AHA Journals, Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Clots - Coagulation, Heart Disease / 18.10.2016

MedicalResearch.com Interview with: Eric A. Secemsky, MD MSc Interventional Cardiology Fellow Massachusetts General Hospital Harvard Medical School Fellow, Smith Center for Outcomes Research in Cardiology Beth Israel Deaconess Medical Center MedicalResearch.com: What is the background for this study? Response: Use of oral anticoagulant (OAC) therapy prior to coronary stenting is a significant predictor of post-procedural bleeding events. Previous studies have estimated that the frequency of chronic OAC use among patients undergoing percutaneous coronary intervention (PCI) is between 3% to 7%. Yet many of these analyses examined select patient populations, such as those admitted with acute myocardial infarction or atrial fibrillation, and preceded the market approval of non-vitamin K antagonist oral anticoagulants (NOACs). As such, the contemporary prevalence of OAC use among all-comers undergoing PCI, as well as associated risks of adverse events, are currently unknown. Therefore, we used PCI data from a large, integrated healthcare system to determine current use of  oral anticoagulant use among all-comers undergoing coronary stenting and the related short- and long-term risks of therapy. (more…)
Author Interviews, FASEB, Heart Disease, Imperial College, Pain Research, Pharmacology / 17.10.2016

MedicalResearch.com Interview with: Dr Nicholas Kirkby BHF Intermediate Fellow | Vascular Biology National Heart & Lung Institute | Imperial College London London MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know drugs like ibuprofen, called ‘non-steroidal anti-inflammatory drugs’ cause an increase in the risk of heart attacks. These side effects cause very real concerns for the many millions of people who rely on them. They are also the reason why there are no new drugs in this class and why they have been withdrawn (2011) for use as a preventative treatment for colon cancer. Previous research from our group suggests that L-arginine supplements may prevent the cardiovascular side effects caused by these drugs. Our findings here suggest that a particular formulations of ibuprofen, called ibuprofen arginate, which is already available in many parts of the world, can act like an L-arginine supplement and that this could potentially protect the cardiovascular system. (more…)
Author Interviews, Coffee, Heart Disease, JAMA / 17.10.2016

MedicalResearch.com Interview with: Luis E. Rohde, MD, ScD Postgraduate Program in Health Science: Cardiology and Cardiovascular Sciences, Medical School, Federal University of Rio Grande do Sul, Cardiovascular Division, Hospital de Clínicas de Porto Alegre MedicalResearch.com: What is the background for this study? Response: Caffeine-rich beverages have been implicated as a common cause of several cardiac-related symptoms, such as palpitations, tachycardia, or irregular heartbeats. Because of this “intuitive” assumption, counseling to reduce or avoid caffeine consumption is still widely recommended in clinical practice by most physicians for patients with any heart disease. (more…)
Author Interviews, BMJ, Heart Disease, Technology / 15.10.2016

MedicalResearch.com Interview with: Dr. Ngai-yin Chan Princess Margaret Hospital Lai Chi Kok, Hong Kong MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) is the most common sustained heart rhythm disorder which can cause stroke, heart failure and an increased risk of death. The risk of stroke can be reduced substantially with drug treatment. However, a quarter of patients with AF causing stroke have silent and asymptomatic AF before stroke. The current guidelines recommend opportunistic screening for AF. Whether systematic community screening for AF with a convenient smartphone ECG can reduce the burden of AF remains unknown. (more…)
Author Interviews, Heart Disease, OBGYNE, Pediatrics / 14.10.2016

