Author Interviews, Heart Disease, JAMA, OBGYNE, Pediatrics / 18.02.2021

MedicalResearch.com Interview with: Amanda Marma Perak, MD, MS Assistant Professor of Pediatrics (Cardiology) and Preventive Medicine (Epidemiology) Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois 60611  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The American Heart Association has formally defined cardiovascular health (CVH) based on the combination of 7 key health metrics: body mass index (weight versus height), blood pressure, cholesterol, glucose, diet, exercise, and smoking status. As we previously showed, the vast majority of pregnant women in the US have suboptimal CVH levels during pregnancy. We also showed that maternal CVH during pregnancy was associated with the risk for adverse newborn outcomes (such as high levels of body fat), but it was unknown what this might mean for longer-term offspring health. In the current study, the key finding was that mothers' CVH levels during pregnancy were associated with their offspring's CVH levels 10-14 years later, in early adolescence. For example, children born to mothers in the poorest category of CVH (representing 6% of mothers) had almost 8-times higher risk for the poorest CVH category in early adolescence, compared with children born to mothers who had ideal CVH in pregnancy. Even children born to mothers with any "intermediate" CVH metrics in pregnancy -- for example, being overweight but not obese -- had over 2-times higher risk for the poorest CVH category in early adolescence. (more…)
Author Interviews, Heart Disease, JACC / 05.02.2021

MedicalResearch.com Interview with: Paaladinesh Thavendiranathan MD, SM Ted Rogers Centre for Heart Research and the Division of Cardiology Peter Munk Cardiac Center, University Health Network, Joint Department of Medical Imaging, , University Health Networ Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? Response: Anthracyclines are a common class of chemotherapy drugs used to treat patients with blood, breast, and many other cancers. Patients receiving anthracycline based cancer therapy who are deemed to be high cardiovascular risk either based on their age or presence of cardiovascular risk factors are at risk of developing heart failure. In high risk patients this risk of heart failure could be between 5-10% over a 5 year period depending on the treatment regimens used. Therefore it is possible that the cancer patient of today can become a heart failure patient of tomorrow. These cancer treatments are however very effective against the cancer.  So it is important to find strategies to prevent the development of heart failure.  Usually oncologists and cardiologists work together to monitor patients during and after cancer therapy using surveillance strategies. One such strategy is to repeat heart ultrasounds to identify heart dysfunction early followed by initiation of cardioprotective therapy.  Traditional approaches measure left ventricular ejection (LVEF) as a metric of heart function.  However, we have learned that with this approach it may be too late when a change in LVEF is identified. Global longitudinal strain (GLS) is a newer echocardiography method that appears to identify heart dysfunction earlier before a major change in LVEF occurs. However, whether initiation of cardioprotective therapy when a change in GLS is identified can prevent a reduction in heart function and development of cardiotoxicity (significant change to heart function) is unknown. The SUCCOUR trial is an international, multicenter randomized controlled trial that compared using an LVEF based approach to surveillance (arm 1) versus the addition of GLS based surveillance (arm 2) in high risk patients receiving anthracycline based therapy. The study enrolled 153 patients in the LVEF arm and 154 patients in the GLS arm. Majority of the patients (~90%) had breast cancer.   (more…)
Author Interviews, Heart Disease / 05.02.2021

MedicalResearch.com Interview with: Sumeet S. Chugh MD Price Professor and Associate Director, Smidt Heart Institute Medical Director, Heart Rhythm Center Director, Center for Cardiac Arrest Prevention Director, Division of Artificial Intelligence in Medicine, Dept of Medicine Cedars-Sinai, Los Angeles MedicalResearch.com: What is the background for this study? Response: For a variety of reasons, sudden cardiac arrest during nighttime hours is the most perplexing and challenging form of this problem and needs to be investigated in detail. Patients are in a resting state, with decreased metabolism, heart rate, blood pressure, and in the absence of daytime triggers, presumably at the lowest likelihood of dying suddenly. The event can often go unrecognized, even by others sleeping in close proximity. Finally, survival from cardiac arrest at night is significantly lower compared to the daytime. There are no community-based studies out there. Small studies of rare heart disease conditions report that men are more likely to suffer this affliction but the reality is that there were not enough women in those studies to do justice to sex-specific analyses. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Nature / 04.02.2021

