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.
Author Interviews, Heart Disease, Lancet, Statins / 11.09.2014

MedicalResearch.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.
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.
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.
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.
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.

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.
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.
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).
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 .
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 .
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.
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.
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.
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.
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.
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.
Author Interviews, General Medicine, Heart Disease, JACC, Vitamin D / 25.08.2014

MedicalResearch.com Interview with Esther Ooi & 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, Denmark Medical Research: What are the main findings of the study? Answer: Our findings suggest that low 25(OH)D levels observationally is simply a marker for elevated atherogenic lipoproteins, and thus question a role for vitamin D supplementation in the prevention of cardiovascular disease.
Author Interviews, Heart Disease, Stem Cells / 21.08.2014

Antonis Hatzopoulos, PhD, FAHA Associate Professor of Medicine- Division of Cardiovascular Medicine Associate Professor of Cell & Developmental Biology Vanderbilt Center for Stem Cell Biology Vanderbilt University Nashville, TN 37232-6300MedicalResearch.com Interview with: Antonis Hatzopoulos, PhD, FAHA Associate Professor of Medicine- Division of Cardiovascular Medicine Associate Professor of Cell & Developmental Biology Vanderbilt Center for Stem Cell Biology Vanderbilt University Nashville, TN 37232-6300 Medical Research: What are the main findings of the study? Dr. Hatzopoulos: Using cell tracking in the normal adult mouse heart, we found that endothelial cells can function as cardiac stem cells to generate new heart muscle.  Our results show that besides heart muscle, endothelial cells produce quiescent and proliferating cardiac progenitor cells that reside in the media and adventitia layers of the coronary arteries, respectively.
AHA Journals, Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease, Stanford / 21.08.2014

Marco Perez, MD Instructor in Cardiovascular Medicine Director, Inherited Cardiac Arrhythmia Clinic Stanford University Medical Center Cardiac Electrophysiology & Arrhythmia Service Stanford, CA 94305-5233MedicalResearch.com Interview with Marco Perez, MD Instructor in Cardiovascular Medicine Director, Inherited Cardiac Arrhythmia Clinic Stanford University Medical Center Cardiac Electrophysiology & Arrhythmia Service Stanford, CA 94305-5233 Medical Research: What are the main findings of the study? Dr. Perez: It was already known that obesity is an important risk factor for atrial fibrillation.  We studied over 80,000 postmenopausal women enrolled in the Women’s Health Initiative who were followed for the onset of atrial fibrillation, an irregular heart rhythm associated with stroke and death.  We found that those who exercised more than 9 MET-hours/week (equivalent to a brisk walk of 30 minutes six days a week) were 10% less likely to get atrial fibrillation than those who were sedentary.  Importantly, the more obese the women were, the more they benefited from the exercise in terms of atrial fibrillation risk reduction.
Author Interviews, Heart Disease, JACC / 20.08.2014

Gregg C. Fonarow, MD, FACC, FAHA Eliot Corday Professor of Cardiovascular Medicine and Science Director, Ahmanson-UCLA Cardiomyopathy Center Co-Chief of Clinical Cardiology, UCLA Division of Cardiology Co-Director, UCLA Preventative Cardiology Program David Geffen School of Medicine at UCLA Los Angeles, CA, 90095-1679MedicalResearch.com Interview with: Gregg C. Fonarow, MD, FACC, FAHA Eliot Corday Professor of Cardiovascular Medicine and Science Director, Ahmanson-UCLA Cardiomyopathy Center Co-Chief of Clinical Cardiology, UCLA Division of Cardiology Co-Director, UCLA Preventative Cardiology Program David Geffen School of Medicine at UCLA Los Angeles, CA, 90095-1679 Medical Research: What are the main findings of the study? Dr. Fonarow: Drawing on data from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF), 15,177 heart failure patients were followed over two years to measure the benefits of implantable device therapy on survival in community practice settings. The study demonstrated that ICD device therapy reduced the likelihood of death during the two-year period by 36 percent, with no significant differences by race or ethnicity. The study also demonstrated a 45 percent reduction in mortality during the two-year period with CRT therapy, again without any significant differences device benefit by race or ethnicity.
Author Interviews, Diabetes, Diabetologia, Heart Disease, Lipids / 19.08.2014