MedicalResearch.com Interview with: Prof. Chung-Yi Li Department of Public Health College of Medicine National Cheng Kung University Tainan Taiwan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Congenital heart disease is the leading congenital malformation that causes perinatal and infant deaths. However, little information is available about the risk factors, especially modifiable environmental and behavioral factors that may have posed adverse effects on fetal cardiac development. We conducted a nationwide population-based study in Taiwan to further evaluate the potential role of maternal chronic diseases in the risk of developing congenital heart disease in offspring. We found that children of women with several kinds of chronic disease were at elevated risk for congenital heart disease; these diseases included type 1 and type 2 diabetes, hypertension, congenital heart defects, anemia, connective tissue disorders, epilepsy, and mood disorders. (more…)
Author Interviews, Heart Disease, Surgical Research / 12.10.2016

MedicalResearch.com Interview with: Miguel Haime, MD VA Boston Healthcare System and Boston Medical Center Boston, MA Dr. Haime discusses an abstract about Somahlution DuraGraft during a rapid response session at the 2016 annual meeting of the European Association for Cardio-Thoracic Surgery (EACTS; 1–5 October, Barcelona, Spain) MedicalResearch.com: What is the background for this study? What are the main findings? Response: Coronary artery bypass grafting (CABG) surgery is the standard of care for multi-vessel coronary heart disease. During CABG, we use saphenous vein grafts as bypass conduits for surgical revascularization. Pathophysiological changes that occur in vein grafts during the surgical procedure can compromise the durability and patency of the graft and increase the risk of vein graft failure. At the European Association for Cardio-Thoracic Surgery (EACTS) annual meeting, we presented results from a retrospective, non-randomized study conducted at VA Boston Healthcare System to evaluate the Real World Evidence of DuraGraft®, a vascular graft treatment designed to prevent vein graft failure after CABG. (more…)
Author Interviews, Breast Cancer, Heart Disease, JAMA / 12.10.2016

MedicalResearch.com Interview with: Husam Abdel-Qadir, MD, FRCPC, DABIM (Cardiology and Internal Medicine) Graduate student, Clinical Epidemiology and Health Care Research Elliot Philipson Clinician Scientist Training Program University of Toronto MedicalResearch.com: What is the background for this study? Response: Breast cancer is the most common malignancy among North American women. The successes of screening and treatment have led to a marked increase in the number of breast cancer survivors, whose cardiovascular health is becoming of prime concern. Many recent publications have raised alarm about the incidence of cardiovascular abnormalities after breast cancer treatment. However, there is a paucity of data about the frequency of death from cardiovascular disease rather than breast cancer. Contemporary estimates of the incidence of competing risks like cardiovascular disease are important to guide discussions about prognosis, subsequent follow-up, and survivorship plans. It is important that such incidence estimates are generated using methodology that appropriately accounts for competing risks to avoid providing results that are biased upwards. (more…)
AHA Journals, Author Interviews, Heart Disease, Occupational Health / 12.10.2016

MedicalResearch.com Interview with: Rasmus Rørth MD From Department of Cardiology Rigshospitalet University of Copenhagen, Denmark MedicalResearch.com: What is the background for this study? Response: Heart failure is considered to be one of the most common, costly, disabling and deadly medical conditions and is thus a major health care problem. The ability to maintain a full-time job addresses a vital indirect consequence and cost of heart failure, beyond the usual clinical parameters such as mortality and hospitalization. Ability to work is more than just another measure of performance status. As well as its financial importance, employment is crucial for self-esteem and quality of life in patients with chronic illness. Obtaining information on labour force inclusion should, therefore, shed light on an unstudied consequence of heart failure and provide a novel perspective on the impact of heart failure on the lives of those who, perhaps, have most to lose from this condition. (more…)
AHA Journals, Author Interviews, Heart Disease, Pharmacology / 06.10.2016

