Author Interviews, Heart Disease / 01.10.2014

MedicalResearch.com Interview with: Lior Yankelson, MD PhD Tel Aviv Medical Center MedicalResearch: What are the main findings of the study? Dr. Yankelson: The main findings of the study are that new onset atrial fibrillation after TAVI does not confer a significant risk for mortality , and confers somewhat increased risk for stroke. The latter issue is expected to become less significant with new technological advancements coming into the market, such as lower profile devices and emboli protection both mechanical and pharmaceutical. The more significant and alarming finding is that patients with atrial fibrillation have more than 4 fold risk for death at 1 year post TAVI compared to patients without afib. This is very significant and raises questions regarding the benefit for the procedure in these patients. (more…)
Author Interviews, Heart Disease, JAMA / 30.09.2014

MedicalResearch.com Interview with: Marwan Badri MBChB, MRCP Cardiovascular disease fellow Lankenau Medical Center Wynnewood Pa Medical Research : What is the background for this study? Dr. Badri: Recent years witnessed increased emphasis of the role of clinical guidelines in cardiovascular care. Physicians are encouraged to practice within the framework of major society guidelines to deliver better, more cost-effective patient care. It is therefore vital that the recommendations in these guidelines are applicable to most of the patient population. Since some clinical trials have been shown in the past to unfavorably exclude women, racial minorities and elderly patients, we conducted this study to see if the clinical trials used to form the American College of Cardiology/American Heart Association adequately represent these patient groups. (more…)
Author Interviews, Case Western, Heart Disease, Scripps / 29.09.2014

MedicalResearch.com Interview with: Philip Gorelick, M.D., M.P.H, F.A.C.P. Medical Director of the Hauenstein Neuroscience Center Saint Mary’s Health Care, Grand Rapids, MI; Professor, Translational Science and Molecular Medicine Michigan State University College of Human Medicine; Board member of the National Stroke AssociationPhilip Gorelick, M.D., M.P.H, F.A.C.P. Medical Director of the Hauenstein Neuroscience Center Saint Mary’s Health Care, Grand Rapids, MI; Professor, Translational Science and Molecular Medicine Michigan State University College of Human Medicine; Board member of the National Stroke Association and Judy Lenane, R.N., M.H.A. Chief Clinical Officer of iRhythm Technologies, Inc. Judy Lenane, R.N., M.H.A. Chief Clinical Officer of iRhythm Technologies, Inc.   Medical Research: What is atrial fibrillation and how common a problem is it among US adults? Dr. Gorelick: Nearly 3 million people in the US suffer from Atrial Fibrillation or “Afib,” an abnormal heart rhythm that causes the heart to beat rapidly and irregularly. While Afib can occur at any age, the incidence increases with age and the number of cases is expected to increase significantly in the coming years as the population ages. Approximately 5 percent of people 65 years and older and one in every 10 people over 80 years of age have Afib. It is more common in those with high blood pressure, heart disease or lung disease. (more…)
Author Interviews, Diabetes, Heart Disease / 29.09.2014

MedicalResearch.com Interview with: Jorge F. Saucedo MD Allstate Foundation, Judson B. Branch Chair of Cardiology Head, Division of Cardiology Co-Director Cardiovascular Institute NorthShore University HealthSystem Clinical Professor of Medicine University of Chicago Pritzker School of Medicine Talla A. Rousan, MD Oklahoma City, OK. First author of study. Medical Research: What are the main findings of the study? Answer: It was found that patients with diabetes mellitus (DM) presenting with acute myocardial infarction (AMI) have a higher in-hospital mortality rate compared to patients without DM. Patients with insulin-requiring diabetes mellitus presenting with non-ST-segment elevation myocardial infarction had higher in-hospital mortality rate than patients with non-insulin requiring diabetes mellitus. (more…)
AHA Journals, Author Interviews, Heart Disease, Karolinski Institute / 29.09.2014

dr_iffat_rahmanMedicalResearch.com Interview Invitation with: Dr. Iffat Rahman Ph.D. Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Rahman: Our study suggests that moderate to high level of physical activity could protect against heart failure in women. (more…)
Author Interviews, Heart Disease, JACC / 29.09.2014

