Author Interviews, Heart Disease, Lipids / 02.04.2020

MedicalResearch.com Interview with: Nathan D. Wong, PhD, FACC, FAHA, FNLA Professor and Director Heart Disease Prevention Program Division of Cardiology, University of California, Irvine MedicalResearch.com: What is the background for this study? Response: Many higher risk persons, despite guideline-recommended therapy such as statins, still suffer from cardiovascular disease events. There are few therapies available to reduce this persistent risk. The REDUCE-IT trial led by Brigham and Women’s Hospital in Boston researchers originally published in November of 2018 was landmark in showing for the first time a highly purified, stable, prescription fish oil product, icosapent ethyl (an EPA only compound marketed as Vascepa®) if given to high risk persons with either cardiovascular disease or diabetes and two or more risk factors who were on statin therapy and had elevated triglyceride levels, achieved an unprecedented 25 percent reduction in the risk of time to first cardiovascular disease events. Given that many persons often experience multiple cardiovascular events, a follow-up analysis showed that TOTAL cardiovascular events were reduced by 30 percent.  (more…)
Author Interviews, Heart Disease, Lipids / 01.04.2020

MedicalResearch.com Interview with: Professor F. J. Raal, FRCP, FCP(SA), Cert Endo, MMED, PhD Director, Carbohydrate & Lipid Metabolism Research Unit Professor & Head, Division of Endocrinology & Metabolism, Faculty of Health Sciences, University of the Witwatersrand MedicalResearch.com: What is the background for this study? How does Evinacumab differ from the three drugs used in triple therapy for this severe form of hypercholesterolemia? Response:      Despite available lipid lowering therapies, the vast majority of patients with homozygous familial hypercholesterolemia are unable to achieve desirable LDL-cholesterol levels and remain at high risk for premature atherosclerotic cardiovascular disease. Unlike statins and PCSK9-inhibitors which act mainly by upregulating LDL receptor activity on the cell surface, evinacumab, a monoclonal antibody inhibitor of ANGPTL3, acts independent of the LDL receptor. (more…)
AstraZeneca, Author Interviews, Diabetes, Heart Disease, JAMA / 01.04.2020

MedicalResearch.com Interview with: John J. V. McMurray,  MD FRCP FESC FACC FAHA FRSE FMedSci British Heart Foundation Cardiovascular Research Centre University of Glasgow Glasgow, United Kingdom  Kieran F Docherty DAPA-HF investigator British Heart Foundation Cardiovascular Research Centre, University of Glasgow     MedicalResearch.com: What is the background for this study? Response: DAPA-HF was a double-blind randomized controlled trial comparing dapagliflozin 10 mg once daily with placebo in 4744 patients with heart failure and reduced ejection fraction (HFrEF). The primary outcome was a composite of time to occurrence of a worsening heart failure event (principally heart failure hospitalization) or cardiovascular death, whichever came first. Dapagliflozin reduced the primary outcome by 26% and reduced the risk of each of heart failure hospitalization and cardiovascular death individually, as well as overall mortality. Patient symptoms were also improved. The aim of the present report was to examine the effect of dapagliflozin separately in patients with and without type 2 diabetes at baseline (45/55% split in the trial). The reason for this was that dapagliflozin was originally introduced as a glucose-lowering medication for the treatment of type 2 diabetes. We find that dapagliflozin was equally beneficial in patients with and without diabetes and was as well tolerated in patients without diabetes as in those with diabetes. More remarkably, among the patients without diabetes, dapagliflozin was as effective in participants with a completely normal glycated haemoglobin (HbA1c) as in those with prediabetes. In patients with a normal HbA1c, dapagliflozin did not lead to any reduction in HbA1c, but did improve clinical outcomes.  (more…)
Author Interviews, Heart Disease, NEJM, Stanford / 31.03.2020