MedicalResearch.com Interview with: Dr. Hugo Aerts, PhD Dana-Farber Cancer Institute Associate Professor, Brigham and Women's Hospital Harvard Medical School Director, Program for Artificial Intelligence in Medicine Brigham And Women's Hospital  MedicalResearch.com: Deep convolutional neural networks to predict cardiovascular risk from computed tomography  Response: Cardiovascular disease is the most common preventable cause of death in Europe and the United States. Effective lifestyle and pharmacological prevention is available, but identifying those who would benefit most remains an ongoing challenge. Hence, efforts are needed to further improve cardiovascular risk prediction and stratification on an individual basis. One of the strongest known predictors for adverse cardiovascular events is coronary artery calcification, which can be quantified on computed tomography (CT). The CT coronary calcium score is a measure of the burden of coronary atherosclerosis and is one of the most widely accepted measures of cardiovascular risk. Recent strides in artificial intelligence, deep learning in particular, have shown its viability in several medical applications such as medical diagnostic and imaging, risk management, or virtual assistants. A major advantage is that deep learning can automate complex assessments that previously could only be done by radiologists, but now is feasible at scale with a higher speed and lower cost. This makes deep learning a promising technology for automating cardiovascular event prediction from imaging. However, before clinical introduction can be considered, generalizability of these systems needs to be demonstrated as they need to be able to predict cardiovascular events of asymptomatic and symptomatic individuals across multiple clinical scenarios, and work robustly on data from multiple institutions. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA, Social Issues, University of Pennsylvania / 02.02.2021

MedicalResearch.com Interview with: Sameed Khatana MD, MPH Instructor, Cardiovascular Medicine Perelman School of Medicine, University of Pennsylvania Physician, Philadelphia VA Medical Center  MedicalResearch.com: What is the background for this study? Response: After declining for decades, the fall in cardiovascular mortality rates in the US has started to slow down and rates may be rising in certain groups. This stagnation in mortality has been most start among middle-aged adults. These trends have occurred at the same time as growing economic inequality. Our analysis aimed to study the relationship between change in cardiovascular mortality rates between 2010 and 2017 for middle-aged adults across the US and change in economic prosperity levels. (more…)
Author Interviews, Cost of Health Care, CT Scanning, Heart Disease, JACC, Statins / 14.01.2021

MedicalResearch.com Interview with: Prasanna Venkataraman MBBS Thomas H. Marwick MBBS, PhD Baker Heart and Diabetes Research Institute Monash University, Melbourne Melbourne, Australia   MedicalResearch.com: What is the background for this study?
  • Coronary artery calcium score (CAC) quantifies coronary calcium as determined by computed tomography and is a good surrogate marker for overall coronary plaque burden. It can help to reclassify patients at intermediate risk – many of whom are actually at low risk and can be reassured. Conversely, the finding of coronary calcium can also motivate patients (and their clinicians) to more aggressively control their cardiovascular risk factors. This is particularly problematic in those with a family history of premature coronary artery disease, where standard risk prediction tools are less accurate. However, CT CAC does not routinely attract third party payer support limiting its access and utilisation.
  • We screened 1084 participants who have a family history of premature coronary disease and a 10-year Pooled cohort Equation (PCE) cardiovascular risk >2% with CAC. We then assessed the cost-effectiveness of commencing statins in those with any coronary calcium compared to a strategy of no CAC testing and commencing statins if their PCE risk was ≥7.5% consistent with current guidelines. 
(more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Heart Disease, JACC / 11.01.2021

