Author Interviews, CHEST, Critical Care - Intensive Care - ICUs, Heart Disease, University of Michigan / 29.06.2016

MedicalResearch.com Interview with: Thomas Valley, MD, MSc Fellow, Pulmonary and Critical Care University of Michigan Ann Arbor, MI 48109-2800 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hospitalizations for cardiovascular condition such as acute myocardial infarction (AMI) and heart failure (HF) are incredibly common and costly. Yet, about 20% of hospitalized patients with these conditions receive substandard care. We assessed whether there was an association between the quality of care a hospital provided for AMI or heart failure and how frequently a hospital used the ICU. We found that hospitals with the highest rates of ICU use for AMI or HF delivered worse quality of care and had higher 30-day mortality for these conditions. (more…)
Author Interviews, Heart Disease, PNAS, UT Southwestern / 28.06.2016

MedicalResearch.com Interview with: Dr. Audrey Chang, PhD Kamm-Stull Lab UT Southwestern Medical Center AudreyN.Chang@UTSouthwestern.edu MedicalResearch.com: What is the background for this study? What are the main findings? Response: The heart is a singular kind of muscle that contracts and relaxes continuously over a lifetime to pump blood to the body’s organs. Contractions depend on a motor protein myosin pulling on actin filaments in specialized structures. Heart contraction is improved when myosin has a phosphate molecule attached to it (phosphorylation), and a constant amount of phosphorylation is essential for normal heart function. The amount of phosphorylation necessary for optimal cardiac performance is maintained by a balance in the activities of myosin kinase enzymes that add the phosphate and an opposing phosphatase enzyme that removes the phosphate. If the amount of phosphorylation is too low, heart failure results. Animal models with increased myosin phosphorylation have enhanced cardiac performance that resist stresses that cause heart failure. In this recent study reported in PNAS, a new kinase that phosphorylates myosin in heart muscle, MLCK4, was discovered and its crystal structure reported, a first for any myosin kinase family member. Compared to distinct myosin kinases in other kinds of muscles (skeletal and smooth), this cardiac-specific kinase lacks a conserved regulatory segment that inhibits kinase activity consistent with biochemical studies that it is always turned on. Additionally, another related myosin kinase found only in heart muscle (MLCK3) contains a modified regulatory segment, allowing partial activity enhanced by the calcium modulator protein, calmodulin. Thus, both myosin kinases unique to cardiac muscle provide phosphate to myosin in normal beating hearts to optimize performance and prevent heart failure induced by stresses. (more…)
Author Interviews, Heart Disease, JAMA, Pharmacology, UCSF / 27.06.2016

MedicalResearch.com Interview with: Dr. Gregory M. Marcus MD Gregory M Marcus, MD, MAS, FACC, FAHA, FHRS Director of Clinical Research Division of Cardiology Endowed Professor of Atrial Fibrillation Research  University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: Conduction system disease, or blockages in the electrically system (as opposed to blockages in the blood vessels, of which most are well-aware), is a common condition responsible for both heart failure in many patients as well as the need for pacemaker implantation. Although treatments for the disease are available, there are no known means to prevent it. This is important as the primary treatment, a pacemaker, can itself cause problems (including procedural complications, a long-term risk of infection with repeated battery changes, and even a greater risk of heart failure). In addition, predictors of what types of individuals are at risk for developing conduction disease has largely remained unknown. Based on the fact that the majority of conduction disease is due to fibrosis, or scarring, of the conduction system, we sought to test the hypothesis that a common drug for high blood pressure with anti-fibrotic properties, Lisinopril, might reduce the risk of new conduction system disease. We took advantage of the fact that more than 20,000 patients with hypertension were randomized to three common high blood pressure drugs that work via different mechanisms in the ALLHAT trial: Lisinopril, amlodipine, and chlorthalidone. We found that participants randomly assigned to Lisinopril were statistically significantly less likely to develop conduction disease. In addition, our analyses revealed several risk factors for the development of conduction disease: older age, male sex, diabetes, smoking, a thicker heart, and white race (compared to black race). (more…)
Alcohol, Author Interviews, BMJ, Heart Disease / 26.06.2016