MedicalResearch.com Interview with: David J. Maron, MD, FACC, FAHA Clinical Professor of Medicine Chief, Stanford Prevention Research Center Director, Preventive Cardiology Stanford University School of Medicine  MedicalResearch.com: What is the background for this study? Response: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. The goals of treating patients with stable coronary disease are to reduce their risk of death and ischemic events and to improve their quality of life. All patients with coronary disease should be treated with guideline-based medical therapy (GBMT) to achieve these objectives. Before the widespread availability of drug-eluting stents, strategy trials that tested the incremental effect of revascularization added to medical therapy did not show a reduction in the incidence of death or myocardial infarction. In one trial, fractional flow reserve–guided percutaneous coronary intervention (PCI) with drug-eluting stents, added to medical therapy, decreased the incidence of urgent revascularization but not the incidence of death from any cause or myocardial infarction at a mean of 7 months, whereas the 5-year follow-up showed marginal evidence of a decrease in the incidence of myocardial infarction. (more…)
Author Interviews, Gender Differences, Heart Disease, Karolinski Institute, Opiods, PNAS / 18.03.2020

MedicalResearch.com Interview with: Mikko Myrskylä PhD Executive Director, Max Planck Institute for Demographic Research Professorial Research Fellow, London School of Economics Professor of Social Statistics University of Helsinki MedicalResearch.com: What is the background for this study? Response: Life expectancy in the U.S. increased at a phenomenal pace throughout the twentieth century, by nearly two years per decade. After 2010, however, U.S. life expectancy growth stalled and has most recently been declining. A critical question for American health policy is how to return U.S. life expectancy to its pre-2010 growth rate. Researchers and policy makers have focused on rising drug-related deaths in their search for the explanations for the stalling and declining life expectancy. (more…)
Author Interviews, Columbia, Heart Disease, Mediterranean Diet, Women's Heart Health / 13.03.2020

MedicalResearch.com Interview with: Dr. Riddhi Shah, PhD AHA SFRN Postdoctoral Research Fellow Division of Cardiology Columbia University Medical Center New York, New York MedicalResearch.com: What is the background for this study? Response: The Mediterranean Diet, characterized by higher intakes of plant foods including plant proteins, monounsaturated fat, fish, and lower consumption of animal products and saturated fat, has long been associated with reduced cardiovascular risk and greater longevity, but the molecular mechanisms underlying these associations have not been fully elucidated. We evaluated associations of an Alternate Mediterranean Diet Score, reflective of adherence to this diet pattern and adapted for US populations, and its components with markers of endothelial inflammation directly measured in endothelial cells harvested from women, including oxidative stress, nuclear factor kappa B (NFκB), and endothelial nitric oxide synthase (eNOS) gene expression. (more…)
Author Interviews, BMJ, Brigham & Women's - Harvard, Heart Disease, Nutrition / 05.03.2020

MedicalResearch.com Interview with: Jean-Philippe Drouin-Chartier, RD PhD Assistant Professor, Faculty of Pharmacy, Université Laval Researcher, NUTRISS Center of INAF, Université Laval Visiting Scientist, Department of Nutrition Harvard TH Chan School of Public Health  MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease (CVD) is a leading cause of death worldwide. Eggs are a major source of dietary cholesterol, but they are also an affordable source of high-quality protein, iron, unsaturated fatty acids, phospholipids, and carotenoids. However, because of the cholesterol content in eggs, the association between egg intake and CVD risk has been a topic of intense debate in the past decades. Many prospective studies on the association between egg intake and cardiovascular disease risk have provided conflicting findings. The aim of our study was to prospectively examine the association between egg consumption and risk of CVD in three cohorts of US men and women, and to conduct a systematic review and a meta-analysis of prospective cohort studies on eggs and CVD.  (more…)
Author Interviews, Heart Disease, Omega-3 Fatty Acids / 03.03.2020

MedicalResearch.com Interview with: Lee Hooper PhD, RD Reader in Research Synthesis, Nutrition & Hydration Norwich Medical School Norwich, UK  MedicalResearch.com: What is the background for this study? Response: Polyunsaturated fats are common healthy eating choices, and fish oil (long-chain omega-3 including EPA and DHA) and flaxseed (containing alpha-linolenic acid, ALA, a plant-based omega-3) supplements are commonly consumed. Worldwide cardiovascular disease was responsible for 37% of premature deaths due to non-communicable disease in 2012, and cancers were responsible for 27%.  Small effects of omega-3 and polyunsaturated fats on cardiovascular diseases and cancers could have big effects on worldwide health. (more…)
Author Interviews, Fertility, Heart Disease, JAMA, OBGYNE / 27.02.2020