MedicalResearch.com Interview with: Katharina Mayer MD Deutsches Herzzentrum München, Technische Universität München, Munich, Germany Medical Research: What are the main findings of the study? Dr. Mayer: Patients whose platelets do not respond well to aspirin carry a higher risk of death or stent thrombosis. Platelet response to aspirin is an independent predictor of ischemic events in patients undergoing percutaneous coronary interventions (PCI). (more…)
Author Interviews, Heart Disease, JACC / 23.09.2014

Jerry D. Estep, M.D., FACC Assistant Professor of Medicine, Weill Cornell Medical College Medical Director, Heart Transplant & LVAD Program Methodist DeBakey Heart & Vascular Center Houston Methodist HospitalMedicalResearch.com Interview with: Jerry D. Estep, M.D., FACC Assistant Professor of Medicine, Weill Cornell Medical College Medical Director, Heart Transplant & LVAD Program Methodist DeBakey Heart & Vascular Center Houston Methodist Hospital Medical Research: What are the main findings of the study? Dr. Estep: There were two major findings: 1-Non-invasive Doppler echocardiographic and invasive measures of mean right atrial pressure (RAP) (r = 0.863; p < 0.0001), systolic pulmonary artery pressure (sPAP) (r=0.880; p<0.0001), right ventricular outflow tract stroke volume (r=0.660; p < 0.0001), and pulmonary vascular resistance (r = 0.643; p= 0.001) correlated significantly. 2-An algorithm integrating mitral inflow velocities, RAP, sPAP, and left atrial volume index was 90% accurate in distinguishing normal from elevated left ventricular filling pressures. (more…)
Author Interviews, General Medicine, Heart Disease, JACC, Karolinski Institute / 23.09.2014

Agneta Åkesson Associate professor, senior lecturer Photo by Anna Persson Nutritional Epidemiology IMM Institute of Environmental Medicine Karolinska Institutet Stockholm, SwedMedicalResearch.com Interview with Agneta Åkesson Associate professor, senior lecturer                                                  Nutritional Epidemiology IMM Institute of Environmental Medicine Karolinska Institutet Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Åkesson: Our study indicates that a healthy diet together with low-risk lifestyle practices such as being physically active, not smoking and having a moderate alcohol consumption, and with the absence of abdominal adiposity may prevent the vast majority of myocardial infarctions in men. (more…)
Author Interviews, General Medicine, Heart Disease, JAMA / 20.09.2014

MedicalResearch.com Interview  Dongyi (Tony) Du, MD, PhD Division of Epidemiology FDA/CDRH/OSB Medical Research: What are the main findings of the study? Dr. Du: The risk for death on the date of surgery was 60% higher for recipients of mechanical aortic valves than recipients of bioprosthetic aortic valves (OR, 1.61 [95%CI, 1.27-2.04; P < .001]; risk ratio [RR], 1.60). The risk difference decreased to 16% during the 30 days after the date of surgery (OR, 1.18 [95%CI, 1.09-1.28; P < .001]; RR, 1.16). The risk for operative mortality was 19% higher for recipients of mechanical compared with bioprosthetic valves (OR, 1.21 [95%CI, 1.13-1.30; P < .001]; RR, 1.19). The number needed to treat with mechanical valves to observe 1 additional death on the surgery date was 290; to observe 1 additional death within 30 days of surgery, 121. (more…)
Author Interviews, Heart Disease / 16.09.2014

Muthiah Vaduganathan, MD MPH Department of Medicine Massachusetts General Hospital Boston, MassMedicalResearch.com Interview with: Muthiah Vaduganathan, MD MPH Department of Medicine Massachusetts General Hospital Boston, Mass Medical Research: What are the main findings of the study? Dr. Vaduganathan: Based on data from a large, multinational randomized controlled trial of patients hospitalized for heart failure and reduced ejection fraction (HFrEF), we conducted a retrospective analyses of the clinical profiles associated with baseline serum uric acid levels. Serum uric acid was commonly elevated in patients hospitalized for heart failure and reduced ejection fraction (mean ~9 mg/dL), especially in men and black patients. Higher uric acid levels were associated with lower systolic blood pressure and EF, higher natriuretic peptides, and more impaired renal function. After accounting for 24 known baseline covariates, serum uric acid was independently predictive of post-discharge mortality and rehospitalization in patients with relatively preserved renal function, but not in those with poor renal function. (more…)
Heart Disease, JACC / 13.09.2014