MedicalResearch.com Interview with: Prof. Michael d’Emden Endocrine Research Unit Royal Brisbane Hospital, Brisbane, Australia Medical Research: What are the main findings of the study? Prof. d’Emden: Our study is the largest trial of women having type 2 diabetes assessing the role of a fibric acid derivative, in this case fenofibrate, ever conducted.  There were 3657 female subjects randomized to placebo or fenofibrate.  The study demonstrated greater reductions in women of total cholesterol, triglycerides and LDL-cholesterol and greater increases in HDL-cholesterol.  In women, fenofibrate decreased total cardiovascular end-points by 30% compared with only 13% in men, although there was no-treatment-by-sex interaction.  The majority of end points assessed revealed a consistent trend to increased benefit being seen in women.
AHA Journals, Author Interviews, Heart Disease / 18.08.2014

MedicalResearch.com Interview with: Sylvie S.L. Leung Yinko, RD MSc Epidemiology '14 Division of Clinical Epidemiology Research Institute of McGill University Health Centre (RI MUHC) Montreal (QC) H3A 1A1 Medical Research: What are the main findings of the study? Answer: Our study indicates that young female patients with premature acute coronary syndrome (ACS) have lower health-related quality of life (HRQL) than their male counterparts. Whereas “sex” refers to whether an individual is biologically male or female, “gender” is a more complex term that refers to social norms, roles, and expectations that are traditionally ascribed to males and females in a society. We found that gender, rather than sex, may larger explain the differences in health-related quality of life between men and women. Particularly, higher femininity score, lower social support and greater housework responsibilities appear to be important gender-related factors linked with poorer HRQL post-ACS.
AHA Journals, Author Interviews, Heart Disease / 16.08.2014

Ryan T. Borne MD University of Colorado Anschutz Medical Campus Division of Cardiology Aurora, CO 80045MedicalResearch.com Interview with: Ryan T. Borne MD University of Colorado Anschutz Medical Campus Division of Cardiology Aurora, CO 80045 Medical Research: What are the main findings of the study? Dr. Borne: Using the NCDR ICD Registry, we identified Medicare beneficiaries aged 65 years and older with low left ventricular ejection fraction (≤ 35%) who underwent primary prevention implantable cardioverter defibrillator implantation, including those receiving cardiac resynchronization therapy with defibrillator, between 2006 and 2010 who could be matched to Medicare claims. We found that while there were modest changes in the patient characteristics undergoing ICD implantation, there were significant improvements over time in mid-term outcomes including 6-month mortality, re-hospitalization, and device-related complications.
AHA Journals, Author Interviews, Heart Disease, UT Southwestern / 13.08.2014

MedicalResearch.com Interview with: Hurst M. Hall, MD and Sandeep Das, MD, MPH Division of Cardiology University of Texas Southwestern Medical Center Dallas, TX Medical Research: What are the main findings of the study? Answer: Most patients treated for a heart attack in the United States during this study period were discharged home on 325 mg of aspirin a day.  This was true even among subgroups expected to be at high bleeding risk. In addition, there was tremendous variability in the proportional use of this higher dose aspirin across hospitals, suggesting a prominent local influence on prescribing patterns.
Author Interviews, Heart Disease, JAMA / 13.08.2014

Dr. Juhani Airaksinen, MD, PhD Heart Center, Turku University Hospital Turku, FinlandMedicalResearch.com Interview with: Dr. Juhani Airaksinen, MD, PhD Heart Center, Turku University Hospital Turku, Finland Medical Research: What are the main findings of the study? Dr. Airaksinen:  The main result of our study is that the risk of thromboembolic complications in general was low (0.7%). However the risk rose to a 3.7-fold level when the delay to cardioversion exceeded 12 hours. The time-dependent increase in the risk of thromboembolic complications was more pronounced in female patients. In addition, as expected, old age, heart failure and diabetes were the other significant predictors of postcardioversion thromboembolic complications.
AHA Journals, Author Interviews, Heart Disease / 13.08.2014