MedicalResearch.com Interview with: Shi Wu Wen PhD Senior Scientist, Clinical Epidemiology Program Professor, Department of Obstetrics & Gynecology University of Ottawa MedicalResearch.com: What is the background for this study? Response: Previous studies have shown that having a baby as a result of using assisted procedures such as IVF nearly doubles the chance that a baby will have heart problems. (more…)
Author Interviews, Heart Disease, JACC, Women's Heart Health / 26.02.2020

MedicalResearch.com Interview with: Haider Aldiwani, MD Fellow in Internal Medicine and C. Noel Bairey Merz, MD, FACC, FAHA Director Barbra Streisand Women’s Heart Center Smidt Heart Institute, Cedars-Sinai Medical Center Los Angeles, CA, 90048   MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease is the leading cause of death in women in the United States. Women are found to have a higher prevalence of ischemia but no obstructive coronary artery disease (INOCA) compared to men. These women are often labeled as “normal” and their symptoms and cardiovascular risk are not managed appropriately. Women with INOCA are higher risk of developing major adverse cardiovascular events including death, myocardial infarction (MI), stroke and heart failure hospitalization. Presenting symptoms of ischemia are variable and more often labelled “atypical” in women.  (more…)
Alzheimer's - Dementia, Author Interviews, Biomarkers, Heart Disease / 25.02.2020

MedicalResearch.com Interview with: Prof. Konstantinos Stellos, MD, DM, MRCP, DSc, FAHA, FESC Professor of Medicine, Chair of Cardiovascular Medicine, Chair of Epitranscriptomics Lead, Vascular Biology & Medicine Theme Hon. Consultant Cardiologist, Newcastle Hospitals NHS Foundation Trust Biosciences Institute Faculty of Medical Sciences Newcastle University MedicalResearch.com: What is the background for this seminar? Can you tell us a little about how amyloid is made and stored? Response: Patients are afraid that they may die due to a heart attack - a major cause of death worldwide- or if they live long they may get dementia compromising severely their quality of life in their last years of life. Many years ago we asked the question whether there is a link between these two ageing-associated diseases. For this reason we studied the clinical value of amyloid-beta peptides in patients with coronary heart disease. We chose to study the amyloid-beta peptides, which are the cleavage product of the beta- and gamma-secretases of the mother protein amyloid precursor protein, because amyloid-beta plaques in brain is the hallmark of Alzheimer's disease. Following amyloid precursor protein (APP) gene transcription, APP is cleaved in the nonamyloidogenic pathway (plasma membrane) by α- and γ- secretases or in the amyloidogenic pathway (endosomes) by β- and γ- secretases. The later pathway generates amyloid beta (Αβ) peptides that are released extracellularly. Αβ accumulation in blood or tissues may result from enhanced production/cleavage or by impaired degradation and/or clearance. The related mechanisms are depicted in Figure 2 of our publication in JACC: http://www.onlinejacc.org/content/75/8/952  (more…)
Author Interviews, Health Care Systems, Heart Disease, JAMA, Medicare / 24.02.2020

MedicalResearch.com Interview with: Rishi KWadhera, MD Beth Israel Deaconess Medical Center Harvard Medical Faculty Physicians MedicalResearch.com: What is the background for this study? Response: In recent years, the Centers for Medicare and Medicaid Services has implemented nationally mandated value-based programs to incentivize hospitals to deliver higher quality care. The Hospital Readmissions Reduction Program (HRRP), for example, has financially penalized hospitals over $2.5 billion to date for high 30-day readmission rates. In addition, the Value-Based Purchasing Program (VBP) rewards or penalizes hospitals based on their performance on multiple domains of care.  Both programs have focused on cardiovascular care. The evidence to date, however, suggests that these programs have not improved health outcomes, and there is growing concern that they may disproportionately penalize hospitals that care for sick and poor patients, rather than for poor quality care. (more…)
Author Interviews, Genetic Research, Heart Disease, Imperial College, JAMA / 19.02.2020