MedicalResearch.com Interview with: Rishi K. Wadhera, MD, MPP, MPhil Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center Associate Program Director, Cardiovascular Medicine Fellowship Assistant Professor of Medicine, Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: The direct toll of the novel coronavirus disease 2019 (COVID-19) in the U.S. has been substantial, but concerns have also arisen about the indirect effects of the pandemic on higher-risk patients with chronic medical conditions, such as cardiovascular disease. Hospitalizations for acute cardiovascular conditions, including myocardial infarction, heart failure, and stroke precipitously declined during the early phase of the pandemic. These patterns have raised concern that patients may be avoiding hospitals due to fear of contracting SARS-CoV-2, and that some have died from cardiovascular conditions without seeking medical care. In addition, there has been growing concern about the the effects of health-care system strain and the deferral of semi-elective procedures on patients with cardiovascular conditions. (more…)
Author Interviews, Clots - Coagulation, COVID -19 Coronavirus, Heart Disease, JAMA / 30.12.2020

MedicalResearch.com Interview with: Ana Blasco, MD, PhD Cardiology Department, Hospital Universitario Puerta de Hierro–Majadahonda Madrid, Spain MedicalResearch.com: What is the background for this study? Response: Our group has been investigating issues related to coronary thrombosis in patients with acute myocardial infarction for years. Recently, we developed a standardized technique for the detection and quantification of extracellular neutrophil networks (NETs) in coronary thrombi. During the first wave of the COVID-19 pandemic in Madrid, Spain, we had some cases of myocardial infarctions with ST elevation and a large thrombotic component among patients with severe SARS-CoV-2 infection. Given the important participation of NETs in severe COVID-19 disease, causing occlusion of microvessels as shown in pulmonary samples, we decided to analyze their role in coronary thrombi. Thanks to similar previous analyzes in patients without COVID-19, we have been able to compare our results with a historical series. (more…)
Abuse and Neglect, Author Interviews, COVID -19 Coronavirus, Emergency Care, Heart Disease / 21.12.2020

MedicalResearch.com Interview with: Michalis Katsoulis PhD Immediate PostDoctoral BHF fellow Institute of Health Informatics Senior Research Fellow, UCL MedicalResearch.com: What is the background for this study? Response: In the early stage of the pandemic, we observed a decline in patient visits to Emergency Departments (ED), including those for cardiac diseases. This decline may have been due to fear of coronavirus infection when attending hospital, public reluctance to overload National Health Service facilities, or difficulty accessing care. In our study, we tried to estimate the impact of reduced ED visits on cardiac mortality in England. We used data from ED visits from the Public Health England Emergency Department Syndromic Surveillance System (EDSSS). For cardiovascular disease outcomes, we obtained mortality counts for cardiac disease from the Office of National Statistics (ONS) for England. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 21.12.2020

MedicalResearch.com Interview with: Chris Clark, PhD Clinical Senior Lecturer in General Practice Primary Care Research Group St Luke's Campus, Exeter MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Various individual studies have suggested that a blood pressure difference between arms is associated with increased mortality and cardiovascular events since we first reported this association in 2002. Such studies have been limited, due to smaller numbers of participants, in the conclusions that could be drawn. Therefore we sought to pool data from as many cohorts as possible to study this association in more detail.  MedicalResearch.com: What are the main findings? Should it be standard practice to measure blood pressure in both arms? Response: Systolic inter-arm difference was associated with increased all-cause and cardiovascular mortality. We found that all-cause mortality increased with inter-arm difference magnitude from a ≥5 mmHg threshold. Systolic inter-arm difference was also associated with cardiovascular events in people without pre-existing disease. This remained significant after adjustment for various internationally used cardiovascular risk scores, namely ASCVD, Framingham or QRISK2. Essentially we found that each increase of 1mmHg in inter-arm difference equated to a 1% increase for a given cardiovascular risk score. When undertaking a cardiovascular assessment, or determining which arm should be used for blood pressure measurement, it is recommended to measure both arms. (more…)
Author Interviews, Heart Disease, JAMA, Lifestyle & Health, USPSTF / 03.12.2020

