Author Interviews, Heart Disease, Red Meat / 15.04.2021

MedicalResearch.com Interview with: [caption id="attachment_57144" align="alignleft" width="200"]Dr Zahra Raisi-Estabragh, PhD fellow Cardiologist Trainee at Queen Mary University of London and Barts Health NHS Trust Dr. Raisi-Estabra[/caption] Dr Zahra Raisi-Estabragh, PhD fellow Cardiologist Trainee at Queen Mary University of London and Barts Health NHS Trust MedicalResearch.com: What is the background for this study? Response: Previous studies have linked greater consumption of red and processed meat to poorer clinical cardiovascular outcomes, for example, higher risk of having a heart attack or of dying from heart disease. However, the biological mechanisms underlying these relationships are not well understood. Furthermore, the impact of meat intake on more direct measures of heart health, such as, structure and function of the heart and blood vessels, has not been previously studied in large cohorts. Examining how meat intake may influence different aspects of cardiovascular health can help us better understand its health effects. 
Author Interviews, Erectile Dysfunction, Heart Disease, JACC, Karolinski Institute / 10.04.2021

MedicalResearch.com Interview with: [caption id="attachment_56968" align="alignleft" width="128"]Martin J Holzmann MD PhD Department of Emergency Medicine Karolinska University Hospital Stockholm, Sweden Dr. Holzmann[/caption] Martin J Holzmann MD PhD Department of Emergency Medicine Karolinska University Hospital Stockholm, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​We published a paper 2007 in Heart where we showed that PDE5i lower mortality in men with a recent myocardial infarction. With this study we wanted to investigate if PDE5i led to a beneficial outcome in men with stable coronary artery disease.
AHA Journals, Author Interviews, Heart Disease, Stroke / 12.03.2021

MedicalResearch.com Interview with: [caption id="attachment_56932" align="alignleft" width="200"]Brandon K Fornwalt, MD, PhD. Associate Professor, Director Department of Imaging Science and Innovation Geisinger Dr. Fornwalt[/caption] Brandon K Fornwalt, MD, PhD Associate Professor, Director Department of Imaging Science and Innovation Geisinger MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) is an abnormal heart rhythm that is associated with outcomes such as stroke, heart failure and death. If we know a patient has atrial fibrillation, we can treat them to reduce the risk of stroke by nearly two-thirds. Unfortunately, patients often don’t know they have AF. They present initially with a stroke, and we have no chance to treat them before this happens. If we could predict who is at high risk of either currently having AF or developing it in the near future, we could intervene earlier and hopefully reduce bad outcomes like stroke. Artificial intelligence approaches may be able to help with this task.
Author Interviews, Chocolate, Heart Disease / 09.03.2021

MedicalResearch.com Interview with: Anne Yuk-Lam Ho, MPH Million Veteran Program (MVP) Data Core MVP Coordinating Center VA Boston Healthcare SystemAnne Yuk-Lam Ho, MPH Million Veteran Program (MVP) Data Core MVP Coordinating Center VA Boston Healthcare System MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease (CVD) has been the leading cause of morbidity and mortality globally. Prevalence of CVD among US population is approximately 7% which places huge burden on our healthcare systems. And prevalence of CVD is as high as 28% among veterans at the VA healthcare system as veteran users are primarily older male with more histories of comorbidities.  Most CVD risk factors including lipids and blood pressure can be controlled by lifestyle modifications, such as diet. Chocolate is among dietary factors that play a role in modulating CVD risk factors is widely consumed in the US (~2.8 billion pounds annually. Although previous studies have reported beneficial effects of chocolate and/or cacao products (rich in flavonoids) on lipids, glucose metabolism and risk of diabetes, and lipids, little is known about the association of chocolate intake with coronary artery disease (CAD) among US veterans. Thus, sought to test the hypothesis that chocolate consumption is associated with a lower risk of CAD among xxx US veterans enrolled in the Million Veteran Program. 
AHA Journals, Author Interviews, Genetic Research, Heart Disease / 08.03.2021

MedicalResearch.com Interview with: [caption id="attachment_56877" align="alignleft" width="200"]Giordano Bottà, PhD CEO and Co-founder Allelica  The Polygenic Risk Score Company Dr. Bottà[/caption] Giordano Bottà, PhD CEO and Co-founder Allelica The Polygenic Risk Score Company MedicalResearch.com: What is the background for this study? Response: Previous research identified that polygenic risk score (PRS) has the highest predictive power compared to other risk factors and identifies individuals with the same risk of those with familial hypercholesterolemia, but are invisible to traditional risk assessment. We explored for the first time the interplay between the main causes of atherosclerosis, LDL cholesterol and PRS.  We were interested in helping cardiologists understand why some individuals have bad arteries full of plaques while others don't in presence of the same LDL levels and no additional risk factors. Our findings explain why this is the case: LDL does not affect everyone the same. We believe that we are at the forefront of a change of paradigm in cardiovascular risk assessment: LDL levels cannot be accessed without considering the genetics of an individual.
AHA Journals, Author Interviews, Heart Disease, Race/Ethnic Diversity, Stroke / 05.03.2021

