology and Nuclear Medicine Erasmus Medical Center, Rotterdam, the Netherlands     MedicalResearch.com Interview with: Christopher Chen, FRCP Department of Pharmacology Yong Loo Lin School of Medicine Memory Aging and Cognition Center National University Health System Singapore Saima Hilal, PhD Department of Pharmacology, National University of Singapore Department of Radiology, Epidemiology and Nuclear Medicine Erasmus Medical Center, Rotterdam, the Netherlands MedicalResearch.com: What is the background for this study? Response: Cerebral microinfarcts (CMIs) are defined as small (usually <1 mm) regions of ischemic change found in the brain which are not readily visible on gross examination or on standard 1.5-T magnetic resonance imaging (MRI). On microscopy they appear as foci of neuronal loss, gliosis, pallor, or cysts. Previous post mortem studies have shown that the presence of CMIs is relatively common in elderly individuals without dementia (24%) but more common in patients diagnosed with Alzheimer disease (43%) or vascular dementia (62%). Whilst a single CMI is likely to be “silent” as the region of brain affected is probably too small to produce symptoms or neurologic deficits, however, as a large number of CMIs exist in many individuals, especially in the cerebral cortex and watershed areas, the overall effect has clinical importance – as shown by neuropathologic studies which demonstrate an important role of CMIs in cognitive dysfunction and dementia. However in vivo studies have been hampered by the inability to detect CMIs reliably on neuroimaging, leading to CMIs being termed “invisible” during life. The advent of high spatial-definition 7-T MRI enabled the identification of cortical  Cerebral microinfarcts in-vivo and importantly a study that directly compared 7-T and 3-T MRIs in the same patients reported that 3-T MRI detected about 1/3 of the lesions found on 7-T MRIs, suggesting that 3-T MRIs, which are more accessible than 7-T, may be able to detect larger cortical CMIs with a lower limit of approximately 1 mm in diameter. Our group has made major contributions recently on the clinical associations of 3T MRI detected cortical CMIs in patients from memory clinics as well as in community based subjects. Associations were found with age, vascular risk factors, other MRI markers of cerebrovascular disease as well as cognition. However, the causes of CMIs remain unclear and may be heterogeneous with microembolism, microthrombosis, and foci of inflammation as possible causative factors. (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA / 12.02.2017

MedicalResearch.com Interview with: Frederick L. Ruberg, MD Director, Cardiovascular Medicine Fellowship Training Program Director, Pilot Grants Program, Boston University Clinical and Translational Science Institute Director, Advanced Cardiac Imaging Program Section of Cardiovascular Medicine Department of Medicine Department of Radiology Boston Medical Center  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ATTR cardiac amyloidosis is an under-recognized cause of congestive heart failure in older adults that results from the deposition of misfolded TTR protein in the heart. One cause of ATTR cardiac amyloidosis is a genetic abnormality, inherited from an affected patient’s parent, that causes the protein TTR to misfold. The most common genetically inherited cause of ATTR amyloidosis in the US is called Val122Ile (V122I), named for the specific mutation in the TTR gene, that is seen in approximately 3.5% of US African Americans. ATTR cardiac amyloidosis was once an untreatable disease, but now new drugs are in different stages of clinical trial testing. Thus, recognition is important to get patients on the right treatments. One of the principal reasons why the disease is under-recognized is that doctors don’t have proven and available diagnostic tests that can be applied in the outpatient clinic. This study demonstrated that a new point-of-care diagnostic test, using measurement of a blood protein called retinol binding protein 4 (RBP4) and other standard of care test information, can accurately diagnose ATTR cardiac amyloidosis. We demonstrated the validity of this test in two separate cohorts of patients with proven ATTR cardiac amyloidosis due to the Val122Ile mutation and control patients with heart failure but without amyloidosis. (more…)
Author Interviews, Cancer Research, Heart Disease, PNAS, UT Southwestern / 09.02.2017

MedicalResearch.com Interview with: Lawrence Lum, Ph.D. Associate Professor Virginia Murchison Linthicum Scholar in Medical Research UT Southwestern Medical Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: Scarring of the adult heart due to excessive fibrotic responses is common after a heart attack, or following radiation therapy for the treatment of certain cancers. We have identified an anti-cancer agent currently in clinical development called WNT-974 that decreases fibrotic responses and improves heart function following myocardial infarction in mice. This unexpected observation was the outcome of a study focused on identifying unwanted adult tissue toxicities associated with this class of chemicals. (more…)
Author Interviews, Heart Disease, Surgical Research, Vitamin C / 06.02.2017