MedicalResearch.com Interview with: Xiaoxi Yao, PhD, MPH, MS Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester, MN MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atrial fibrillation (AF) is the most common arrhythmia requiring treatment, affecting 3-6 million Americans. AF is associated with a 5 fold risk of stroke, which can be substantially reduced by oral anticoagulants. For over a half century, warfarin was the only option for long-term oral anticoagulation in the U.S., but the use of warfarin can be cumbersome. Warfarin has numerous interactions with food and other drugs, and requires regular lab testing and dose adjustment. Since 2010, four non–vitamin K antagonist oral anticoagulants (NOACs) have been approved by the FDA. In comparison to warfarin, the fixed-dosage NOACs provide more convenient therapeutic options and demonstrated at least equivalent efficacy and safety in large phase III clinical trials. However, the outcomes achieved in idealized clinical trial settings may not necessarily translate to routine clinical practice. In this large cohort of patients with nonvalvular AF, we assessed the real-world effectiveness and safety of three NOACs (dabigatran, rivaroxaban, and apixaban), comparing each agent with warfarin. We found apixaban was associated with lower risks of both stroke and major bleeding, dabigatran was associated with similar risk of stroke but lower risk of major bleeding, and rivaroxaban was associated with similar risks of both stroke and major bleeding in comparison to warfarin. (more…)
Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Heart Disease, JACC, Salt-Sodium / 06.10.2016

MedicalResearch.com Interview with: Nancy Cook ScD Professor of Medicine, Harvard Medical School Professor in the Department of Epidemiology Harvard T.H. Chan School Public Health Brigham & Women’s Hospital Division of Preventive Medicine Boston, MA 02215 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association of sodium intake with later mortality has been controversial. While there is a well-accepted effect on blood pressure, the effects of sodium on later cardiovascular disease, and particularly mortality, have been subject to dispute. While the adverse effects of high sodium are now widely accepted, effects at lower levels of sodium intake are less clear. Some recent studies have found a J-shaped relationship, with increased disease rates among those consuming lower levels of sodium, contrary to the effects on blood pressure. In contrast, we found a direct linear relationship of usual intake of sodium with later mortality over 20 years of follow-up. Those with the lowest sodium intake experienced the lowest mortality. Our measure of intake was based on the average over 1-3 years of several measures of 24hr urine sodium excretion, the gold standard of sodium measurement. This is much more precise than measurements based on a single 24hr sodium excretion or especially on a spot urine sample, which is used in many publications that found the J-shaped curve. Our data were assessed in a healthy cohort of men and women without hypertension or cardiovascular disease, so had less potential bias due to these factors. We thus believe that our results showing the lowest mortality among those consuming the lowest levels of sodium are more accurate. (more…)
Author Interviews, Exercise - Fitness, Heart Disease, JACC, Pediatrics / 03.10.2016

MedicalResearch.com Interview with: Dr. James McKinney MD MSc FRCP(C) Division of Cardiology University of British Columbia MedicalResearch.com: What is the background for this study? What are the main findings? Response: Sudden cardiac death (SCD) is the leading medical cause of death in young athletes. Sporting activity may predispose athletes with underlying cardiovascular conditions to develop life threatening ventricular arrhythmias during physical exercise. Despite being a relatively rare event, the death of a young healthy person is a tragic event that is difficult to comprehend. The prevalence of an underlying cardiovascular disorder in young athletes that predisposes to SCD is approximately 0.3%. Sudden cardiac death is often the first clinical manifestation of an underlying cardiovascular condition; up to 80% of athletes are previously asymptomatic. Pre-participation screening is the systematic practice of medically evaluating athletes for the purpose of identifying (or raising suspicion of) abnormalities that could provoke sudden death. There is agreement amongst sporting and medical bodies that athletes should undergo some form of pre-participation screening. An Achilles’ heel of screening is the significant number of false-positive screens that require subsequent costly secondary testing to rule out disease. Prevention of sudden cardiac death among athletes is a common goal, however the optimal strategy for its achievement is uncertain. (more…)
Author Interviews, Heart Disease, OBGYNE, Pediatrics, Women's Heart Health / 30.09.2016