Susan Cheng MD Cardiovascular Division, Brigham and Women's Hospital Boston, MA 02115MedicalResearch.com Interview with: Susan Cheng MD Cardiovascular Division, Brigham and Women's Hospital Boston, MA 02115   Medical Research: What are the main findings of the study? Dr. Cheng: We've known for some time that smoking, high cholesterol, high blood pressure, diabetes, and obesity all contribute to a person’s risk of being at risk for heart disease. The goal of our study was to look back over the last two decades and see how we've been doing in reducing the impact of these major cardiovascular risk factors on the actual risk for developing heart and vascular disease. We found that, not surprisingly, we've been doing generally better over time at lowering the overall impact of some risk factors such as smoking and high cholesterol. On the other hand, the impact of hypertension and diabetes has been high and has remained high over time.
Author Interviews, Heart Disease / 13.08.2014

Professeur Philippe Gabriel Steg Département de Cardiologie Hôpital Bichat, Assistance Publique - Hôpitaux de Paris Université Paris-Diderot, Sorbonne Paris Cité, Paris, FranceMedicalResearch.com Interview with: Professeur Philippe Gabriel Steg Département de Cardiologie Hôpital Bichat, Assistance Publique - Hôpitaux de Paris Université Paris-Diderot, Sorbonne Paris Cité, Paris, France Medical Research: What are the main findings of this study? Prof. Philippe Steg:
  • Due to increasing use of angiography and revascularization, as well as improved drug therapy, the prevalence of angina and ischemia has diminished.
  • Most of the events (Cardiovascular death or Myocardial Infarction) occur in patients without angina or ischemia. This is very novel and important and stresses the importance of proper secondary prevention over "testing". We cannot be reassured by having a negative test for angina and ischemia.
  • Additionally, angina appears associated with a consistently greater risk than ischemia alone (having both is worse), so we need to pay attention to angina as a dire prognostic marker.
  • Findings should be no different in the US.
  • Most studies of silent ischemia antedate the advent of modern effective therapies or used very liberal definitions for "silent ischemia". (see our discussion)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity / 10.08.2014

MedicalResearch.com Interview with: Sahil Khera, MD and Dhaval Kolte, MD, PhD Department of Medicine, Division of Cardiology New York Medical College, NY Medical Research: What are the main findings of the study? Answer: We used the publicly available Nationwide Inpatient Sample (NIS) databases for our study. We analyzed data on 6.5 million patients with heart attack (all types) from 2002 to 2011 in United States. Out of these 3.98 million were admitted with a diagnosis of non-ST elevation myocardial infarction (NSTEMI). Our objective was to describe how the care for patients with NSTEMI has changed over the past 10 years and whether this has resulted in better patient outcomes. We looked at the proportion of patients with NSTEMI who underwent cardiac catheterization each year. We also studied how many patients died in the hospital, how long was the hospital stay, and what was the total cost of hospitalization for this condition. Lastly, we determined if the changes in treatment and outcomes over the years were similar for different age- groups, men and women, and for different racial/ethnic groups. In this analysis, we looked at cardiac catheterization trends after NSTEMI for both within 24 hours and within 48 hours. This is the first study of its kind to analyze two different time frames of early catheterization simultaneously. Although there was an increase in the proportion of patients with NSTEMI with increase in utilization of early cardiac catheterization and decrease in in-hospital death and length of stay, age-, sex-, and race/ethnicity-specific differences in the management and outcomes of NSTEMI were observed, and further studies are needed to develop strategies to ensure more equitable care for patients with this type of heart attack.
AHA Journals, Author Interviews, Biomarkers, Heart Disease / 08.08.2014

MedicalResearch.com Interview with: Rakesh K. Mishra, MD San Francisco Veterans Affairs Medical Center San Francisco, CA 94121. Medical Research: What are the main findings of the study? Dr. Mishra: Increased levels of both BNP and NT-proBNP are associated with elevated risk of adverse cardiovascular events in patients with stable coronary artery disease. However, when added to existing clinical models of risk, NT-proBNP is superior to BNP for risk reclassification.