MedicalResearch.com Interview with: Harri Hemilä, MD, PhD Department of Public Health University of Helsinki MedicalResearch.com: What is the background for this study? Response: I have a long term interest in vitamin C. Previously I have shown that it alleviates exercise-induced bronchoconstriction (EIB) (http://dx.doi.org/10.1186/1710-1492-10-58 ) and shortens the duration of colds ( http://dx.doi.org/10.1371/journal.pmed.0020168 ). Now I had been following the literature and I noted that a number of randomized trials were being published about vitamin C for preventing post-operative atrial fibrillation (POAF). Therefore I reasoned that it is worthwhile to analyze that set of trials (more…)
Author Interviews, Heart Disease, JACC / 06.02.2017

MedicalResearch.com Interview with: Dan Hu (Helen), MD. PhD. FAHA. FACC. FHRS. Research Scientist II, Associate Professor Clinical Consultant of Molecular Genetic Department SCRO Chair of Stem Cell Center Masonic Medical Research Laboratory Utica, NY 13501 MedicalResearch.com: What is the background for this study? Response: Short QT Syndrome (SQTS) is a rare genetic disease characterized by an abnormally short QT interval in subjects with structurally normal hearts. It is a recognized cause of cardiac rhythm disorders, including both atrial and ventricular arrhythmias, and sudden cardiac death (SCD). As an inherited channelopathy, the molecular basis for SQTS has been associated with mutations in 6 genes: KCNH2 (IKr, SQTS1), KCNQ1 (IKs, SQTS2), and KCNJ2 (IK1, SQTS3), which encode different potassium channels; CACNA1C, CACNB2b and CACNA2D1 (SQTS4-6), which encode the L-type calcium channel (ICa). This study sought to evaluate the phenotypic and functional expression of an apparent hotspot mutation associated with SQTS. (more…)
Author Interviews, Heart Disease, JAMA, Tobacco Research, UCLA / 01.02.2017

MedicalResearch.com Interview with: Holly R. Middlekauff, MD Professor UCLA Division of Cardiology David Geffen School of Medicine UCLA MedicalResearch.com: What is the background for this study? What are the main findings? Response: E-cigarettes are the fastest rising tobacco product in the US today, but almost nothing is known about their cardiovascular effects. Rather than wait decades for epidemiological data in e-cigarette users to become available, we reasoned that investigations into the known mechanisms by which tobacco cigarettes increase heart disease would provide insights into the health risks of e-cigarettes. We focused on 2 critical mechanisms: 1) cardiac adrenaline activity, and 2) oxidative stress, measured in chronic e-cigarrete users compared to matched, healthy controls. The major findings were that, compared to healthy controls, e-cig users had increased cardiac adrenaline activity (measured by a technique called "heart rate variability"). Furthermore, compared to healthy controls, the e-cig users had increased susceptibility to oxidative stress. (more…)
Author Interviews, Heart Disease, NEJM, NIH, Pediatrics / 30.01.2017

MedicalResearch.com Interview with: Victoria Pemberton, RNC, MS, CCRC Program Officer Division of Cardiovascular Sciences National Heart, Lung, and Blood Institute, NIH Bethesda, Maryland MedicalResearch.com: What is the background for this study? What are the main findings?
  • Previous studies have examined cardiac arrest when it occurs outside of the hospital in both children and adults, with current guidelines recommending hypothermia (body cooling) or normothermia (maintenance of normal body temperature) after such an arrest.   This trial addresses pediatric cardiac arrest in a hospital setting, for which no previous data existed. Because children who experience an in-hospital cardiac arrest differ significantly from children who arrest outside of the hospital, it is important to test these treatments in this population.
  • The trial found no significant differences in survival and neurobehavioral functioning a year after cardiac arrest between children assigned to the hypothermia arm and those assigned to normothermia.
Author Interviews, Diabetes, Endocrinology, Heart Disease, Lipids, Pharmacology, Weight Research / 30.01.2017

MedicalResearch.com Interview with: Gianluca Iacobellis MD PhD Professor of Clinical Medicine Division of Endocrinology, Diabetes and Metabolism Department of Medicine University of Miami, FL MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know that epicardial fat, the visceral fat of the heart, is associated with coronary artery disease, diabetes and obesity. My studies have shown that epicardial fat can be easily measured with non invasive imaging procedures. Remarkably, epicardial fat has recently emerged as therapeutic target responding to medications targeting the fat. Liraglutide, a GLP-1 analog has shown to provide modest weight loss and beneficial cardiovascular effects beyond its glucose lowering action. So , we sought to evaluate the effects of liraglutide on epicardial fat. (more…)
Author Interviews, Heart Disease, Neurological Disorders, Pediatrics, Science, Stem Cells / 27.01.2017