MedicalResearch.com Interview with: Dr. Ioanna Tzoulaki Imperial College London MedicalResearch.com: What is the background for this study? Response: Considerable progress has been made in identifying genetic variants that are associated with heart disease. We aimed to investigate whether genetic information can be used to assess the risk of individuals developing heart disease in the future and whether genetic tests can improve current risk assessment strategies which are based on easy to measure factors such as age, sex, smoking status, cholesterol levels, blood pressure and presence of type 2 diabetes. (more…)
AHA Journals, Author Interviews, Heart Disease, Stroke / 18.02.2020

MedicalResearch.com Interview with: Dorothy Sears Ph.D. Professor of Nutrition College of Health Solutions Arizona State University MedicalResearch.com: What is the background for this study? Response: Historically, heart disease among women has been understudied despite this being the number one cause of death in women. One in three women will die from heart disease.  Older women are the fasting growing population in the US and after menopause experience a dramatic increase in risk for cardiometabolic diseases such as cardiovascular disease and type 2 diabetes. For these reasons, it is critical to understand the impact of modifiable behaviors on this risk.  Accumulating evidence shows that prolonged sitting is a highly prevalent behavior, associated with cardiometabolic and mortality risk, and greatest in older adults. Thus, overweight or obese postmenopausal women who partake in prolonged sitting time likely have highly compounded cardiometabolic risk. (more…)
Author Interviews, Blood Pressure - Hypertension, Columbia, Heart Disease, JAMA / 17.02.2020

MedicalResearch.com Interview with: George Hripcsak, MD, MS Vivian Beaumont Allen Professor of Biomedical Informatics Chair, Department of Biomedical Informatics Columbia University Director, Medical Informatics Services NewYork-Presbyterian Hospital/Columbia MedicalResearch.com: What is the background for this study? Response: Diuretics are considered among the best drugs to treat hypertension, but there are no randomized studies to tell us which diuretic is best. Hydrochlorothiazide is the most frequently used diuretic for hypertension, but another drug, chlorthalidone, is gaining favor, with the most recent US hypertension guideline expressing a preference for it. Chlorthalidone is known to be longer acting and therefore perhaps more effective. Other (non-randomized) studies have been inconsistent, and some of them imply that chlorthalidone may be more effective. But other studies have shown that chlorthalidone may have more side effects. (more…)
Author Interviews, Heart Disease, Psychological Science / 11.02.2020

MedicalResearch.com Interview with: Prof. Geoffrey Tofler MBBS MB FRACP FACC Professor of Preventative Cardiology, University of Sydney Senior Staff Cardiologist, Royal North Shore Hospital New South Wales, Australia MedicalResearch.com: What is the background for this study? Response: Bereavement due to the death of a loved one is one of the most stressful experiences to which almost every human is exposed. Grief is an unavoidable and natural reaction to the loss.  While in most people the grief reaction gradually diminishes, an increased risk of heart attack or has been described in the early weeks and months following bereavement.   Although this increase in heart attacks is well recognised, until now there have not been any previous studies to provide guidance on how to safely reduce the risk. (more…)
AHA Journals, Author Interviews, Heart Disease, Menopause, Race/Ethnic Diversity, University of Pittsburgh / 05.02.2020

MedicalResearch.com Interview with: Samar R. El Khoudary, M.D., M.P.H. Associate Professor of Epidemiology and Saad Samargandy, M.P.H. Ph.D. Student University of Pittsburgh Graduate School of Public Health MedicalResearch.com: What is the background for this study? Response: Research findings suggest that women experience adverse changes in multiple clinical measures of their cardiovascular health during the menopause transition period. We were interested in evaluating the timing of critical changes in arterial stiffness and investigating potential racial differences in how arterial stiffness progresses during the menopause transition. Arterial stiffness refers to the elasticity of arteries and it measures the rate at which blood flows through arteries. Stiffer arteries can lead to dysfunction in how well the heart pumps and moves blood, and damage to the heart, kidneys and other organs. We used a subset of data from SWAN Heart, an ancillary study that enrolled women from Pittsburgh and Chicago between 2001 and 2003 and included two examinations of early markers of cardiovascular health over time. Ultimately, 339 women were included in this study, 36% black and the rest white. (more…)
Author Interviews, Heart Disease, Science / 31.01.2020