Thomas M. Maddox, MD MSc FACC FAHA Cardiology, VA Eastern Colorado Health Care System Associate Director, VA CART Program Associate Professor, Department of Medicine, University of Colorado School of MedicineMedicalResearch.com Interview with: Thomas M. Maddox, MD MSc FACC FAHA Cardiology, VA Eastern Colorado Health Care System Associate Director, VA CART Program Associate Professor, Department of Medicine, University of Colorado School of Medicine Medical Research: What are the main findings of the study? Dr. Maddox: We were curious to know if the VA, as a provider of PCI at centers without on-site CT surgery, was providing better access to its veterans without compromising their safety.  We were pleased to find that there was evidence of better access, with patients reducing their drive time to PCI facilities by, on average, 90 minutes.  In addition, there was no compromised safety.  Rates of both peri-procedural and 1-year adverse outcomes were low and no different between centers with and without on-site CT surgery. (more…)
Diabetes, Heart Disease / 13.09.2014

Carlos F. Sánchez-Ferrer, M.D., Ph.D. Professor of Pharmacology Universidad Autónoma de Madrid, Spain.MedicalResearch.com Interview with: Carlos F. Sánchez-Ferrer, M.D., Ph.D. Professor of Pharmacology Universidad Autónoma de Madrid, Spain. Medical Research: What are the main findings of the study? Dr. Sánchez-Ferrer: We were studying the possible ways of interaction between high glucose levels, which are found in diabetes mellitus, with vascular damage, which is the most common and devastating consequence of this disease. An intriguing fact is that a very strict control of blood sugar in diabetic patients is not sufficient to avoid the development of such diabetes-induced cardiovascular diseases. We think our results can explain why this is happening. Using cultured smooth muscle cells from the main human artery (aorta) in the presence of high concentrations of extracellular glucose, we observed: 1. In the absence of inflammation, excess glucose in the culture fluid didn’t enter the cells. 2. When extra glucose was forced into the cells, no harm was done in the absence of inflammation. 3. When the inflammation-stimulating protein interleukin-1 (IL-1) was introduced, more glucose entered the cells. 4. With IL-1, the glucose entering the cells was metabolized via chemical pathways that spur escalating inflammation, overwhelming the cells’ ability to counteract it. 5. In the presence of the anti-inflammatory drug anakinra, which blocks the activity of IL-1, the deleterious changes didn’t occur. (more…)
Author Interviews, Diabetes, Diabetes Care, Heart Disease / 12.09.2014

Kristian Filion, PhD FAHA Assistant Professor of Medicine Division of Clinical Epidemiology Jewish General Hospital/McGill University Montreal, Quebec H3T 1E2 CanadaMedicalResearch.com Interview with: Kristian Filion, PhD FAHA Assistant Professor of Medicine Division of Clinical Epidemiology Jewish General Hospital/McGill University Montreal, Quebec H3T 1E2 Canada Medical Research: What are the main findings of the study? Dr. Filion: Previous studies have raised concerns that the use of incretin-based drugs, a type of medication used to treat diabetes, may increase the risk of congestive heart failure.  We therefore examined this potential drug safety issue using a large, population-based database, which allowed us to study the safety of these medications in a real world setting.  In doing so, we found that the use of incretin-based drugs was not associated with an increased risk of congestive heart failure among patients with type 2 diabetes.  Similar results were obtained among both classes of incretin-based drugs (glucagon like peptide-1 [GLP-1] analogs and dipeptidyl peptidase-4 [DPP-4] inhibitors), and no duration-response relationship was observed. (more…)
AHA Journals, Author Interviews, Heart Disease, Obstructive Sleep Apnea / 11.09.2014

MedicalResearch.com Interview with: Marcia Klein M.D., Ph.D. Adjunctive professor Rio de Janeiro State University This study was conducted at the Discipline of Clinical and Experimental Pathophysiology - Rio de Janeiro State University and the financial support of FAPERJ. Medical Research: What was the main findings of the study? Dr. Klein: The main findings were that a diet with moderate calories restriction in obese patients with obstructive sleep apnea may be able not only to reduce body fat but also to reduce obstructive sleep apnea severity and blood pressure. (more…)
Author Interviews, Heart Disease, Lancet, Statins / 11.09.2014

Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Herlev Hospital, Copenhagen University Hospital Dept. Clinical Biochemistry Herlev Ringvej 75, DK-2730 Herlev, DenmarkMedicalResearch.com Interview with: Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Herlev Hospital, Copenhagen University Hospital Dept. Clinical Biochemistry Herlev Ringvej Herlev, Denmark Medical Research: What are the main findings of the study? Dr. Nordestgaard: Among all patients with diabetes in Denmark during 1996-2009 and compared with non-statin users, statin users had a 40% lower risk of diabetic retinopathy, a 34% lower risk of diabetic neuropathy, and a 12% lower risk of gangrene of the foot, while the risk of diabetic nephropathy was similar. (more…)
Author Interviews, Heart Disease / 10.09.2014

Mintu Turakhia, MD MAS, FHRS FACC FAHA Assistant Professor of Medicine and (by courtesy) of Health Research & Policy Stanford University School of Medicine Director of Cardiac Electrophysiology Core Investigator, Center for Innovation to Implementation VA Palo Alto Healthcare SystemMedicalResearch.com Interview with: Mintu Turakhia, MD MAS, FHRS FACC FAHA Assistant Professor of Medicine and (by courtesy) of Health Research & Policy Stanford University School of Medicine Director of Cardiac Electrophysiology Core Investigator, Center for Innovation to Implementation VA Palo Alto Healthcare System Medical Research: What are the main findings of the study Dr. Turakhia: We found that the reported success rate of a study correlated with the number of times the study was cited in the literature, even after adjustment for a wide range of factors. (more…)
Author Interviews, Heart Disease, JACC / 09.09.2014

MedicalResearch.com Interview with: Laura A. Graham, MPH Center for Surgical, Medical Acute Care Research, and Transitions Birmingham Veterans Affairs Medical Center Section of Gastrointestinal Surgery, Department of Surgery University of Alabama at Birmingham, Birmingham Medical Research: What are the main findings of the study? Answer: The main findings of the study are that the recommendations made in the guidelines published by the American College of Cardiology / American Heart Association in 2007 were effective at reducing postoperative major adverse cardiac events following noncardiac surgery in patients with a cardiac stent.1  These guidelines recommended the delay of noncardiac surgeries in patients with a drug-eluting stent for 365 days if the surgery was not emergent or the delay of surgery for 4 to 6 weeks among patients with a bare metal stent.1  In addition to a 26% reduction in postoperative major adverse cardiac events, we also found an increase in the time between drug-eluting stent placement and non-cardiac surgery consistent with the guideline recommendations. (more…)
Author Interviews, Gender Differences, Heart Disease / 04.09.2014

Sumeet S. Chugh MD Pauline and Harold Price Endowed Professor Associate Director, the Heart Institute Section Chief, Clinical Cardiac Electrophysiology Cedars-Sinai Medical Center, Los Angeles, CAMedicalResearch.com Interview with: Sumeet S. Chugh MD Pauline and Harold Price Endowed Professor Associate Director, the Heart Institute Section Chief, Clinical Cardiac Electrophysiology Cedars-Sinai Medical Center, Los Angeles, CA Medical Research: What are the main findings of the study? Dr. Chugh: Our study, conducted in the community, showed that there are unique alterations in sex hormone levels identified among patients who have sudden cardiac arrest. Male victims have lower testosterone and both males and females have higher estrogren levels. (more…)
Author Interviews, BMJ, Heart Disease, Metabolic Syndrome / 04.09.2014

Dr Weiguo Zhang, MD PhD Cardiovascular and Neurological Institute 6771 San Fernando, Irving, TX 75039, USAMedicalResearch.com Interview with: Dr Weiguo Zhang, MD PhD Cardiovascular and Neurological Institute 6771 San Fernando, Irving, TX 75039, USA

Medical Research: What are the main findings of the study?