MedicalResearch.com Interview with: Paul D. Morton, Ph.D. Research PostDoc and lead study author of “Abnormal Neurogenesis and Cortical Growth in Congenital Heart Disease.” Children’s National Health System Washington, DC Nobuyuki Ishibashi, M.D. Director of the Cardiac Surgery Research Laboratory at Children’s National Health System and co-senior study author. Vittorio Gallo, Ph.D. Director of the Center for Neuroscience Research at Children’s National Health System and co-senior study author.     Richard A. Jonas, M.D. Chief of the Division of Cardiac Surgery at Children’s National Health System and co-senior study author. MedicalResearch.com: What is the background for this study? Response: Congenital heart disease (CHD) is the leading birth defect in the United States and often results in an array of long-term neurological deficits including motor, cognitive and behavioral abnormalities. It has become increasingly clear that children with CHD often have underdeveloped brains. In many cases of complex CHD, blood flow to the brain is both reduced and less oxygenated, which has been associated with developmental abnormalities and delay. The cellular mechanisms underlying the impact of CHD on brain development remain largely unknown. We developed a preclinical chronic hypoxia model to define these mechanisms. (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, Technology / 27.01.2017

MedicalResearch.com Interview with: Lucas Marzec MD Instructor of Medicine Section of Cardiac Electrophysiology Division of Cardiology University of Colorado School of Medicine Aurora, CO 80045 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The addition of cardiac resynchronization therapy (CRT) to an implantable cardioverter defibrillator (ICD) reduces the risk of mortality and heart failure events in select patients with left ventricular systolic dysfunction. Given these benefits, it is important to ensure patients who have a guideline recommendation for CRT are considered for this therapy at the time of ICD implantation. Previously, little data were available on the contemporary use of CRT among guideline eligible patients undergoing ICD implantation. Although ICDs alone reduce the risk of mortality in patients with heart failure and reduced systolic function, prior work shows these devices are not uniformly provided to eligible patients and that rates of ICD implantation vary widely by hospital. Prior to our study, it was unknown whether similar variation in the use of the combination of ICD and CRT (CRT-D) exists. We analyzed data from the National Cardiovascular Data Registry (NCDR) ICD Registry to identify patient, provider, and hospital characteristics associated with CRT-D use and to determine the extent of hospital level variation in the use of CRT-D among patients eligible for CRT undergoing implantation of an ICD. (more…)
Author Interviews, Diabetes, Heart Disease, JACC, Stanford / 27.01.2017

MedicalResearch.com Interview with: Fumiaki Ikeno M.D. Program Director (U.S.) Japan Biodesign Stanford Biodesign Medical Director/Research Associate Experimental Interventional Laboratory Division of Cardiology Stanford University MedicalResearch.com: What is the background for this study? What are the main findings? Response: We sought to determine whether the extent of coronary disease in terms of the number of lesions and their complexity in Type 2 Diabetes patients could predict major cardiovascular events, and hypothesized that revascularization would have greater effectiveness relative to medical therapy among patients with more number of lesions and higher complexity in coronary artery disease. Coronary bypass surgery, catheter-based treatment, and medical therapy all had similar cardiovascular outcomes among patients with less complexity of coronary artery disease who had type 2 diabetes mellitus, stable ischemic heart disease, and no prior coronary revascularization. Among patients with mid or high complexity coronary artery disease, coronary revascularization with bypass surgery significantly reduced the rate of major cardiovascular events during 5 years of follow-up. (more…)
Author Interviews, Heart Disease, Lipids, Omega-3 Fatty Acids / 21.01.2017