MedicalResearch.com Interview with: [caption id="attachment_56856" align="alignleft" width="149"]Fernando D Testai, MD, PhD, FAHA Associate Professor of Neurology and Rehabilitation Stroke Medical Director University of Illinois Health Dr. Testai[/caption] Fernando D Testai, MD, PhD, FAHA Associate Professor of Neurology and Rehabilitation Stroke Medical Director University of Illinois Health MedicalResearch.com: What is the background for this study? Response: Stroke constitutes a leading cause of disability and mortality in the United States. Large observational studies have shown that up to 90% of the strokes are caused by modifiable vascular risk factors, including hypertension, diabetes mellitus, and several others. In addition, previous history of stroke is one of the most powerful predictors of recurrent stroke. Thus, controlling vascular risk factors in patients with stroke is of paramount importance. To this end, the American Heart Association and the American Stroke Association have developed specific targets for blood pressure, glycemic, and cholesterol levels.
Author Interviews, Columbia, COVID -19 Coronavirus, Exercise - Fitness, Heart Disease, JAMA / 05.03.2021

MedicalResearch.com Interview with: [caption id="attachment_56853" align="alignleft" width="133"]David J. Engel, MD, FACC Division of Cardiology Columbia University Irving Medical Center New York, New York Dr. Engel[/caption] David J. Engel, MD, FACC Division of Cardiology Columbia University Irving Medical Center New York, New York MedicalResearch.com: What is the background for this study? Response: ​​Early reports and observations in the COVID-19 pandemic found that patients recovering from mild to severe forms of COVID-19 illness had a higher prevalence of cardiac injury in comparison with what historically has been seen and reported with other viruses. This cardiac injury, categorized as inflammatory heart disease, could have serious implications, including a risk for exercise-triggered sudden cardiac death, for athletes and highly active people who have had prior COVID-19 illness and who return to intensive exercise activity with unknowing subclinical cardiac injury. To address these concerns in COVID positive athletes, the ACC generated return to play cardiac screening recommendations (troponin blood test, ECG, resting echocardiogram) for all competitive athletes after COVID-19 infection prior to resumption of competitive and intensive sport activity. The professional leagues were among the first organizations to return to full-scale sport activity in the setting of the pandemic, and they uniformly adopted and implemented the ACC return to play screening recommendations for all athletes that tested positive for COVID-19. The leagues recognized that there was value in collaborating and formally analyzing their pooled cardiac data, not only for league athlete health and safety purposes, but also to share broadly this information to add to the growing body of knowledge about the virus.
Author Interviews, Heart Disease, MD Anderson, Menopause, University of Pittsburgh, Weight Research / 04.03.2021

MedicalResearch.com Interview with: [caption id="attachment_56828" align="alignleft" width="160"]Samar El Khoudary, PhD, MPH, BPharm, FAHA Associate Professor of Epidemiology University of Pittsburgh Graduate School of Public Health Dr. El Khoudary[/caption] Samar El Khoudary, PhD, MPH, BPharm, FAHA Associate Professor of Epidemiology University of Pittsburgh Graduate School of Public Health MedicalResearch.com: What is the background for this study? Response: Research increasingly shows that it isn’t so important how much fat a woman is carrying, which doctors typically measure using weight and BMI, as it is where she is carrying that fat. To investigate this, we looked at 25 years of data on 362 women from Pittsburgh and Chicago who participated in the Study of Women’s Health Across the Nation (SWAN) Heart study. The women, who were an average age of 51, had their visceral adipose tissue—fat surrounding the abdominal organs—measured by CT scan and the thickness of the internal carotid artery lining in their neck measured by ultrasound, at a few points during the study. Carotid artery thickness is an early indicator of heart disease.
Author Interviews, COVID -19 Coronavirus, Heart Disease, Nature, Statins / 27.02.2021

MedicalResearch.com Interview with: [caption id="attachment_56799" align="alignleft" width="200"]Aakriti Gupta MD MS Fellow, Interventional Cardiology Columbia University Irving Medical Center NewYork-Presbyterian Hospital Dr. Gupta[/caption] Aakriti Gupta MD MS Fellow, Interventional Cardiology Columbia University Irving Medical Center NewYork-Presbyterian Hospital  MedicalResearch.com: What is the background for this study? Response: While taking care of patients with COVID-19 last spring and summer at the height of the pandemic, we observed that patients who got very sick and required hospitalization had high rates of hyperinflammation with elevated CRP levels, and thromboembolic phenomena. As cardiologists who frequently prescribe statins for hyperlipidemia, they were a class of drugs that came naturally to mind for their anti-inflammatory, anticoagulant and immunomodulatory properties in addition to their cholesterol lowering properties. As such, we decided to look at the association of statin use with in-hospital mortality in patients who are hospitalized with COVID-19.
Author Interviews, Colon Cancer, Heart Disease, JAMA, Nutrition / 18.02.2021