MedicalResearch.com Interview with: Gregory M Marcus, MD, MAS, FACC, FAHA, FHRS Director of Clinical Research Division of Cardiology Endowed Professor of Atrial Fibrillation Research University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: Multiple epidemiologic studies have demonstrated that alcohol consumption likely increases the risk for atrial fibrillation and reduces the risk for myocardial infarction. However, the results have been conflicting, they generally all rely on self-report of alcohol consumption (which is known to be unreliable, particularly in those that drink more heavily), and there is almost certainly confounding related to an individual’s choice to consume alcohol (which in most settings is ubiquitously available). In addition, the relationship between alcohol and heart failure remains poorly understood, with evidence suggesting there may be both harmful and beneficial effects. Finally, the relationship between alcohol consumption and these various cardiovascular diseases (atrial fibrillation, myocardial infarction, and heart failure) have not been examined within the same cohort of individuals in a simultaneous fashion. (more…)
Author Interviews, Heart Disease, JACC, Surgical Research / 23.06.2016

MedicalResearch.com Interview with: Dr. Stefan Toggweiler, MD Heart Center, Luzerner Kantonsspital Lucerne, Switzerland MedicalResearch.com: What is the background for this study? Response: Transcatheter aortic valve replacement (TAVR) is increasingly used for the treatment of aortic stenosis in inoperable and high-risk patients. It is well known that TAVR is associated with acute and delayed occurrence of conduction disorders. Namely, delayed high-degree atrioventrcular block is a feared complication. Thus, patients are usually monitored by telemetry for a few days, but there is currently no consensus on the duration of telemetry. In this study, we evaluated how the postprocedural ECG determines the need for permanent pacemaker implantation in patients undergoing TAVR. (more…)
Author Interviews, Genetic Research, Heart Disease, NEJM / 23.06.2016

MedicalResearch.com Interview with: Professor Chris Semsarian MBBS PhD MPH FRACP FAHMS FAHA FHRS FCSANZ Professor of Medicine, University of Sydney Cardiologist, Royal Prince Alfred Hospital NHMRC Practitioner Fellow Head, Molecular Cardiology Program Centenary Institute, Newtown NSW Australia MedicalResearch.com: What is the background for this study? Response: Sudden cardiac death is a tragic and devastating event at all ages, and especially in the young (aged under 35 years). Understanding the causes and circumstances of SCD in the young is critical if we are to develop strategies to prevent SCD in the young. Our study represents the first prospective, population-based study of SCD in the young across two nations, Australia and New Zealand. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, JAMA, Pharmacology / 22.06.2016

MedicalResearch.com Interview with: Thomas Andrew Gaziano, MD, MSc Department of Cardiology Assistant Professor Harvard Medical School MedicalResearch.com: What is the background for this study? Response: Heart failure (HF) is the leading cause of admissions to hospitals in the United States and the associated costs run between $24-47 billion annually. Targeting neurohormonal pathways that aggravate the disease has the potential to reduce admissions. Enalapril, an angiotensin converting enzyme-inhibitor (ACEI), is more commonly prescribed to treat HF than Sacubitril/Valsartan, an angiotensin-receptor/neprilysin inhibitor (ARNI). The latter was shown to reduce cardiovascular death and hospitalizations due to heart failure in a multi-country, randomized clinical (PARADIGM-HF), compared to Enalapril. In order to assess the cost-effectiveness of Sacubitril/Valsartan, compared to Enalapril, in the United States, we created a model population with population characteristics equivalent to the population in the PARADIGM-HF trial. Using a 2-state Markov model we simulated HF death and hospitalizations for patients with a left ventricular ejection fraction (LVEF) of 40% or less. (more…)
Author Interviews, Heart Disease, JACC, UCSD / 22.06.2016

MedicalResearch.com Interview with: Jonathan Hsu, MD, MAS, FACC, FAHA, FHRS Assistant Professor Cardiac Electrophysiology, Division of Cardiology University of California, San Diego (UCSD) MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide and imparts significant stroke risk. In patients with AF determined to be at intermediate to high risk for thromboembolism, anticoagulation with warfarin (a vitamin K antagonist) or the newer non-vitamin K antagonist oral anticoagulants clearly reduces morbidity and mortality compared to aspirin. We sought to evaluate practice patterns of cardiovascular specialists in the United states to determine how often AF patients at risk for stroke are prescribed aspirin over oral anticoagulation, and predictors of this practice. (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, UCSF / 22.06.2016