MedicalResearch.com Interview with: Dr. John Epling, M.D., M.S.Ed Professor of family and community medicine Virginia Tech Carilion School of Medicine in Roanoke, VA. Medical director of research for family and community medicine Medical director of employee health and wellness for the Carilion Clinic Dr. Epling joined the U.S. Preventive Services Task Force in January 2016. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cardiovascular disease, which includes heart disease and stroke, is one of the leading causes of death in the United States. Nearly half of all adults have at least one risk factor for cardiovascular disease. Evidence shows that counseling aimed at helping people improve their diet and increase their physical activity can help prevent cardiovascular disease. This typically involves a trained counselor who provides education, helps people set goals, shares strategies, and stays in regular contact.  The Task Force recommends behavioral counseling interventions that promote a healthy diet and physical activity to help people at risk for cardiovascular disease stay healthy. (more…)
AHA Journals, Author Interviews, Heart Disease, Women's Heart Health / 30.11.2020

MedicalResearch.com Interview with: Justin A. Ezekowitz, MBBCh, MSc Professor, Department of Medicine Co-Director, Canadian VIGOUR Centre Director, Cardiovascular Research, University of Alberta Cardiologist, Mazankowski Alberta Heart Institute MedicalResearch.com: What is the background for this study? What are the main findings? Are women older, sicker when they experience heart disease? Response: Previous research looking at sex-differences in heart health has often focused on recurrent heart attack or death, however, the vulnerability to heart failure between men and women after heart attack remains unclear. Our study includes all patients from an entire health system of over 4 million people and includes information not usually available in other analyses. Women were nearly a decade older and more often had a greater number of other medical conditions when they presented to hospital for their first heart attack, and were at greater risk for heart failure after the more severe type of heart attack (also known as a ST-elevation MI). This gap between men and women has started to narrow over time. (more…)
Author Interviews, Heart Disease, JAMA, Pediatrics, Surgical Research / 25.11.2020

MedicalResearch.com Interview with: Michael R. Flaherty, DO Attending, Pediatric Critical Care Medicine Co-Director, Trauma and Injury Prevention Outreach Program, MGH Instructor in Pediatrics, Harvard Medical School Boston, MA 02114 MedicalResearch.com: What is the background for this study? What are the main findings?   Response: This study was a joint collaboration between Massachusetts General Hospital and Boston Children’s Hospital. The Consumer Product Safety Commission (CPSC) found an increasing incidence of rare earth magnet ingestions by children causing serious injury; Injuries are particularly serious when a child ingests two of these small magnets, or a magnet with another metal object – this can lead to bowel walls becoming attached and kinked, leading to catastrophic bowel injury and/or death. The Consumer Product Safety Commission initiated campaigns to limit sales in 2012 with voluntary recalls and safety standards, as well as public awareness campaigns, legislative advocacy, and lawsuits. In October 2014, the CPSC published their final rule, “Safety Standard for Magnet Sets,” which prohibited the sale of magnets based on a pre-specified size and power scale, essentially eliminating the ability to sell SREMs. This rule was appealed by largest manufacturer of these magnets, Zen Magnets, LLC., and in November 2016 this rule was legally reversed by the U.S. Court of Appeals Tenth Circuit resulting in a resurgence of these magnets on the market. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, Pediatrics, USPSTF / 19.11.2020

MedicalResearch.com Interview with: Martha Kubik, Ph.D., R.N. Professor and director of the School of Nursing College of Health and Human Services at George Mason University USPSTF Task Force Member MedicalResearch.com: What is the background for this study? What are the main findings? Has the recommendation changed over the last decade? Response: High blood pressure is becoming more common among children and teens in the United States and can have serious negative health effects in childhood and adulthood, such as kidney and heart disease. However, there is not enough research to know whether treating high blood pressure in young people improves cardiovascular health in adulthood. The Task Force continued to find that there is not enough evidence to recommend for or against screening for high blood pressure in children and teens who do not have signs or symptoms. (more…)
AHA Journals, Author Interviews, Heart Disease, University of Michigan / 17.11.2020