MedicalResearch.com Interview with: [caption id="attachment_56684" align="alignleft" width="142"]Nathorn (Nui) Chaiyakunapruk PharmD, PhD Professor, Department of Pharmacotherapy University of Utah College of Pharmacy Dr. Chaiyakunapruk[/caption] Nathorn (Nui) Chaiyakunapruk PharmD, PhD Professor, Department of Pharmacotherapy University of Utah College of Pharmacy  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Colorectal cancer is one of the cancers for which we found that the risk can be significantly reduced by modifying diet. Individual components of your diet can contribute to an overall healthy diet pattern to lower the risk of colorectal cancer or increase it. Strong scientific evidence shows that limiting red meat and alcohol consumption, eating foods containing fiber and calcium, consumption of dairy products especially yogurt can help prevent colorectal cancer. 
Author Interviews, Heart Disease, JAMA, OBGYNE, Pediatrics / 18.02.2021

MedicalResearch.com Interview with: [caption id="attachment_56672" align="alignleft" width="133"]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 Dr. Marma Perak[/caption] 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.
Author Interviews, Heart Disease, JACC / 05.02.2021

MedicalResearch.com Interview with: [caption id="attachment_56538" align="alignleft" width="149"]Dr-Paaladinesh Thavendiranathan.jpg Dr. Thavendiranathan[/caption] 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.  
Author Interviews, Heart Disease / 05.02.2021

MedicalResearch.com Interview with: [caption id="attachment_56573" align="alignleft" width="143"]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 Dr. Chugh[/caption] 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.
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Nature / 04.02.2021

MedicalResearch.com Interview with: [caption id="attachment_56558" align="alignleft" width="200"]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 Dr. Aerts[/caption] 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.
Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA, Social Issues, University of Pennsylvania / 02.02.2021

MedicalResearch.com Interview with: [caption id="attachment_49581" align="alignleft" width="180"]Sameed Khatana, MD, MPH Fellow, Cardiovascular Medicine, Perleman School of Medicine Associate Fellow, Leonard Davis Institute of Health Economics University of Pennsylvania Dr. Khatana[/caption] 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.
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. 
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Heart Disease, JACC / 11.01.2021

MedicalResearch.com Interview with: [caption id="attachment_56374" align="alignleft" width="200"]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  Dr. Wadhera[/caption] 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.
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.
Abuse and Neglect, Author Interviews, COVID -19 Coronavirus, Emergency Care, Heart Disease / 21.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56306" align="alignleft" width="171"]Michalis Katsoulis PhD Immediate PostDoctoral BHF fellow Institute of Health Informatics Senior Research Fellow, UCL Dr. Katsoulis[/caption] 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.
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Heart Disease / 21.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56279" align="alignleft" width="172"]Dr-Chris Clark.jpg Dr. Clark[/caption] 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.
Author Interviews, Heart Disease, JAMA, Lifestyle & Health, USPSTF / 03.12.2020

MedicalResearch.com Interview with: [caption id="attachment_56105" align="alignleft" width="133"]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[/caption] 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.
AHA Journals, Author Interviews, Heart Disease, Women's Heart Health / 30.11.2020

MedicalResearch.com Interview with: [caption id="attachment_56073" align="alignleft" width="200"]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 Dr. Ezekowitz[/caption] 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.
Author Interviews, Heart Disease, JAMA, Pediatrics, Surgical Research / 25.11.2020

MedicalResearch.com Interview with: [caption id="attachment_56023" align="alignleft" width="200"]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 Dr. Flaherty[/caption] 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.
Author Interviews, Blood Pressure - Hypertension, Heart Disease, Pediatrics, USPSTF / 19.11.2020

MedicalResearch.com Interview with: [caption id="attachment_56002" align="alignleft" width="133"]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 Dr. Kubik[/caption] 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.
AHA Journals, Author Interviews, Heart Disease, University of Michigan / 17.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55974" align="alignleft" width="125"]Sara Saberi, MD, MS Assistant Professor Inherited Cardiomyopathy Program Frankel Cardiovascular Center University of Michigan Hospital Michigan Medicine Dr. Saberi[/caption] 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.
Author Interviews, COVID -19 Coronavirus, Heart Disease / 17.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55944" align="alignleft" width="200"]Benjamin D. Horne, PhD Cardiovascular and Genetic Epidemiologist Intermoumtain Health Dr. Horne[/caption] 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. 
Author Interviews, Heart Disease, JACC / 17.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55919" align="alignleft" width="200"]Simon Winther, MD, PhD Associate professor Department of Cardiology, Gødstrup Hospital Herning, Denmark Dr. Winther[/caption] 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. 
Aging, Author Interviews, Geriatrics, Heart Disease, Lancet, Lipids / 11.11.2020

MedicalResearch.com Interview with: [caption id="attachment_55907" align="alignleft" width="128"]Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry Herlev and Gentofte Hospital Copenhagen University Hospital Herlev, Denmark Dr. Nordestgaard[/caption] 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