MedicalResearch.com Interview with: Dominik D Alexander, PhD, MSPH Principal Epidemiologist EpidStat Institute Ann Arbor, MI Seattle, WA MedicalResearch.com: What is the background for this study? What are the main findings? Response: In recent years, the body of scientific literature on n-3 LCPUFA (EPA/DHA) intake and coronary heart disease (CHD) risk has exploded with mixed results. It was only logical to conduct a comprehensive meta-analysis of randomized controlled trials (RCTs) to estimate the effect of EPA+DHA on CHD, and to conduct a comprehensive meta-analysis of prospective cohort studies to estimate the association between EPA+DHA intake and CHD risk. Among RCTs, there was a nonstatistically significant reduction in CHD risk with EPA+DHA provision (SRRE=0.94; 95% CI, 0.85-1.05). Subgroup analyses of data from RCTs indicated a statistically significant CHD risk reduction with EPA+DHA provision among higher-risk populations, including participants with elevated triglyceride levels (SRRE=0.84; 95% CI, 0.72-0.98) and elevated low-density lipoprotein cholesterol (SRRE=0.86; 95% CI, 0.76-0.98). Meta-analysis of data from prospective cohort studies resulted in a statistically significant SRRE of 0.82 (95% CI, 0.74-0.92) for higher intakes of EPA+DHA and risk of any CHD event. (more…)
Author Interviews, Heart Disease / 21.01.2017

MedicalResearch.com Interview with: Dr. Elena Arbelo MD PhD Department of Cardiology, Cardiovascular Institute Hospital Clínic de Barcelona University of Barcelona Barcelona, Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Almost 20 years after its first description, catheter ablation is a widely-used treatment strategy for patients with symptomatic atrial fibrillation (AF) (AFib) resistant to antiarrhythmic drugs (AAD). If we look at the results of the ESC Pilot Atrial Fibrillation General Registry1, which included about 3000 consecutive in- and outpatients with AF presenting to cardiologists in nine participating countries in Europe, catheter ablation had previously attempted 7.6% overall, most often in those with paroxysmal AF (15.6%). A further 7.8% were prescribed an ablation as part of their management, which went up to a 19.3% in the case of paroxysmal AFib. On the other hand, several randomised clinical trials (RCTs) have shown better results of AFib ablation compared to antiarrhythmic drugs (AADs)2-6. However, these studies had a rather small sample size of selected patients, and interventions were undertaken by experienced operators with clearly pre-specified protocols. With rising prevalence of AFib and increasingly available treatment options, it was of utmost importance to have an accurate picture of contemporary AFib ablation and its outcomes which will allow the identification of practice gaps and assist evidence-based guidelines for the management of these patients. (more…)
Author Interviews, BMJ, Gender Differences, Heart Disease, Social Issues / 20.01.2017

MedicalResearch.com Interview with: Sanne Peters, PhD Research Fellow in Epidemiology The George Institute for Global Health University of Oxford Oxford United Kingdom MedicalResearch.com: What is the background for this study? Response: People from disadvantaged backgrounds are, on average, at greater risk of cardiovascular diseases than people with more affluent backgrounds. Some studies have suggested that these socioeconomic inequalities in cardiovascular disease are more consistent and stronger in women than in men. However, the literature is inconsistent. (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity / 20.01.2017

MedicalResearch.com Interview with: Fatima Rodriguez, MD, MPH Chief Cardiovascular Medicine Fellow Stanford University MedicalResearch.com: What is the background for this study? Response: Hispanics are the largest minority group in the U.S. Although cardiovascular disease (CVD) is the leading cause of death for Hispanics, most studies exploring disparities focus on Black and White differences. Additionally, Hispanics are often aggregated into one homogenous group, which masks important differences. There is also an interesting epidemiological phenomenon known as the “Hispanic paradox” that states that although Hispanics have greater risk factors for CVD, they experience lower mortality. (more…)
Author Interviews, Diabetes, Heart Disease / 13.01.2017

MedicalResearch.com Interview with: Dr. Abhinav Sharma MD Duke Clinical Research Institute, Duke University, Durham, NC Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada Renato D. Lopes, MD, PhD, MHS Duke Clinical Research Institute Durham, NC  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Impaired fasting glucose (IFG) has been demonstrated to be a risk factor for cardiovascular death; however, there is growing research suggesting that IFG also increases the risk of non-cardiovascular deaths such as cancer. The data on the distribution of causes of death among patients with impaired fasting glucose and cardiovascular risk factors have not been described. Our analysis used data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial. We identified that while myocardial death is the most common adjudicated cause of death, overall, non-cardiovascular deaths were more common that cardiovascular deaths. Among non-cardiovascular, cancer deaths were the most common cause of death. Furthermore, the burden of non-cardiovascular deaths increases relative to cardiovascular death over time. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Lancet, Medical Imaging, MRI, Social Issues / 12.01.2017