MedicalResearch.com Interview with: Melissa C. Bartick, M.D. Assistant Professor of Medicine Department of Medicine, Cambridge Health Alliance, Cambridge Harvard Medical School, Boston Massachusetts MedicalResearch.com: What is the background for this study? Response: There has never been a study that combined maternal and pediatric health outcomes and costs into a single model. My colleague Arnold Reinhold and I had published a pediatric study in 2010, which was widely publicized but needed to be updated. My colleagues and I published a maternal study in 2013. But the two studies had different methodologies, and so the total costs could not be simply added together. Here, we wanted to get a picture of the impact of breastfeeding in the US public health as whole, by creating a single model that combined maternal and pediatric outcomes. That had never been done before. (more…)
Author Interviews, BMC, Heart Disease, Mediterranean Diet, Nutrition / 30.09.2016

MedicalResearch.com Interview with: Dr Nita Forouhi, MRCP, PhD, FFPHM Programme Leader MRC Epidemiology Unit University of Cambridge School of Clinical Medicine Institute of Metabolic Science Cambridge Biomedical Campus MedicalResearch.com: What is the background for this study? What are the main findings? Response: The benefits of the Mediterranean diet for cardiovascular health are well documented in countries of the Mediterranean region and some other countries, but there is little such evidence in the UK general population. Our work fills this research gap. In our study we followed up 23,902 initially healthy Britons living in Norfolk (Eastern England) for an average of 12 to 17 years, and determined the occurrence of new cases of cardiovascular diseases (CVD) and deaths due to CVD during that time period. Our results showed that those adults who adhered to a Mediterranean diet had 6% to 16% lower risk of developing CVD, compared to those who had dietary habits further away from the Mediterranean-type diet pattern. This was the case even when we accounted for several important risk factors and correlates of CVD, including as age, sex, body mass index, lifestyle habits such as smoking, alcohol intake and physical activity, and socio-economic factors. We also modelled what would happen in the study population if all the participants increased their adherence to the Mediterranean-type diet. From this we estimated that nearly 4% of all new cardiovascular disease cases, or 12.5% of cardiovascular deaths in the population could potentially be avoided. This is novel information about the potential health benefit of a Mediterranean-type diet in a UK context. However, we should remember that our study was an observational study, not a clinical trial with a dietary intervention, and thus we cannot imply a cause and effect relationship between increasing adherence to the Mediterranean diet and reduction in cardiovascular disease. We defined the Mediterranean diet using a 15 point score based on guideline recommendations from a Mediterranean dietary pyramid published by the Mediterranean Diet Foundation. The recommendations had not previously been specifically tested for their associations with health, so our findings, for the first time, show the utility of the Mediterranean dietary pyramid. (more…)
Author Interviews, Exercise - Fitness, Heart Disease / 29.09.2016

MedicalResearch.com Interview with: Headshot portrait of Dr. Kim Harmon, family medicine, sports medicine.Kimberly G. Harmon, MD University of Washington Seattle, WA 98195. MedicalResearch.com: What is the background for this study? Response: Sudden cardiac death (SCD) in a young athlete is tragic devastating families and communities.  It has been characterized as “rare” by some, however, previous studies have looked at broad age ranges of athletes and used various methods to determine the incidence rate, sometimes only including athletes which have events during school sponsored events.  In addition, many studies only look at sudden cardiac death and do not include sudden cardiac arrest (SCA) where the athlete has a cardiac arrest but is resuscitated and survives. SCA is important to include as ideally we would like to prevent both SCA and SCD in athletes.  In this paper, over 1/3 of all US high school athletes were studied for six years to determine the incidence and the causes of SCA/D.   Media reports were used to identify cases and then autopsies were obtained in those who died. (more…)
AHA Journals, Author Interviews, Heart Disease, Lipids / 28.09.2016