MedicalResearch.com Interview with: Gregory M Marcus, MD, MAS, FACC, FAHA, FHRS Director of Clinical Research Division of Cardiology Endowed Professor of Atrial Fibrillation Research University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: We and others have previously demonstrated that, despite the observation that African Americans on average exhibit more risk factors for atrial fibrillation, they demonstrate a substantially reduced risk of the disease. This suggests that, if we could understand the mechanism underlying this apparent paradox, we might learn something fundamentally important to atrial fibrillation that would be relevant to treating or preventing the disease regardless of race. Building on our previous work demonstrating that, among African Americans, more European ancestry (determined by genomic testing) was a statistically significant predictor of atrial fibrillation, we sought to identify the gene(s) that might underlie this observation. The analysis took two forms. First, we examined if any differences among several well-established single nucleotide polymorphisms (SNP) associated with atrial fibrillation might mediate the race-atrial fibrillation relationship. One such SNP statistically mediated (rs10824026) up to about a third of the race-atrial fibrillation relationship. It’s important to mention that a causal relationship cannot be proven here. Perhaps more remarkable was the observation that the disease-associated alleles of the SNPs most closely associated with atrial fibrillation in multiple studies were actually significantly more common among African Americans, pointing to the complex nature of both the race-atrial fibrillation relationship as well as the genetics of atrial fibrillation. Finally, leveraging the ancestral relationships, we performed a genome wide admixture mapping study with the hope of reducing the penalty for multiple hypothesis testing incurred in conventional genome wide association studies. While several loci revealed associations with atrial fibrillation with small p values, none met our criteria for genome wide significance. (more…)
Author Interviews, Heart Disease, JAMA, Pharmacology, UCLA / 22.06.2016

MedicalResearch.com Interview with: Gregg C. Fonarow, MD, FACC, FAHA Eliot Corday Professor of Cardiovascular Medicine and Science Director, Ahmanson-UCLA Cardiomyopathy Center Co-Chief of Clinical Cardiology, UCLA Division of Cardiology Co-Director, UCLA Preventative Cardiology Program David Geffen School of Medicine at UCLA Los Angeles, CA, 90095-1679 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Fonarow: Angiotensin receptor neprilysin inhibitors (ARNI) have been demonstrated to reduce mortality in patients with heart failure with reduced ejection fraction. However, to date, the population level impact of optimal implementation of this therapy in the United States has not been evaluated. This new analysis estimates that as many 28,484 deaths in heart failure with reduced ejection fraction patients annually could be prevented or postponed with optimal use of angiotensin receptor neprilysin inhibitors (with sensitivity analyses demonstrating a range of 18,230 to 41,017). (more…)
Author Interviews, Heart Disease, Pediatrics, Weight Research / 22.06.2016

MedicalResearch.com Interview with: Annika Rosengren MD Department of Molecular and Clinical Medicine, Institute of Medicine Sahlgrenska Academy University of Gothenburg, Gothenburg, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: In an earlier study we found that while hospitalizations for heart failure decreased among people aged 55 and older in Sweden 1987-2006, there was a clear increase among those younger than 45 years, particularly in young men. We thought that increasing body weight in the population might be a factor behind this. We used anonymized data from more than 1.6 million Swedish men from the Swedish conscript registry aged on average 18 and followed them from adolescence onwards. Those who were overweight as teenagers were markedly more likely to develop heart failure in early middle age. The increased risk of heart failure was found already in men who were within the normal body weight range (a body mass index of 18.5 to 25) in adolescence, with an increased risk starting in those with a BMI of 20 and rising steeply to a nearly ten-fold increased risk in those who were very obese, with a BMI of 35 or over. Among men with a BMI of 20 and over, the risk of heart failure increased by 16% with every BMI unit, after adjustments for factors that could affect the findings, such as age, year of enlistment into the Swedish armed forces, other diseases, parental education, blood pressure, IQ, muscle strength and fitness. (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA, Personalized Medicine, UCSF / 21.06.2016