Prof. Zhang: Higher heart rate has emerged as a cardiovascular risk factor and is associated with higher mortality rate. However the mechanistic link between heart rate and mortality outcome in population has been missing. The main findings of the present study in a relatively large population are two-fold: Firstly, there is a strong and positive association between resting heart rate and metabolic syndrome, which is defined when an adult has 3 of the following: obesity (waist circumference ≥90 cm for men or ≥80 for women); hypertriglyceridemia (triglycerides ≥1.7 mmol/L); low plasma level of high-density lipoprotein <1.03 mmol/L for men or <1.30 mmol/L for women); hypertension (systolic blood pressure/ diastolic blood pressure≥130/85 mmHg or current use of antihypertensive medications); hyperglycemia (fast blood glucose ≥5.6 mmol/L or previously diagnosed type 2 diabetes or current use of hypoglycaemic agents or insulin). Secondly and more importantly, those without metabolic syndrome but with higher resting heart rate will have greater risk in developing metabolic syndrome in the near future. As such, the findings from both cross-sectional and longitudinal studies provide evidence that resting heart rate is an independent risk factor for existing metabolic syndrome and a powerful predictor for its future incidence. (more…)

Author Interviews, Heart Disease, JACC / 04.09.2014

Martin Huth Ruwald, MD, PhD Post doctoral research fellow Heart Research Follow-up Program University of Rochester Medical Center Rochester, NY, USMedicalResearch.com Interview with: Martin Huth Ruwald, MD, PhD Post doctoral research fellow Heart Research Follow-up Program University of Rochester Medical Center Rochester, NY, US Medical Research: What are the main findings of the study? Dr. Ruwald: A high percentage of biventricular pacing is required for optimal outcome in patients treated with cardiac resynchronization therapy (CRT), but the influence of ectopic beats on the success of biventricular pacing has not been well established. We found that patients with increasing amount of ectopic beats (the ectopic burden) (≥0.1%) were more likely to achieve low biventricular pacing <97% and had higher risk of heart failure or death and ventricular arrhythmias. Similarly the study identified patients with a very low amount of ectopic beats, less than 1 in 1000, who are very likely to obtain high biventricular pacing and who have very low risk of adverse outcomes. (more…)
Author Interviews, Heart Disease / 03.09.2014

Jean-Philippe Couderc, PhD, MBA Associate Professor of Medicine Research Associate professor of Electrical and Computer Engineering University of Rochester, NY Heart Research Follow-Up Program - Cardiology Department Rochester, New-York 14642MedicalResearch.com: Interview with: Jean-Philippe Couderc, PhD, MBA Associate Professor of Medicine Research Associate professor of Electrical and Computer Engineering University of Rochester, NY Heart Research Follow-Up Program - Cardiology Department Rochester, New-York 14642 Medical Research: What are the main findings of the study? Dr. Couderc: We have developed a unique technology which enables any individual to evaluate if he/she suffers from atrial fibrillation (AF) by using a simple video camera (webcam). There are approximately 3.2 million people with AF in the US, and estimated 30 million people in the world. It has been shown that around 30% of people suffering from AF are not aware of their disease, this form is called 'silent' atrial fibrillation.  AF is a progressive disease leading to stroke and heart failure.  It results in significant morbidity and mortality. The total cost of AF in the US is estimated to $7billion and 75% of this cost is associated with patient hospitalization. (more…)
Author Interviews, Heart Disease, NEJM / 01.09.2014

Gilles Montalescot M.D., Ph.D. Professor of Cardiology University of Paris VI; Director, Cardiac Care Unit Institute of Cardiology, Pitié-Salpêtrière University Hospital Paris, FranceMedicalResearch.com Interview with: Gilles Montalescot M.D., Ph.D. Professor of Cardiology University of Paris VI; Director, Cardiac Care Unit Institute of Cardiology, Pitié-Salpêtrière University Hospital Paris, France Medical Research: What are the main findings of the study? Dr. Montalescot : Among the 1862 patients with ongoing STEMI who were enrolled in the ATLANTIC study, we found no difference between those randomized to pre-hospital (in-ambulance) ticagrelor 180 mg and those randomized to in-hospital (in-catheterization laboratory) ticagrelor 180 mg in terms of either pre-PCI ST-segment elevation resolution (≥70%) or pre-PCI TIMI 3 flow in the culprit artery, which were the co-primary endpoints. There was also no difference between the groups in terms of major adverse cardiovascular events at 30 days, with the exception that rates of definite stent thrombosis were lower in the pre-hospital ticagrelor group than in the in-hospital group, both in the first 24 hours (0% versus 0.8%, p= 0.008) and at 30 days (0.2% versus 1.2%, p = 0.02). The safety of pre-hospital ticagrelor did not appear to be an issue, since the incidence of non-CABG-related major bleeding was low and similar in both treatment groups, whichever bleeding definition was used (PLATO, TIMI, STEEPLE, GUSTO, ISTH or BARC). (more…)
Author Interviews, Heart Disease, JAMA / 31.08.2014