MedicalResearch.com Interview with: Steven R. Houser, PhD, FAHA Senior Associate Dean, Research Vera J. Goodfriend Endowed Chair, Cardiovascular Research Chair and Professor, Physiology Director, Cardiovascular Research Center (CVRC) Professor, Medicine Deborah M EatonDeborah M Eaton  Doctorate Student / Research Assistant Temple University   MedicalResearch.com: What is the background for this study? Response: Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for approximately 50% of cases of HF and to date clinical trials with HFpEF patients have failed to produce positive outcomes. Part of this is likely due to the lack of HFpEF animal models for preclinical testing. Our lab addressed this gap in knowledge by developing an animal model that mimics critical features of the human HFpEF phenotype. We performed an in-depth cardiopulmonary characterization highlighting that the model has characteristics of human disease. We then tested the effects of a pan-HDAC inhibitor, vorinostat/SAHA, in collaboration with Dr. Timothy McKinsey, who is an expert in HDAC inhibitors and recently published work1 that laid the foundation for this study.  (more…)
Author Interviews, Cannabis, Columbia, Heart Disease, JACC / 21.01.2020

MedicalResearch.com Interview with: Ersilia DeFilippis, MD Second-year cardiology fellow Columbia University Irving Medical Center and NewYork-Presbyterian MedicalResearch.com: What is the background for this study? Response: Marijuana use has been increasing significantly and is the most commonly illicit drug used in the United States. In recent years, more states have been legalizing its use for both recreational and medicinal purposes. We have all seen news reports regarding the rise of vaping-related health hazards. Yet, data are limited regarding the cardiovascular effects of marijuana which is what drove us to explore this topic. (more…)
Author Interviews, Heart Disease, JAMA / 15.01.2020

MedicalResearch.com Interview with: Mandeep R. Mehra, MD, MSc, FRCP The William Harvey Distinguished Chair in Advanced Cardiovascular Medicine Medical Director, Heart and Vascular Center Brigham and Women’s Hospital Executive Director Center for Advanced Heart Disease Brigham and Women’s Hospital Professor of Medicine, Harvard Medical School    MedicalResearch.com: What is the background for this study? Response: Left Ventricular assist devices meaningfully prolong survival in patients with heart failure who are no longer responsive to guideline-directed medications. The MOMENTUM 3 trial tested a new generation device, the HeartMate 3 pump, to a more commonly used pump, the HeartMate II device. This trial showed the superiority of the new heart pump and found that survival free of a disabling stroke or need to place a second pump is improved considerably. In this prespecified analysis of the trial, we compared patients who were considered as eligible for transplantation to those considered ineligible for heart transplantation. We showed that these categories are associated with similar superiority of the HeartMate 3 pump compared to the control pump despite the categorization into these discrete buckets. (more…)
Author Interviews, Biomarkers, Heart Disease, JAMA, UCLA / 09.01.2020

MedicalResearch.com Interview with: Olujimi A. Ajijola, MD, PhD Neurocardiology Research Center of Excellence Cardiac Arrhythmia Center University of California, Los Angeles MedicalResearch.com: What is the background for this study? Response: It hadn’t been understood why some people with basic heart failure might live longer than others despite receiving the same medications and medical device therapy. Through this research we set out to determine whether a biomarker of the nervous system could help explain the difference. This study revealed a biomarker that can specifically predict which patients with “stable” heart failure have a higher risk of dying within one to three years. (more…)
Author Interviews, Genetic Research, Heart Disease, JAMA, Weight Research / 08.01.2020