MedicalResearch.com Interview with: Peter Ganz, MD Chief, Division of Cardiology Director, Center of Excellence in Vascular Research Zuckerberg San Francisco General Hospital Maurice Eliaser Distinguished Professor of Medicine University of California, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ganz:  The research described in the JAMA paper involved measuring 1,130 different proteins in nearly 2000 individuals with apparently stable coronary heart disease, who were followed up to 11 years. Initially, two hundred different proteins were identified whose blood levels could be related to the risk of heart attacks, strokes, heart failure and death, and ultimately a combination of nine proteins was selected for a risk prediction model, based on their combined accuracy and sensitivity. Application of these findings to samples of patients with stable coronary heart disease demonstrated that some of those who were deemed clinically stable instead had a high risk of adverse cardiovascular outcomes, while other patients with the same clinical diagnosis had a very low risk. Thus, individuals who all carried the same clinical diagnosis of stable coronary heart disease had a risk of an adverse cardiovascular event that varied by as much as 10-fold, as revealed by analysis of the levels of the nine proteins in their blood. Given such large differences in risk and outcomes, patients could reasonably opt to be treated differently, depending on their level of risk. We hope that in the future, management of patients with stable angina will at least in part rely on risk assessment based on levels of blood proteins. (more…)
Author Interviews, Heart Disease, Nature, University Texas, Weight Research / 21.06.2016

MedicalResearch.com Interview with: Mikhail Kolonin, PhD, Associate Professor Director, Center for Metabolic and Degenerative Diseases Harry E. Bovay, Jr. Distinguished University Chair in Metabolic Disease Research The Brown Foundation Institute of Molecular Medicine University of Texas Health Science Center at Houston Houston, TX 77030 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Epidemiology studies have indicated that in obese patients progression of prostate, breast, colorectal, and other cancers is more aggressive. Adipose (fat) tissue, expanding and undergoing inflammation in obesity, directly fuels tumor growth. Adipose tissue is composed by adipocytes and stromal/vascular cells, which secrete tumor-trophic factors. Previous studies by our group have demonstrated that adipose stromal cells, which support blood vessels and serve as adipocyte progenitors, are recruited by tumors and contribute to cancer progression. Mechanisms underlying stromal cell trafficking from fat tissue to tumors have remained obscure. We discovered that in obesity a chemokine CXCL1, expressed by cancer cells, attracts adipose stromal cells to tumors. (more…)
Author Interviews, Heart Disease, Stem Cells / 21.06.2016

MedicalResearch.com Interview with: Fu Guosheng MD Professor and Chairman, Department of Cardiology Sir Run Run Shaw Hospital, College of Medicine Zhejiang University Hangzhou, China MedicalResearch.com: What is the background for this study? Response: Acute myocardial infarction (AMI) remains a major cause of long term morbidity and mortality worldwide. Although we can re-vascularize the occluded vessels by cardiac intervention or coronary artery bypass graft (CABG), it is not helpful for the damaged myocardium, which urges us to find a new therapeutic method. An increasing body of evidence from a wide range of experimental animal studies and clinical trials suggests that endothelial progenitor cell (EPC) transplantation can repair “broken” heart by involving direct angiogenesis and secreting protective paracrine factors, which has a bright prospect for clinical application. However, transplantation of autologous EPC has numerous limitations, including the limited supply of expanded EPC, the impaired function and activity of the transplanted cells, and so on. Therefore, it is desirable to develop novel proangiogenic strategies that improve the efficacy of EPC transplantation. (more…)
AHA Journals, Author Interviews, Heart Disease, Technology, Yale / 17.06.2016

MedicalResearch.com Interview with: Dr. James V. Freeman MD Assistant professor of cardiology and Assistant Clinical Professor of Nursing Internal Medicine Yale School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Freeman: Randomized trials of left atrial appendage (LAA) closure with the Watchman device have shown varying results, and its cost-effectiveness compared to anticoagulation has not been evaluated using all available contemporary trial data. We used a Markov decision model to estimate lifetime quality-adjusted survival, costs, and cost-effectiveness of LAA closure with Watchman, compared directly with warfarin and indirectly with dabigatran, using data from the long-term (mean 3.8 year) follow-up of PROTECT AF and PREVAIL randomized trials. Using data from PROTECT AF, the incremental cost-effectiveness ratios (ICER) compared to warfarin and dabigatran were $20,486 and $23,422 per quality adjusted life year (QALY), respectively. Using data from PREVAIL, LAA closure was dominated by warfarin and dabigatran, meaning that it was less effective (8.44, 8.54, and 8.59 QALYs, respectively) and more costly. (more…)
Author Interviews, Heart Disease, Outcomes & Safety / 17.06.2016