MedicalResearch.com Interview with: Dr. Johan Frostegård MD PhD Professor of medicine Karolinska Institutet's Institute of Environmental Medicine and Consultant at Karolinska University Hospital's Emergency Clinic MedicalResearch.com: What is the background for this study? What are the main findings? Response: Statins are one of the worlds most sold medications, which has generated large profits, but also, in my opinion, helped many people. Still, side effects are much discussed after more than 2 decades of use, as exemplified by a current debate between Lancet and BMJ (the former has the opinion that side effects are not major issues, but the latter do not agree). Also the exact role of LDL (low density lipoprotein, also known as the ”bad cholesterol”) as a risk factor is discussed, and can vary, according to many researchers. LDL levels are important among middle aged persons, especially men, as a risk markers for cardiovascular disease, especially myocardial infarction. LDL is most likely less important as a risk factor in individuals above 60 years of age, and also among women – as compared to middle aged men. (more…)
Author Interviews, Heart Disease, Kidney Disease, Surgical Research / 25.09.2016

MedicalResearch.com Interview with: Pablo Codner, MD; Amos Levi, MD (firsts authors) and Prof. Ran Kornowski, MD, FACC, FESC (senior author) Rabin Medical Center Derech Ze`ev Israel. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe aortic stenosis (AS) who are deemed inoperable by the “heart team”, for those at high risk for surgery and also for patients at intermediate surgical risk. Currently this therapeutic alternative is being compared with surgical aortic valve replacement in patients at low risk for surgery. Patients with chronic kidney disease were excluded from most randomized trials. We evaluated outcomes within a large multicenter cohort of patients undergoing TAVR distinguished by renal function, from 11 high volume centers in 8 different countries across Europe and Asia. In our experience patients with renal dysfunction were associated with poor clinical outcomes. All-cause and cardiovascular mortality rates during the follow-up period increased with declining renal function. A glomerular filtration rate ≤30 mL/min was identified on multivariate analysis as an independent predictor for all-cause and cardiovascular mortality. We also found higher rates of severe bleeding and vascular complications among patient with advanced or end stage renal failure. (more…)
Author Interviews, Heart Disease, Technology / 23.09.2016

MedicalResearch.com Interview with: biotricityWaqaas Al-Siddiq, Founder and CEO of Biotricity MedicalResearch.com: Would you tell us a little about yourself? How did you get interested in combining healthcare with technology? Response: I am the president and CEO of biotricity which is a healthcare technology company dedicated to providing diagnostic and post-diagnostic solutions for both the physician and consumer for long-term chronic care management. I got interested in combining healthcare and technology while I was doing research for monitoring remote environments in critical scenarios. I thought that it would be very interesting to apply that to healthcare because it’s a problem that no one has figured out how to solve yet. And it’s a problem that is driving healthcare costs out of control. (more…)
Author Interviews, Genetic Research, Heart Disease, JACC / 20.09.2016

MedicalResearch.com Interview with: Prof. dr. P. van der Harst Interventional Cardiologist Scientific Director Cardiac Catheterization Laboratory University Medical Center Groningen Groningen The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: The electrocardiogram harbors important clues for the development and progression of heart diseases. We studied the voltages of the QRS-complex, a measure of cardiac hypertrophy which is associated with heart failure and various cardiomyopathies. We carried out a genome-wide association study (GWAS) and identified 52 regions in the genome that were associated with one or more QRS characteristics. 32 of these were novel. In these 52 regions we found 67 candidate genes that are might play a role in the adequate function of the human heart and the development of heart disease. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JACC, Kidney Disease / 19.09.2016