MedicalResearch.com Interview with: Sara Saberi, MD, MS Assistant Professor Inherited Cardiomyopathy Program Frankel Cardiovascular Center University of Michigan Hospital Michigan Medicine MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by HCM? How common is it and whom does it affect? Response: HCM is short for hypertrophic cardiomyopathy, the most common genetic myocardial disorder. It occurs in 1:500 people worldwide and because it is inherited in an autosomal dominant fashion, it affects men and women equally. HCM is characterized by unexplained left ventricular (LV) hypertrophy, hypercontractility, myofibrillar disarray and myocardial fibrosis with associated abnormalities in LV compliance and diastolic function. In some patients, there is progressive adverse cardiac remodeling, associated with chronic heart failure and atrial fibrillation as a result of diastolic dysfunction, left ventricular outflow tract (LVOT) obstruction, or less commonly, LV systolic dysfunction. Current medical management of obstructive HCM (oHCM) is limited to the use of beta blockers and non-dihydropyridine calcium channel blockers, or disopyramide, none of which have been shown to modify disease expression or outcomes after onset. Mavacamten is a first-in-class, small molecule, selective inhibitor of cardiac myosin specifically developed to target the underlying pathophysiology of HCM by reducing actin–myosin cross-bridge formation. The phase 3 EXPLORER-HCM trial showed that mavacamten improved exercise capacity, LVOT gradients, symptoms, and health status compared with placebo in patients with symptomatic oHCM. At selected study sites, participants were enrolled in a cardiac magnetic resonance (CMR) imaging substudy. CMR is the gold standard for measurement of ventricular mass, volumes and noninvasive tissue characterization, making it an ideal imaging modality to assess the effect of mavacamten on cardiac structure and function in patients with HCM. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease / 17.11.2020

MedicalResearch.com Interview with: Benjamin D. Horne, PhD Cardiovascular and Genetic Epidemiologist Intermoumtain Health MedicalResearch.com: What is the background for this study? Response: The Intermountain Mortality Risk Score (IMRS) is a risk prediction tool developed in 2009 and repeatedly validated over the last decade to predict death, major adverse health events such as heart attack and stroke, and the onset of major chronic diseases. IMRS is computed using sex-specific weightings of parameters from the complete blood count (CBC) and basic metabolic profile (BMP), and age. The CBC and BMP are commonly-ordered clinical laboratory panels that include hemoglobin, white blood cell count, glucose, creatinine, sodium, calcium, and other factors whose testing is standardized and the results are objective and quantitative with no need to know what diagnoses a patient may have. IMRS is known to be a superior predictor of death compared to comorbidity-based risk scores and has been found to predict health outcomes in people with no chronic disease diagnoses as well as patients with coronary heart disease, atrial fibrillation, heart failure, chronic obstructive pulmonary disease, chronic kidney disease, and various other diagnoses. IMRS has not been evaluated as a predictor of health outcomes for people with COVID-19, but if it does it could be useful for people to use to evaluate their own risk of poor outcomes if they are infected with SARS-CoV-2, for clinical personnel to guide the care of patients with COVID-19, and for public health professionals to use to determine who among those never diagnosed with COVID-19 is at higher risk of poor health outcomes and should be the first to receive a COVID-19 immunization.  (more…)
Author Interviews, Heart Disease, JACC / 17.11.2020

MedicalResearch.com Interview with: Simon Winther, MD, PhD Associate professor Department of Cardiology, Gødstrup Hospital Herning, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Both European and American guidelines have traditionally recommended estimating the pre-test probability (PTP) of CAD based on the classic Diamond-Forrester approach using sex, age, and type of chest complaints. However, The European Society of Cardiology (ESC) has recently suggested a novel concept of Clinical Likelihood of CAD as a more comprehensive assessment of CAD probability but no strategy has been proposed. I this study, we improve the estimation of the likelihood of obstructive coronary artery disease (CAD) by combining the classic pre-test probability model (Diamond–Forrester approach using sex, age, and symptoms) with clinical risk factors and coronary artery calcium score in symptomatic patients with suspected CAD. Hence, we propose a simple clinical tool for the individual estimation of clinical likelihood of CAD. The tool was developed by stepwise simplification of advanced machine learning models without significant loss of accuracy and the model were validated the both European and North American cohorts.  (more…)
Aging, Author Interviews, Geriatrics, Heart Disease, Lancet, Lipids / 11.11.2020