MedicalResearch.com Interview with: Ravi V. Shah, MD Cardiology Division, Department of Medicine Massachusetts General Hospital Boston, MA Venkatesh L. Murthy MD, PhD Division of Cardiovascular Medicine Department of Medicine and Frankel Cardiovascular Center University of Michigan Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: We were interested in evaluating how added information like fitness assessed on a treadmill exercise test, physical activity questionnaires and genetic risk scores could inform patients and doctors’ understanding of how an individuals BMI might change over time. We used one of the latest and broadest polygenic risk scores. We investigated the CARDIA cohort, a study sponsored by the National Heart, Lung, and Blood Institute, who were young adults aged 18 to 30 and have been followed serially for 25 years. (more…)
Aging, Author Interviews, Exercise - Fitness, Heart Disease, JACC / 08.01.2020

MedicalResearch.com Interview with: Dr Charlotte Manisty PhD MRCP Senior Lecturer Consultant Cardiologist Barts Heart Centre and University College University College Hospitals, London MedicalResearch.com: What is the background for this study? Response: The normal ageing process results in vascular stiffening which in turn contributes to adverse cardiovascular events including heart attacks and strokes.  We know that trained athletes have more compliant blood vessels than their peers, and previous small studies of supervised exercise training have shown that such interventions can reduce blood pressure. We aimed to assess the impact of unsupervised exercise training on cardiovascular physiology in novice runners preparing for a first-time marathon using advanced noninvasive imaging in order to better understand whether it is possible to ‘reverse’ vascular ageing. (more…)
Author Interviews, Heart Disease, Race/Ethnic Diversity / 07.01.2020

MedicalResearch.com Interview with: Robert H. Schneider, MD, FACC Director, Institute for Natural Medicine and Prevention Dean, College of Integrative Medicine Maharishi University of Management Fairfield, Iowa 52556 MedicalResearch.com: What is the background for this study? Response: Abnormal enlargement of heart, known as left ventricular hypertrophy (LVH), is an important risk factor for cardiovascular disease (CVD). It doubles the risk for heart attacks, heart failure, arrhythmias, stroke, and mortality. African Americans have twice the rate of LVH compared to whites. This may partly explain the disproportionally high CVD death rates in blacks. Psychosocial stress contributes the development of LVH and CVD. African Americans are exposed to excess psychosocial stress imposed by socioeconomic disparities and racism. However, there is little known about the potential role of stress reduction in the prevention of LVH in the general population or African Americans in particular. Therefore, this study was conducted to assess if stress reduction with Transcendental Meditation could prevent left ventricular hypertrophy in African Americans and thereby help to prevent subsequent heart disease. (more…)
Alcohol, Author Interviews, Heart Disease, NEJM / 02.01.2020

MedicalResearch.com Interview with: Professor Peter M Kistler MBBS, PhD, FRACP Head of Clinical Electrophysiology Research Baker Heart and Diabetes Institute Head of Electrophysiology at The Alfred hospital Professor of Medicine University of Melbourne. MedicalResearch.com: What is the background for this study? Response: There is a well known association between alcohol intake and atrial fibrillation form population based studies which demonstrate that for every 1 standard drink the incidence of AFib increases by 8%. This is the first randomised study to determine of alcohol reduction/abstinence leads to a reduction in AFib episodes and time to recurrence. (more…)
Author Interviews, Heart Disease, NEJM / 28.12.2019

MedicalResearch.com Interview with: Jean-Claude Tardif CM, MD, FRCPC, FCCS, FACC, FAHA, FESC, FCAHS Director, Montrel Heart Institute Research Center Professor of medicine Canada Research Chair in translational and personalized medicine University of Montreal endowed research chair in atherosclerosis Montreal Heart Institute MedicalResearch.com: What is the background for this study? Response: Inflammation appears to play an important role in atherosclerosis. Inhibition of interleukin-1ß by canakinumab reduced the rate of cardiovascular events by 15% CANTOS. In contrast, methotrexate did not affect cardiovascular outcomes or plasma markers of inflammation in CIRT. Colchicine is an inexpensive, orally administered, potent anti-inflammatory medication that has been used for centuries. Colchicine is currently indicated for the management of patients with gout, familial Mediterranean fever and pericarditis. In the LODOCO study, patients with stable coronary disease treated with colchicine 0.5 mg once daily experienced fewer cardiovascular events as compared with those not receiving colchicine. However, that study enrolled only 532 patients and was not placebo-controlled. Because acute coronary syndromes are associated with higher risks of recurrent events and exacerbated inflammation, we conducted the COLchicine Cardiovascular Outcomes Trial (COLCOT) in patients with a recent myocardial infarction to evaluate the effects of colchicine on cardiovascular outcomes and its long-term safety and tolerability. (more…)
Annals Internal Medicine, Author Interviews, Biomarkers, Heart Disease / 23.12.2019