Massimo Imazio. MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital and University of Torino Torino, ItaliaMedicalResearch.com Interview with: Massimo Imazio on behalf of the COPPS-2 Investigators Massimo Imazio. MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital and University of Torino Torino, Italia Medical Research: What is the background for this investigation? Dr. Imazio: Post-pericardiotomy syndrome, post-operative atrial fibrillation (AF), and post-operative effusions may be responsible for increased morbidity and healthcare costs after cardiac surgery. Postoperative use of colchicine prevented these complications in a single trial (the COPPS trial published on EHJ in 2010). Here all events occurred within 3 months and colchicine was given after cardiac surgery starting from postoperative day 3 for 1 month. However most postoperative AF events are reported in the first 3 days and thus pre-treatment with colchicine may give better outcomes. Thus we performed the COPPS-2 giving colchicine 48 to 72 hours before surgery for 1 month without a loading dose and weight adjusted doses (i.e. 0.5 mg twice daily for patients >70kg or 0.5 mg once for patients <70Kg) in order to improve patients compliance.The Colchicine for Prevention of the Post-pericardiotomy Syndrome and post-operative atrial fibrillation (COPPS-2 trial) is an investigator-initiated, double-blind, placebo-controlled, randomized clinical trial. A total of 360 consecutive candidates for cardiac surgery, 180 for each arm, were enrolled in 11 Italian centers between March 2012 and March 2014. Main exclusion criteria were absence of sinus rhythm at enrollment, cardiac transplantation, and contraindications to . (more…)
Author Interviews, Heart Disease, NEJM / 30.08.2014

MedicalResearch.com Interview with: John J.V. McMurray, M.D Professor of Medical Cardiology British Heart Foundation, Cardiovascular Research Centre University of Glasgow, Glasgow, United Kingdom MedicalResearch.com Interview with: John J.V. McMurray, M.D Professor of Medical Cardiology British Heart Foundation, Cardiovascular Research Centre University of Glasgow, Glasgow, United Kingdom Medical Research: What are the main findings of the study? Dr. McMurray: That compared to an evidence-based dose of an evidence-based ACE inhibitor (enalapril 10 mg bid), LCZ696 reduced the primary composite outcome of cardiovascular death or heart failure hospitalization by 20%, both the components of that composite and all-cause mortality (the latter by 16%) - all reductions are highly statistically significant and clinically important. LCZ696 treated patients also reported fewer symptoms and physical limitations due to heart failure. We think this is a remarkable finding - to beat what has been the gold-standard, cornerstone, therapy for around 25 years. The findings show conclusively that adding neprilysin inhibition to renin-angiotensin system blockade is superior to renin-angiotensin system blockade alone in patients with heart failure and reduced ejection fraction . (more…)
Aging, Author Interviews, BMJ, Heart Disease / 28.08.2014

MedicalResearch.com Interview with: Philip Haycock, PhD Post-Doctoral Research Assistant MRC Integrative Epidemiology Unit University of Bristol Bristol, BS8 2BN, UK Medical Research: What are the main findings of the study? Dr. Haycock: We found that shorter telomeres were significantly associated with risk of coronary heart disease and that the association was independent of conventional vascular risk factors, including age, sex, body mass index, smoking, history of diabetes, blood pressure and lipid markers. (more…)
Author Interviews, Diabetes, Diabetes Care, Heart Disease, Pharmacology / 27.08.2014

Dr. Frank B. Hu Department of Nutrition Harvard School of Public Health Boston, MAMedicalResearch.com Interview with: Dr. Frank B. Hu Department of Nutrition Harvard School of Public Health Boston, MA Medical Research: What are the main findings of the study? Dr. Hu: in this study among approximately 5000 patients with type 2 diabetes followed for up to 10 years, longer duration of sulfonylurea therapy was associated with a higher risk of coronary heart disease. The continuous sulfonylurea therapy for 10 years was associated with almost two times greater risk of coronary heart disease compared with nonusers. However, given the observational nature of the study, we cannot make causal inference from these findings. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA / 27.08.2014