MedicalResearch.com Interview with: Sahil Agrawal MD, MD Heart and Vascular Center St. Luke’s University Health Network Bethlehem, PA 18015 MedicalResearch.com: What is the background for this study? Dr. Agrawal: Patients admitted on a weekend have previously been known to have poorer outcomes compared to patients admitted on weekdays for various acute illnesses. With the advent of early fibrinolytic therapy and subsequently, emergent primary percutaneous coronary interventions (PCI), such discrepancies in outcomes have been largely resolved for ST-segment elevation myocardial infarctions (STEMI). In contrast, treatment of non-ST segment elevation myocardial infarction (NSTEMI) has remained less stringent such that invasive coronary angiography and potential intervention is often delayed for those presenting on a weekend rather than a week day. According to current ACC/AHA guidelines for NSTEMI, an early invasive strategy (EIS) is the preferred method of management unless barred by presence of contraindications (comorbid conditions) or patients’ preference. We were interested in investigating differences in utilization of EIS between patients admitted on a weekend versus those admitted on a weekday for an NSTEMI, and to evaluate the impact of such differences on in-hospital mortality in such patients. (more…)
AHA Journals, Author Interviews, Columbia, Compliance, Heart Disease / 17.06.2016

MedicalResearch.com Interview with: Ian Kronish, MD, MPH Florence Irving Assistant Professor of Medicine Center for Behavioral Cardiovascular Health Columbia University Medical Center MedicalResearch.com: What is the background for this study? Dr. Kronish: Prior studies have shown that adherence to statins is suboptimal both in patients prescribed statins for primary prevention and in high-risk patients who are prescribed statins to prevent recurrent events. But, to our knowledge, prior studies had not examined the impact of a hospitalization for a myocardial infarction (MI) on subsequent adherence to statins. We wondered whether the hospitalization would serve as a wake-up call that led patients to become more adherent after the MI. At the same time, we were concerned that the physical and psychological distress that arises after a hospitalization for an MI may lead to a decline in statin adherence. (more…)
AHA Journals, Author Interviews, CT Scanning, Diabetes, Heart Disease / 17.06.2016

MedicalResearch.com Interview with: Prof. David A. Halon MB ChB, FACC, FESC Associate Professor of Clinical Medicine Technion, Israel Institute of Technology. Director, Interventional Cardiology Lady Davis Carmel Medical Center Haifa, Israel MedicalResearch.com: What is the background for this study? Prof. Halon: Type 2 diabetics are well known to have more cardiovascular events than non-diabetics but even among diabetics this risk is heterogeneous and some remain at very low risk. It remains uncertain if additional diagnostic modalities over and above clinical risk scores may be helpful in defining which diabetics are at high risk for an adverse event. We performed a study using cardiac CT angiography (CCTA) in 630 type 2 diabetics 55-74 years of age with no history of coronary artery disease to examine if CTA findings would have additional prognostic value over traditional risk scores for cardiovascular or microvascular based events over 7.5 years of follow-up. (more…)
Author Interviews, Heart Disease, Kidney Disease / 15.06.2016

MedicalResearch.com Interview with: Burns C. Blaxall, PhD, FAHA, FACC, FAPS Director of Translational Science, Heart Institute Co-Director, Heart Institute Research Core & Biorepository Professor, UC Department of Pediatrics MedicalResearch.com: What is the background for this study? Dr. Blaxall: The development of kidney disease subsequent to chronic heart failure is known clinically as cardiorenal syndrome 2, and is associated with dual organ failure and reduced survival. Furthermore, patients undergoing invasive cardiac procedures that require heart-lung bypass are at significant risk for developing kidney injury. According to the National Kidney Foundation, cardiorenal syndrome 2 presents a considerable economic burden of around $30 billion annually. Previous work has demonstrated the role of G protein-coupled receptor (GPCR) signaling and the activation of G protein βγ (Gβγ) subunits in the development and progression of heart failure, however little is known regarding the role of this signaling pathway in kidney disease. (more…)
Annals Internal Medicine, Author Interviews, Chemotherapy, Heart Disease, Karolinski Institute, Leukemia / 15.06.2016