MedicalResearch.com Interview with: Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry Herlev and Gentofte Hospital Copenhagen University Hospital Herlev, Denmark  MedicalResearch.com: What is the background for this study? Response: Previous studies have yielded mixed results regarding the association between elevated cholesterol levels and increased risk of atherosclerotic cardiovascular disease in individuals above age 70 years; with some studies showing no association and others only minimal association. However, these previous studies were based on cohorts recruiting individuals decades ago where life-expectancy were shorter and where treatment of comorbidities were very different from today (more…)
AHA Journals, Author Interviews, Heart Disease, Surgical Research / 30.10.2020

MedicalResearch.com Interview with: Stavros G. Drakos, MD, PhD, FACC Professor of Cardiology Univ. of Utah Healthcare & Medical School and the Salt Lake VA Medical Center. Dr. Drakos is Medical Director of the University's Cardiac Mechanical Support/Artificial Heart Program Co-Director Heart Failure & Transplant and Director of Research for the Division of Cardiology MedicalResearch.com: What is the background for this study? Response: Heart transplantation and LVADs are first line therapies for advanced chronic heart failure. There were some earlier anecdotal observations and single center small studies from several programs in the US and overseas that left ventricular assist devices (LVADs) significantly reduce the strain on failing hearts and in some cases, using LVADs for limited periods of time has allowed hearts to “rest” and remodel their damaged structures. As a result of these repairs, described as “reverse remodeling,” heart function can improve to the point that the LVAD can be removed. The new study sought to broaden the reach of the research with a multicenter trial involving physicians and scientists at the University of Utah Health, the University of Louisville, University of Pennsylvania, the Albert Einstein College of Medicine/Montefiore Medical Center, the Cleveland Clinic, and the University of Nebraska Medical Center.  (more…)
Author Interviews, Heart Disease, JACC, Omega-3 Fatty Acids / 27.10.2020

MedicalResearch.com Interview with: Antoni Bayes-Genis, MD, PhD, FESC, FHFA Head, Heart Institute. Hospital Universitari Germans Trias i Pujol Full Professor, Autonomous University Barcelona MedicalResearch.com: What is the background for this study? What are the main findings? Response: Omega-3 fatty acids are incorporated into the phospholipids of cellular membranes, including cardiac contractile cells, and have a wide range of demonstrated physiological effects. Several potential mechanisms have been investigated, including antiarrhythmic, anti-inflammatory, and endothelial. Omega-3 fatty acids lower heart rate and improve heart rate variability, both associated with lower sudden cardiac death risk, one of the complications that may occur after a myocardial infarction. Increased omega-3 fatty acids also enhance arterial elasticity by increasing endothelium-derived vasodilators, which is associated with blood pressure–lowering effects. They also have a cardioprotective effect on platelet-monocyte aggregation, and lower triglyceride levels. (more…)
Author Interviews, Cognitive Issues, Emory, Exercise - Fitness, Heart Disease / 27.10.2020

MedicalResearch.com Interview with: Henry Mahncke, PhD Chief Executive Officer Posit Science https://www.brainhq.com/?v4=true&fr=yDr. Mahncke earned his PhD at UCSF in the lab where lifelong brain plasticity was discovered. At the request of his academic mentor, he currently leads a global team of more than 400 brain scientists engaged in designing, testing, refining, and validating the computerized brain exercises found in the BrainHQ app from Posit Science, where he serves as CEO. MedicalResearch.com Tell us what’s important about this new study in people with heart failure? Response: Heart failure is a common condition that even when properly treated can have adverse long-term health outcomes and high medical costs. Heart failure commonly causes cognitive impairment, which can have devastating effect on patient abilities to engage in self-care, and which contributes to poor clinical outcomes, increased rehospitalizations, and higher mortality rates. What makes these results exciting is that the Emory University researchers discovered that a simple intervention – a fairly modest amount of walking and brain exercise – not only significantly improved a standard measure of cognition, but also significantly improved multiple measures that drive better health outcomes and lower costs. MedicalResearch.com: What is heart failure? Response: Heart failure – sometimes called congestive heart failure or congestive cardiac failure – is when the heart cannot pump sufficient blood flow to maintain the body’s needs. Common symptoms include excessive tiredness, shortness of breath and swelling particularly in legs. It’s treated with a combination of lifestyle changes, drugs, and devices. An estimated 6.5 million Americans are diagnosed with heart failure, with 960,000 new cases each year, leading some to describe it as reaching epidemic proportions. In older adults, it’s the most common cause of hospital readmissions within 30 days of discharge and among the most costly areas of Medicare expenditures. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lifestyle & Health, Nutrition / 26.10.2020