MedicalResearch.com Interview with: Dr Ahmed Tawakol MD Co-Director, Cardiac MR PET CT Program Massachusetts General Hospital and Harvard Medical School  MedicalResearch.com: What is the background for this study? What are the main findings? Response: While the link between stress and heart disease has long been established, the mechanism mediating that risk hasn’t been clearly understood. Animal studies showed that stress activates bone marrow to produce white blood cells, leading to arterial inflammation.  This study suggests an analogous path exists in humans. Moreover, this study identifies, for the first time in animal models or humans, the region of the brain (the amygdala) that links stress to the risk of heart attack and stroke. The paper reports on two complementary studies. The first analyzed imaging and medical records data from almost 300 individuals who had PET/CT brain imaging, primarily for cancer screening, using a radiopharmaceutical called FDG that both measures the activity of areas within the brain and reflects inflammation within arteries.  All participants in that study had no active cancer or cardiovascular disease at the time of imaging and each had information in their medical records on at least three additional clinical visits after imaging. The second study enrolled 13 individuals with a history of post-traumatic stress disorder, who were evaluated for their current levels of perceived stress and received FDG-PET scanning to measure both amygdala activity and arterial inflammation. (more…)
Author Interviews, Heart Disease, Nutrition, Red Meat / 11.01.2017

MedicalResearch.com Interview with: Wayne W. Campbell PhD Center on Aging and the Life Course Purdue University MedicalResearch.com: What is the background for this study? Response: Organizations that promote healthy eating often recommend consuming no more than 3.5-4.5 2-3 ounce servings of red meat per week. This recommendation is mainly based on data from epidemiological studies that observe a cohort of peoples’ eating habits over time and relate those habits to whether or not they experience a cardiovascular event, such as a heart attack or stroke, or cardiovascular-related death. These studies show associations between dietary choices and health but are unable to determine if a dietary choice is actually causing the disease. Randomized controlled clinical trials are able to determine causality by isolating one dietary variable to see the effects of that variable on certain health risk factors. Therefore, our lab compiled data from randomized controlled trials assessing the consumption of ≤ vs >3.5 servings of total red meat per week on blood lipids and lipoproteins and blood pressures, since these are common measures taken by clinicians to determine the risk for developing cardiovascular disease. (more…)
Author Interviews, Heart Disease / 10.01.2017

MedicalResearch.com Interview with: Dr. Mohammed Qintar, MD Cardiovascular Fellow St Luke’s Health System Kansas City MedicalResearch.com: What is the background for this study? What are the main findings? Response: One in four patients experience recurrent chest pain after acute myocardial infarction, but not all patients present with cardiac chest pain secondary to coronary ischemia. The frequency of non-cardiac chest pain re-hospitalitzation after acute myocardial infarction and its impact on patients’ health status has not been described after acute myocardial infarction (AMI). Both providers evaluating these patients and patients who have recently suffered an AMI are understandably concerned about any recurrent chest pain symptoms, and often present for urgent evaluation of these symptoms. In the first year after acute myocardial infarction, we found that a third of patients hospitalized for evaluation of chest pain actually presented with non-cardiac chest pain. Compared with patients not hospitalized with chest pain, non-cardiac chest pain hospitalization was associated with worse angina-related quality of life and general mental and physical health status. The quality of life for patients hospitalized with non-cardiac chest pain was similar to patients hospitalized with cardiac chest pain, suggesting a significant impact on their quality of life even though their pain did not reflect underlying coronary ischemia. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Surgical Research / 10.01.2017

MedicalResearch.com Interview with: Deepak L. Bhatt, MD, MPH, FACC, FAHA, FSCAI, FESC Executive Director of Interventional Cardiovascular Programs, Brigham and Women’s Hospital Heart & Vascular Center Professor of Medicine, Harvard Medical School Boston, MA 02115 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cangrelor is a potent, fast on, fast off, intravenous ADP receptor antagonist that is now available for use during PCI. Glycoprotein IIb/IIIa inhibitors are intravenous antiplatelet agents that work by a different mechanism. Doctors have asked whether there is any advantage to combining them or whether one class is preferable to the other during PCI. We analyzed close to 25,000 patients from the CHAMPION trials. Cangrelor’s efficacy in reducing peri-procedural ischemic complications in patients undergoing PCI was present irrespective of glycoprotein IIb/IIIa inhibitor administration. However, glycoprotein IIb/IIIa inhibitor use resulted in substantially higher bleeding rates, regardless of whether the patient was randomized to cangrelor or to clopidogrel. Thus, in general, cangrelor and glycoprotein IIb/IIIa inhibitors should not routinely be combined. If an operator wishes to use a potent intravenous antiplatelet during PCI, cangrelor is similarly efficacious as glycoprotein IIb/IIIa inhibitors, but with less bleeding risk. (more…)