MedicalResearch.com Interview with: Torsten Dahlén MD Centre for Hematology Karolinska University Hospital Solna Stockholm Sweden MedicalResearch.com: What is the background for this study?  Dr. Dahlén: Patients diagnosed with CML have had a dramatic increase in life-expectancy since the widespread introduction of tyrosine kinase inhibitors (TKI) in 2001. However, treatment is today regarded as life-long. We thus need to observe for late-effects of continuous TKI exposure. Recent reports have demonstrated a linkage between TKI treatment, especially more potent 2nd and 3rd generation drugs, and to the occurrence of peripheral arterial occlusive disease (PAOD). This study aimed to use real-world data utilizing Swedish population based registries together with the dedicated Swedish CML registry which contains data and follow-up on more than 98% of all CML patients diagnosed in Sweden since 2002. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JACC / 14.06.2016

MedicalResearch.com Interview with: Duk-Woo Park, MD, PhD Division of Cardiology, Asan Medical Center University of Ulsan College of Medicine and National Evidence-based Healthcare Collaborating Agency Seoul, Republic of Korea MedicalResearch.com: What is the background for this study? What are the main findings? Response: Currently, less restrictive blood pressure (BP) target by the 2014 hypertension guidelines (JNC-8) and more intensive BP target of the SPRINT is now conflicting, which causes uncertainty and confusion among clinicians. In our study, the proportion of persons who would meet the SPRINT BP goals is substantially less than those who would meet the 2014 guideline blood pressure goals. There is a positive association between the risk of major cardiovascular events and increasing levels of BP control status under different 2014 guideline and SPRINT criteria. Our study reconfirmed the findings of the SPRINT trials in real-world population. (more…)
Author Interviews, Environmental Risks, Heart Disease / 12.06.2016

MedicalResearch.com Interview with: Marko Mornar Jelavic, MD, PhD Department for Internal Medicine and Dialysis Health Center Zagreb Zagreb, Croatia MedicalResearch.com: What is the background for this study? Response: Zagreb is the capital and the largest city of the Republic of Croatia which is placed in South-Eastern Europe. The wider Zagreb metropolitan area has the total population of up to 1.2 million (20% of the total Croatia’s population). The climate of Zagreb is classified as a humid continental. The average daily mean temperature in winter is around +1 °C (from December to February) and the average temperature in summer is 22.0 °C. For the first time, we wanted to investigate whether particles of dimensions ≤10 micrometers (PM10) nitrogen dioxide (NO2) and ozone (O3), as well as certain meteorological conditions (air temperature, humidity and pressure) have any impact on appearance of myocardial infarction (MI) in the region with a humid continental climate. (more…)
Author Interviews, Diabetologia, Heart Disease, Johns Hopkins, Lifestyle & Health, Race/Ethnic Diversity / 10.06.2016

MedicalResearch.com Interview with: Joshua J. Joseph, MD Christopher D. Saudek M.D. Fellow in Diabetes Research Division of Endocrinology, Diabetes and Metabolism Johns Hopkins University School of Medicine MedicalResearch.com: What does your study explore? Response: Our study explores two basic questions: (a) Are multi-ethnic people with higher levels of cardiovascular health less likely to develop diabetes based on the AHA ideal cardiovascular health metric? (b) Do these associations vary by race/ethnicity (non-Hispanic white, Chinese American, African American, and Hispanic American)? MedicalResearch.com: Why did you choose this topic to explore? Response: The literature has shown a strong association between lifestyle factors and elevated risk of diabetes in majority non-Hispanic white studies. One study of American Indians showed that meeting a greater number of ideal cardiovascular health goals was associated with a reduced risk of diabetes. We aimed to assess the association of baseline ideal cardiovascular health with incident diabetes within a multi-ethnic population, due to variation of ideal cardiovascular health by race/ethnicity. (more…)
Author Interviews, Dermatology, Heart Disease / 09.06.2016