MedicalResearch.com Interview with: Samia Mora, MD MHS Associate Professor, Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA 02215 @SamiaMoraMD MedicalResearch.com: What is the background for this study? Response: Couples, both married couples and domestic partners, are likely to share similar environmental exposures, adopt similar behavior patterns, and have similar characteristics. However, the degree to which couples share similar levels of cardiovascular (CV) risk factors and behaviors is uncertain. If high levels of poor CV risk factor measures and behaviors are common in both members of a couple, programs that target improvement of these risk factors and behaviors may simultaneously benefit CV health in both members of the couple. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, Vaccine Studies / 20.10.2020

MedicalResearch.com Interview with: Douglas L. Kriner, PhD The Clinton Rossiter Professor in American Institutions Department of Government Cornell University MedicalResearch.com: What is the background for this study? Response: When a safe and effective vaccine for COVID-19 reaches the market, the world will not change overnight.  Rather, government and public health individuals will have to develop a comprehensive plan to distribute the vaccine and to convince potentially wary Americans to take it. Our study examined the influence of both specific vaccine characteristics and the politics surrounding it on public willingness to vaccinate.  Both matter in important ways.  For example, efficacy is unsurprisingly a major driver of public opinion; Americans are more willing to take a vaccine that is more efficacious. (more…)
Author Interviews, Baylor College of Medicine Houston, Heart Disease, Social Issues, Tobacco Research / 19.10.2020

MedicalResearch.com Interview with: Mahmoud Al Rifai MD MPH Section of Cardiology, Department of Medicine Baylor College of Medicine Houston Salim S. Virani, MD, PhD Section of Cardiology Michael E. DeBakey Veterans Affairs Medical Center Section of Cardiology, Department of Medicine Baylor College of Medicine Houston    MedicalResearch.com: What is the background for this study? Response: E-cigarettes typically cost more than combustible cigarettes and there is more variability in cost due to a wide variety of flavors, e-cigarette liquid, and vaping device that are available in the market. Therefore, use of e-cigarettes may vary depending on income with potentially higher use among higher income individuals. (more…)
Author Interviews, Cost of Health Care, Emory, Heart Disease, JAMA, Surgical Research / 21.09.2020

MedicalResearch.com Interview with: David H. Howard, PhD Professor, Health Policy and Management Rollins School of Public Health Emory University, Atlanta, Georgia MedicalResearch.com: What is the background for this study? Response: Application of the False Claims Act (FCA) to medically unnecessary care is controversial, both in the courts and in the Department of Justice. Although there haven’t been many FCA suits against hospitals and physicians for performing unnecessary percutaneous coronary interventions (PCIs), the suits that have occurred have been against some of the highest-volume hospitals and physicians. Some cardiologists have been sentenced to prison. (more…)
Author Interviews, Heart Disease, Lipids, PAD, Women's Heart Health / 27.08.2020

MedicalResearch.com Interview with: First Author: Dhruv Mahtta, DO, MBA Cardiovascular Disease Fellow Baylor College of Medicine Houston, TX Senior & Corresponding Author Dr. Virani Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center, Houston, TX Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Houston, TX @virani_md MedicalResearch.com: What is the background for this study? What are the main findings? What do you think accounts for the gender differences? Response: We know that women with ischemic heart disease (IHD) have lower prescription rates for statin and high-intensity statin therapy. In this study, we assessed whether the same trends hold true for women with other forms of atherosclerotic cardiovascular disease (ASCVD) i.e. women with peripheral artery disease (PAD) or ischemic cerebrovascular disease (ICVD). Maximally tolerated statin therapy is a Class-I indication in patients with clinical ASCVD which includes PAD and ICVD. We also assessed statin adherence among men and women with PAD and ICVD. Lastly, we performed exploratory analyses to assess whether statin therapy, statin intensity, and statin adherence in women with PAD and ICVD were associated with cardiovascular outcomes and/or mortality.  (more…)
Author Interviews, CDC, COVID -19 Coronavirus, Heart Disease / 25.08.2020