MedicalResearch.com Interview with: Elvira Gosmanova MD Department of Nephrology University of Tennessee Health Science Center Memphis TN, 38163 MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been long known that elevated blood pressure is a risk factor for numerous adverse health-related outcomes. However, the majority of individuals do not have blood pressure in a constant range. In contrary, blood pressure measured in the same individual tends to fluctuate over time. Moreover, some individuals have more blood pressure fluctuation, as compared with others. The impact of fluctuation in blood pressure is still poorly understood. Smaller studies suggested that increased fluctuation in blood pressure may be associated with hazardous health outcomes. However, large scale studies were still lacking. Therefore, we conducted a study involving close to 3 million US veterans to investigate the association of increased visit-to-visit variability of systolic blood pressure (which was our measure of fluctuation of blood pressure over time) and all-cause mortality, and incident coronary heart disease, stroke, and end-stage renal disease. We found that there was strong and graded increase in the risk of all the above outcomes with increasing visit-to-visit variability of systolic blood pressure. (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 19.09.2016

MedicalResearch.com Interview with: Nish Patel, MD and Nileshkumar J. Patel, MD University of Miami Miller School of Medicine MedicalResearch.com: What is the background for this study? Response: Out of hospital cardiac arrest (OHCA) is estimated to affect approximately 300,000 people in the United States annually. Pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF) contributes 23-54% of OHCA patients, with the median values at the lower end of this range. Coronary artery disease is thought to be responsible for up to 70% of these OHCA cases. It has been suggested that urgent coronary intervention in unconscious patients after cardiac arrest may improve survival. In the 2015 American Heart Association (AHA) guidelines, coronary angiography is recommended in patients with OHCA patients with a suspected cardiac etiology and ST elevations (STE) on ECG (Class of recommendation I, Level of evidence B), and it should be considered in patients after cardiac arrest presenting without STE but with suspected cardiac etiology of cardiac arrest (Class of recommendation II a, Level of evidence B). However, there is paucity of information about the use of coronary angiography and percutaneous coronary intervention (PCI) and its potential benefit for the VT/VF OHCA patient population. Therefore, we reviewed the Nationwide Inpatient Sample (NIS), to examine temporal trends of coronary angiography and PCI in VT/VF OHCA in the United States, for patients with and without STE. We also studied the temporal trends of survival to discharge in these patient populations. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 19.09.2016

MedicalResearch.com Interview with: Islam Elgendy, MD Cardiology Fellow University of Florida MedicalResearch.com: What is the background for this study? What are the main findings? Response: The optimal systolic blood pressure target in adults with coronary artery disease is not well known. The Eighth Joint National Committee Panel recommended a target therapeutic goal <150 mm Hg for adults aged ≥60 years and <140 mm Hg in those aged <60 years. These recommendations are inconsistent with the different society guidelines (such as American Heart Association/American College of Cardiology, European Society of Cardiology, and American Society of Hypertension) which recommended a therapeutic target < 140 mm Hg. Given that the dyad of hypertension and coronary artery disease is the most prevalent chronic disease dyad among adults, we aimed to assess the long term risk of all-cause mortality with the different systolic blood pressure targets. Using the extended follow-up data from the US cohort of the INVEST trial, we demonstrated that achieving a systolic blood pressure of 130 to <140 mm Hg in the initial 2-3 years of treatment is associated with reduced all-cause mortality after ≈11.6 years of follow-up in hypertensive patients with coronary artery disease. (more…)
AHA Journals, Author Interviews, Brigham & Women's - Harvard, Endocrinology, Heart Disease, Thyroid Disease / 17.09.2016

MedicalResearch.com Interview with: Layal Chaker, MD, MSc PhD candidate Department of Endocrinology and Epidemiology Erasmus Medical Center Rotterdam, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: The association of thyroid function with coronary heart disease is well–established but not much was known about the association of thyroid function with sudden cardiac death. We conducted the study with the hypothesis that thyroid hormone levels affect cardiovascular risk factors and therefore could also affect the risk of sudden cardiac death (SCD). We were surprised to see that when we control our analyses for these cardiovascular risk factors, the association of high and high-normal thyroid function with SCD remained similar, suggesting that other pathways could play a role. Thyroid hormone has different effects on the cardiovascular systems and future studies should identify which pathway could be responsible for the increased risk of sudden cardiac death with higher thyroid hormone levels. This could lead to better assessment of individual risk and identify possible prevention targets. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 17.09.2016