Prof Richard McManus MA PhD FRCGP NIHR School for Primary Care Research, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire United KingdomMedicalResearch.com Interview with Prof Richard McManus MA PhD FRCGP NIHR School for Primary Care Research, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire United Kingdom Medical Research: What are the main findings of the study? Prof. McManus: The TASMIN-SR clinical trial followed 552 patients with an average age of 70 and high blood pressure with pre-existing cardiovascular disease, diabetes or chronic kidney disease. After training in how to self-monitor blood pressuring using a readily available device, patients took readings twice each morning for the first week of each month, and following an individualised management plan were able to request additional medication from their general practitioner without the need for consultation. At the end of the study, patients who self-managed had significantly lower blood pressure (by 9.2 / 3.4 mmHg) than those who were visiting their GP for blood pressure monitoring, which would be expected to lower stroke risk by around 30% if sustained. (more…)
Author Interviews, Heart Disease, JACC, JAMA / 26.08.2014

MedicalResearch.com Interview with: Dr. Peter Godsk Jørgensen Copenhagen City Heart Study Frederiksberg Hospital, Frederiksberg, Denmark Medical Research: What are the main findings of your study? Dr. Jørgensen: In the coming decades, a larger and larger proportion of the population will be aged 65 years or above. At present, no risk prediction models have been developed specifically for estimation of risk in this population. ECG changes are easily recognized and identify subclinical signs of end-organ disease. Our data reveal that not only are ECG changes a very frequent finding that independently predicts cardiovascular disease, they significantly improve risk prediction when added to the most used European and US risk models. Thus, our data demonstrate that adding ECG changes will correctly reclassify more than one third of the persons aged 65 years and above without cardiovascular disease. (more…)
Author Interviews, General Medicine, Heart Disease, JAMA / 26.08.2014

Steven M. Bradley, MD, MPH Veterans Affairs Eastern Colorado Health CareSystem Denver, ColoradoMedicalResearch.com Interview with Steven M. Bradley, MD, MPH Veterans Affairs, Eastern Colorado Health CareSystem Denver, Colorado Medical Research: What are the main findings of the study? Dr. Bradley: In 539 hospitals participating in the CathPCI Registry that performed elective coronary angiography on more than 500,000 patients, 22% of patients were asymptomatic at the time of coronary angiography. We observed marked variation in the hospital rate of angiography performed in asymptomatic patients, ranging from 0.2% to 66.5%, suggesting broad variation in the quality of patient selection for coronary angiography across hospitals.  Additionally, hospitals with higher rates of asymptomatic patients at diagnostic angiography also had higher rates of inappropriate PCI, due to greater use of PCI in asymptomatic patients. These findings suggest that patient selection for diagnostic angiography is associated with the quality of patient selection for PCI as determined by Appropriate Use Criteria. By addressing patient selection upstream of the catheterization laboratory, we may improve on the optimal use of both angiography and PCI. (more…)
Author Interviews, Heart Disease, JAMA / 26.08.2014

Michael B. Rothberg, MD, MPH Department of Internal Medicine Medicine Institute, Vice Chair for Research Cleveland Clinic, Cleveland, OhioMedicalResearch Interview with: Michael B. Rothberg, MD, MPH Department of Internal Medicine Medicine Institute, Vice Chair for Research Cleveland Clinic, Cleveland, Ohio Medical Research: What are the main findings of the study? Dr. Rothberg: In this randomized study we found that when people are presented with no information about the benefits of elective PCI, most assumed that it would prevent a heart attack. Unfortunately, this is incorrect, so people may choose to have the procedure based on false information.  We also found that simply telling them that PCI would not prevent a heart attack successfully dispelled this belief for most,  but not all, participants.  Explaining why PCI does not prevent heart attacks in this circumstance was the most effective way to change people's beliefs.  We also found that most people were willing to take medications, but when they were told that PCI does not prevent heart attacks, they were more likely to agree to medication. (more…)