MedicalResearch.com Interview with: Eric J. Chow, MD, MS, MPH Epidemic Intelligence Service Officer (completed in 2020); Influenza Division. Centers for Disease Control and Prevention  MedicalResearch.com: What is the background for this study? What are the main findings?
  • Both heart disease and influenza epidemics cause substantial morbidity and mortality every year. In some seasons, influenza virus infections alone contribute up to 810,000 hospitalizations and 61,000 deaths. There is increasing evidence that there is overlap between infections, specifically influenza, and heart disease. In our study, we sought to describe the frequency and risk factors for acute cardiac events in patients who are hospitalized with influenza.
  • In over 80,000 adults hospitalized with influenza over 8 seasons (2010-2018), almost 12% were diagnosed with acute cardiac events, with acute heart failure and acute ischemic heart disease being the most common.
  • Among patients hospitalized with influenza who experienced acute cardiac events, almost one-third were admitted to the intensive care unit and 7% died while hospitalized.
  • Our study also reaffirmed that people who are older, smoke tobacco or have underlying cardiovascular disease, diabetes and kidney disease are at increased risk for the most common acute cardiac events, acute heart failure and acute ischemic heart disease.
  • Although vaccinated persons had a lower risk of acute ischemic heart disease and acute heart failure, this study was not designed to specifically assess vaccine effectiveness.  However, this and other studies support the importance of influenza vaccines for people with underlying heart conditions. 
(more…)
Author Interviews, Heart Disease, JAMA, Lipids / 21.08.2020

MedicalResearch.com Interview with: First Author Dhruv Mahtta, DO, MBA Cardiovascular Disease Fellow Baylor College of Medicine Houston, TX Senior & Corresponding Author Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development Michael E. DeBakey VA Medical Center, Houston, TX MedicalResearch.com: What is the background for this study? Response: The incidence of atherosclerotic cardiovascular disease among young patients has been on the rise. These patients with premature and extremely premature atherosclerotic cardiovascular disease experience similar rates of mortality compared to older adults. Additionally, these young patients have a greater accrued rate of life-time morbidity. Therefore, secondary prevention measures such as use of guideline concordant statin therapy and aspirin therapy are paramount in this population.  (more…)
Author Interviews, Heart Disease, JAMA, Lipids, Metabolic Syndrome, UCSF / 12.08.2020

MedicalResearch.com Interview with: Prakash Deedwania, MD, FACC,FAHA,FASH,FHFSA,FESC Professor of Medicine, UCSF School of Medicine, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: This paper describes the findings form the FOURIER study, a very large study evaluating the efficacy of evolocumab, a PCSK9 inhibitor in patients with metabolic syndrome and preexisting atherosclerotic cardiovascular disease (ASCVD) who were already being treated with statins. In this largest study of its kind of 27,000 patients we found that 60% of patients with ASCVD had metabolic syndrome. We also found that the presence of metabolic syndrome identified a higher risk of future cardiac & coronary events in these patients despite them receiving maximum tolerated doses of statin. Furthermore, study treatment with evolocumab was efficacious in reducing the increased risk during the median follow up of nearly 3 years . Unlike treatment with statins there was no risk of new-onset diabetes with evolocumab, which was generally well tolerated. What was interesting thatpatients without metabolic syndrome had much less benefit with PCSK9 inhibition. These findings suggest that the presence of metabolic syndrome can help the clinicians identify the ASCVD patients who are most likely to benefit from treatment with PCSK9 inhibitors. This will be of great help for the cost containment of therapeutic strategy as PCSK9 inhibitors as a class are still quite expensive drugs. (more…)