MedicalResearch.com Interview with: Holly Mattix-Kramer, MD, MPH Public Health Sciences Medicine, Nephrology Associate Professor Loyola Medicine, Illinois MedicalResearch.com: What is the background for this study? What are the main findings? Response: The background is that the Systolic Blood Pressure Lowering Intervention Trial (SPRINT) showed that intensive systolic blood pressure lowering reduces all-cause mortality by 27% compared to standard blood pressure lowering among adults age 50 years and older without diabetes or stroke but with high cardiovascular disease risk. We applied these findings to the U.S. population and asked "What if intensive systolic blood pressure lowering were applied to the U.S. population who meet SPRINT eligibility criteria? We found that approximately 18.1 million U.S. adults meet SPRINT criteria and that their annual mortality rate is 2.2%. If intensive systolic blood pressure lowering reduces all-cause mortality by 27%, then the annual mortality rate would be reduced to 1.6% and approximately 107,500 deaths would be prevented each year. (more…)
Author Interviews, Gender Differences, Heart Disease, JAMA, Menopause / 15.09.2016

MedicalResearch.com Interview with: Taulant Muka, MD, MPH, PhD Postdoctoral Researcher Erasmus University, Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: Menopause marks a major life transition for women, resulting in the loss of ovarian follicle development. Although menopause is a universal phenomenon among women, the timing of the final menstrual period differ greatly between women, and is considered a marker of aging. By quantifying data of nearly 310,329 non-overlapping women, we found that women who experienced an early menopause (i.e. younger than 45 years) have an excess risk of CHD, CVD-mortality and all-cause mortality. Furthermore, being 45-49 years at menopause compared to ≥50 years was associated with increased risk of carotid atherosclerosis. (more…)
Author Interviews, Heart Disease, Infections, Surgical Research / 14.09.2016

MedicalResearch.com Interview with: Josep Rodés-Cabau, MD Director, Catheterization and Interventional Laboratories Quebec Heart and Lung Institute Professor, Faculty of Medicine, Laval University Quebec City, Quebec, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Infectious endocarditis (IE) is one of the most serious complications after surgical prosthetic valve replacement. There are however scarce data regarding the incidence, predictive factors, treatment, and outcomes of IE post-TAVR. To date, the present study represents the largest series of IE post-TAVR, and the main findings can be summarized as follows: (1) the incidence of infective endocarditis (IE) post-TAVR is similar to that reported for IE after surgical prosthetic valve replacement; (2) among patients undergoing TAVR, younger age, male sex, a history of diabetes mellitus, and moderate-to-severe residual aortic regurgitation were associated with a higher risk of IE, (3) Enterococci species was the most frequently isolated pathogen, (4) IE post-TAVR was associated with a very high rate of in-hospital complications and mortality during index hospitalization and at follow-up. (more…)
Annals Internal Medicine, Author Interviews, Heart Disease, Transplantation / 14.09.2016

MedicalResearch.com Interview with: Prof. Xavier Jouven Service de Cardiologie Hôpital Européen Georges Pompidou Paris MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many cardiac arrests (around 300 000 per year in United States). The possibility to collect organs from a certain proportion of those cardiac arrests represents an important opportunity to fill the gap of the organ shortage. It is absolutely mandatory to identify patients with no chance of survival. This study showed 3 criteria which allow this early identification. Several thousands of patients die every year waiting for organ transplantation. (more…)
Author Interviews, Clots - Coagulation, Heart Disease, Stroke / 13.09.2016