MedicalResearch.com Interview with: Dr. PJ Devereaux MD, PhD, FRCP(C) Director of the Division of Cardiology Scientific Leader Anesthesiology, Perioperative Medicine, and Surgical Research Group Population Health Research Institute McMaster University  MedicalResearch.com: What is the background for this study? Response: There is an ethical obligation to provide patients with an accurate estimation of the potential benefits of surgery and the potential risks, to facilitate informed decision making about the appropriateness of surgery.  There are two common approaches to risk estimation. First, physicians commonly use clinical risk indices.  Based upon a patient’s clinical history (e.g., history of prior heart attack or stroke) an estimate of perioperative risk is determined.  Research demonstrates that these clinical risk indices have suboptimal risk discrimination capabilities, and they will underestimate risk in many patients. The second approach that has commonly been used is to have patients undergo an expensive and time consuming non-invasive cardiac test (e.g., stress nuclear cardiac study).  Although these non-invasive cardiac tests can enhance risk estimation in some patients who will have a perioperative cardiac event, these tests more commonly exaggerate risk in patients who will not have a complication. (more…)
Author Interviews, Heart Disease / 20.12.2019

MedicalResearch.com Interview with: Shiwani Mahajan, MBBS Postdoctoral Associate Yale/YNHH Center for Outcomes Research and Evaluation (CORE) New Haven, CT 06510  MedicalResearch.com: What is the background for this study? Response: Although the mortality rates among patients hospitalized for myocardial infarction (MI) have seen a decreasing trend, patients with MI continue to have a delayed presentation to the hospital and a large number of them die before reaching the hospital. One critical aspect of lowering mortality associated with MI is ensuring timely access to lifesaving emergency cardiac care, for which prompt recognition of symptoms of a MI and appropriate rapid emergency response are crucial. As such, in this study, we used nationally representative data to estimate awareness of 5 common symptoms of a MI (including chest pain or discomfort; shortness of breath; pain or discomfort in arms or shoulders; feeling weak or lightheaded; and jaw or neck or back pain), and the appropriate response to a MI (i.e. calling emergency medical services), among adults in the US. (more…)
Author Interviews, Heart Disease, Surgical Research / 21.11.2019

MedicalResearch.com Interview with: Chayakrit Krittanawong, MD Section of Cardiology Baylor College of Medicine Houston, TX MedicalResearch.com: What is the background for this study? Response: Transcatheter Aortic valve Implantation (TAVI) has emerged as equally effective alternative to surgical aortic valve replacement (SAVR) to treat severe aortic stenosis (AS) in all risk groups. In particular, less is known about the heart failure (HF) patients who undergo TAVI. Whether certain subtypes of HF respond differently after TAVI remains a mystery. In this study, we sought to assess and compare the incidence and predictors of in-hospital mortality among patients with heart failure with preserved ejection fraction (HFREF) versus heart failure with preserved ejection fraction (HFPEF). (more…)
Author Interviews, Heart Disease / 20.11.2019

MedicalResearch.com Interview with: Matthew Budoff MD Professor of Medicine, UCLA Endowed Chair of Preventive Cardiology Lundquist Institute Torrance, CA 90502 MedicalResearch.com: What is the background for this study? Response: We present the nine-month interim analysis results from the EVAPORATE mechanistic study of Icosapent Ethyl, after benefits were seen with the REDUCE-IT Trial, demonstrating 25% event reduction. This trial was a serial multi-detector computed tomographic (MDCT) study to look at plaque progression between icosapent ethyl (4 gm/day) and matching placebo.  (more…)