MedicalResearch.com Interview with: Alexander Egeberg, MD PhD Gentofte Hospital Department of Dermatology and Allergy Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Egeberg: While psoriasis has been associated with an increased risk of cardiovascular disease (CVD), studies have generally neglected to adjust for family history of CVD which is a well-established cardiovascular risk factor. In a population-based study of young patients with psoriasis, we found an increased risk of CVD only in patients with a positive family history of CVD but not in those patients that did not have a positive family history. (more…)
Author Interviews, Heart Disease, Lancet, Mediterranean Diet, Weight Research / 07.06.2016

MedicalResearch.com Interview with: Dr Ramon Estruch, MD PhD Senior Consultant in the Internal Medicine Department of the Hospital Clinic Barcelona MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Estruch: Although weight stability requires a balance between calories consumed and calories expended, it seems that calories from vegetable fats have different effects that calories from animals on adiposity. Thus, an increase of dietary fat intake (mainly extra virgin olive oil or nuts) achieved naturally in the setting of Mediterranean diet does not promote weight gain or increase in adiposity parameters such as waist circumference. (more…)
Annals Thoracic Surgery, Author Interviews, Heart Disease, Surgical Research / 07.06.2016

MedicalResearch.com Interview with: Giovanni Esposito MD, PhD Associate Professor of Cardiology Department of Advanced Biomedical Sciences Federico II University, Naples Napoli - Italy and Giuseppe Gargiulo, MD PhD Student Federico II University of Naples, Italy
MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Esposito: Aortic stenosis (AS) is the most frequent type of valvular heart disease in Europe and North America. As soon as symptoms occur, the prognosis of severe AS is poor, with majority of patients dying within 2 to 5 years. Unfortunately medical therapy of AS has no significant effects on patient survival, therefore the only treatment able to improve patient prognosis is valve replacement. Until 2002, the only treatment strategy was the surgical aortic valve replacement (SAVR). SAVR requires an open-heart procedure and cannot be offered to all patients with AS due to their advanced age and presence of comorbidities that make them inoperable or at high-risk for surgery. In the last decade, the less invasive percutaneous approach called transcatheter aortic valve implantation (TAVI) has demonstrated to be a valid alternative to SAVR for those patients deemed inoperable or at high risk for SAVR. After the first percutaneous intervention performed by Alain Cribier in 2002, TAVI has rapidly accumulated growing interest and enthusiasm that led to the first PARTNER trial guiding current guideline recommendations. Both American and European guidelines recommend to perform TAVI in all patients judged inoperable, and to consider TAVI as an alternative in high-risk patients, but with a Class IIb and a preference to SAVR. However, scientific evidence on TAVI exploded in the last few years, the guidelines cited are outdated (2014 and 2012 respectively), we have today 5 randomized trials and many other observational studies including patients with different pre-procedural risk (i.e lo-to-intermediate and high-risk), as well as long-term results of prior studies (i.e. 5-year follow-up of the PARTNER trial and 3-year of the US CoreValve trial), therefore we conducted a systematic review and meta-analysis comparing clinical outcomes, including short- and mid-term mortality, of adult patients with severe aortic stenosis undergoing either TAVI or SAVR with the aim to update this comparison and offer new perspectives. (more…)
Author Interviews, Baylor University Medical Center Dallas, Heart Disease, Surgical Research / 07.06.2016

MedicalResearch.com Interview with: Jeffrey M. Schussler, MD, FACC, FSCAI, FSCCT, FACP Baylor Scott & White Health Care System Cardiology: Baylor University Medical Center, Dallas, Tx Medical Director: CVICU Hamilton Heart and Vascular Hospital Professor of Medicine: Texas A&M School of Medicine MedicalResearch.com: What is the background for this study? Dr. Schussler: For the past few years, there has been an increased interest in performing coronary catheterization through the wrist. This is a technique that has been done (with great success and low complication rate) in other countries for years, with adoption rates >90% in some places. The US has been slower to adopt performing catheterization from the wrist, but the rate of using this approach has grown tremendously in the last 5 years. While less than 5% of all interventions were done using radial access previously, it now appraches 30% nationally. This increased rate of adoption been spurred on by studies which have shown lower incidences of complications, as well as some mortality benefit, and in particular in those patients who are highest risk for complications. (more…)