MedicalResearch.com Interview with: Menno Huisman, MD, PhD Associate professor Department of Medicine Leiden University Medical Center The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: GLORIA™-AF is one of the largest ongoing global registry programs examining the use of oral antithrombotic agents in real-world clinical practice. The program is designed to characterize the population of newly diagnosed patients with non-valvular atrial fibrillation (NVAF) at risk for stroke, and to study patterns, predictors and outcomes of different regimens for stroke prevention. At the ESC Congress 2016, we presented the first Phase II results of GLORIA-AF from approximately 3,000 NVAF patients, which showed that treatment with PRADAXA was associated with low incidences of stroke, major bleeding and life threatening bleeding. Less than 1% of PRADAXA-treated patients experienced a stroke over two years (0.63%). Major bleeding occurred in 1.12% of PRADAXA-treated patients and 0.54% experienced a life-threatening bleed. (more…)
Author Interviews, Heart Disease, Weight Research / 13.09.2016

MedicalResearch.com Interview with: Maria Korre, ScD Post-Doctoral Research Fellow Environmental & Occupational Medicine & Epidemiology Program Department of Environmental Health Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease (CVD) is the leading cause of on-duty death among firefighters (45% of on-duty fatalities) and a major cause of morbidity. It is crucial to note though, that the risk of on-duty CVD events is not evenly distributed among all firefighters, but is highly concentrated among the most susceptible individuals. Given that firefighting is an inherently dangerous occupation and many of its hazards cannot be engineered out of the job, we have concentrated our efforts on understanding what can make an individual firefighter susceptible. As in the general population, these cardiovascular events are largely due to coronary heart disease (CHD), however, there is an increasing recognition of the role of left ventricular (LV) hypertrophy/cardiomegaly in the risk of sudden cardiac death (SCD) independent of the presence of CHD. Evidence suggests an improved prognostic value, when LV hypertrophy is based on the accurate assessment of LV mass. LV mass is a strong predictor of CVD events and despite it’s critical prognostic significance, it’s measurement and role in clinical practice has yet to be established. In this paper we aimed to identify the most important predictors of LV mass after indexing for height among career male firefighters as assessed by both echocardiography and cardiac magnetic resonance. (more…)
Author Interviews, Heart Disease, Stem Cells / 12.09.2016

MedicalResearch.com Interview with: Rafael Kramann, MD, FASN RWTH Aachen University Division of Nephrology and Clinical Immunology Pauwelsstr 30 52074 Aachen, Germany MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vascular calcification contributes centrally to the increased cardiovascular morbidity and mortality in patients with diabetes or chronic kidney disease. Vascular calcification is of major clinical importance as it predicts cardiovascular events, affects plaque stability contributing to stroke and myocardial infarction and also contributes to chronic heart failure by stiffening of the arterial wall. However, the cellular origin of vascular calcification is incompletely understood. While it is known that resident vascular smooth muscle cells and circulating macrophages are involved the contribution of adventitial cells is controversial and partly unknown. Our data indicates that adventitial progenitor cells marked by expression of Gli1 are key drivers of vascular calcification in athero- and arteriosclerosis. Genetic ablation of this cell population completely abolished vascular calcification in a mouse model of high lipid load and chronic kidney disease. Identification of this progenitor population might be the first step towards a cell-specific targeted therapy of vascular calcification. (more…)
Author Interviews, BMJ, Heart Disease, Stroke / 12.09.2016

MedicalResearch.com Interview with: Ayodele Odutayo, DPhil student Centre for Statistics in Medicine Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Oxford, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atrial fibrillation is associated with an increased risk of all cause mortality and stroke, as well as higher medical costs and a reduced quality of life. The association between atrial fibrillation and cardiovascular outcomes other than stroke is less clear. We found that atrial fibrillation is associated with a wide range of cardiovascular events, including cardiovascular mortality, major cardiovascular events, heart failure, ischaemic heart disease, chronic kidney disease, and sudden cardiac death, as well as stroke and all cause mortality. The relative and absolute risk increase associated with many of these events is greater than that of stroke. Interventions are needed to reduce the risk of non-stroke cardiovascular outcomes in adults with atrial fibrillation. (more…)