Author Interviews, Heart Disease, Hospital Readmissions, JACC, Outcomes & Safety / 18.10.2013

Saul Blecker, MD, MHS Department of Population Health, NYU School of Medicine, New York, NY Department of Medicine, NYU School of Medicine, New York, NYMedicalResearch.com Interview with: Saul Blecker, MD, MHS Department of Population Health, NYU School of Medicine Department of Medicine, NYU School of Medicine, New York, NY   MedicalResearch.com: What are the main findings of the study? Dr. Blecker: Inpatient quality of care has focused primarily on patients with acute heart failure, commonly identified by principal discharge diagnosis code. However, patients with heart failure are commonly hospitalized for other causes and should benefit from many of the same treatments. We found that in our sample, as compared to patients with a principal diagnosis of heart failure, heart failure patients hospitalized with a non–heart failure diagnosis had lower rates of guideline-concordant care, including assessment of left ventricular function and prescription for an ACE inhibitor or ARB, at time of discharge. This is important as our study suggests that these therapies were associated with reduced mortality for patients hospitalized with heart failure, regardless of the reason for hospitalization. (more…)
Author Interviews, Cancer Research, Heart Disease, Radiology / 16.10.2013

Prof. Dr. Gunnar Brix Division of Medical and Occupational Radiation Protection Federal Office for Radiation Protection Institut für Med. Strahlenhygiene 85764 NeuherbergMedicalResearch.com: Prof. Dr. Gunnar Brix Division of Medical and Occupational Radiation Protection Federal Office for Radiation Protection Institut für Med. Strahlenhygiene 85764 Neuherberg MedicalResearch.com:  What are the main findings of the study? Answer: We investigated the cumulative radiation exposure and cancer risk of more than 1200 patients with ischemic heart diseases (IHD) from diagnostic and therapeutic imaging procedures performed 3 month before and 12 month after the date of diagnosis. The major findings were:
  • ­    87% of patient exposure resulted from heart catheter procedures.
  • ­    The average cumulative effective dose was 13.3 mSv in males and 10.3 mSv in females. The highest dose was nearly 100 mSv.
  • ­    The estimated average attributable life-time risk of male and female patients to develop a radiation-induced cancer in their remaining life was 0.09 % and  0.07 %, respectively. This correspond to 1 excess cancer in about 1100 male and 1400 female IHD patients. The highest risk was 0.9 %.
  • ­ The effective dose is inadequate to characterize individual radiation risks, since neither the age nor the sex of the patient is taken into account. According to our results, cancer risks can vary by a factor of more than 10 for comparable values of the effective dose. (more…)
Author Interviews, Exercise - Fitness, Heart Disease, Weight Research / 14.10.2013

MedicalResearch.com Interview with: Christian K. Roberts Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing University of California, Los Angeles, CA MedicalResearch.com: How would you best summarize the main findings/results of this study? Answer: Our main finding was that HDL functioned better in its antioxidant role in subjects who participated in resistance exercise training (i.e. weight training) a minimum of 4 days a week, regardless of their weight—one group was lean (BMI <25) and the other overweight/obese (BMI >27) —than those who didn’t exercise (overweight, BMI >27, and untrained). In addition, HDL had similar effectiveness as an antioxidant in the overweight-trained group as in the as lean-trained group. Although indices of weight were associated with dysfunctional HDL, differences in fitness may be a better measure of who has healthier functioning HDL. (more…)
Author Interviews, Heart Disease, Mineral Metabolism, Stroke / 14.10.2013

Abhishek Sharma, M.B.B.S. Maimonides Medical Center in Brooklyn, N.Y.MedicalResearch.com Interview with: Abhishek Sharma, M.B.B.S. Maimonides Medical Center in Brooklyn, N.Y.   MedicalResearch.com: What are the main findings of the study? Answer:  Evidence from RCT's and observational studies suggests a significantly increased risk of atrial fibrillation (AF) requiring hospitalization, but no increase in risk of stroke or cardiovascular mortality with the use of bisphosphonate. (more…)
Author Interviews, Cost of Health Care, Heart Disease / 11.10.2013

Ankur Pandya PhD Assistant Professor of Public Health in the Division of Health Policy Department of Public Health at Weill Cornell Medical CollegeMedicalResearch.com Interview with: Ankur Pandya PhD Assistant Professor of Public Health in the Division of Health Policy Department of Public Health at Weill Cornell Medical College MedicalResearch.com: What are the main findings of the study? Dr. Pandya: Our study looked at the impact of some of the future risk factors for cardiovascular disease in the United States.  Using nine National Health and Nutrition Examination Survey waves from 1973 to 2010 we forecasted disease risk and prevalence from 2015 to 2030. We found that despite continued improvements in the disease’s treatment and declining smoking rates, increasing obesity rates, the aging population, and declining mortality from the disease should cause a rise in health care costs, disability, and reductions in the quality of life associated with increased disease prevalence. (more…)
Author Interviews, Heart Disease, JAMA, Surgical Research / 09.10.2013

Dr. Mary T Hawn MD Center for Surgical, Medical Acute Care Research and Transitions (C-SMART), Birmingham Veterans Administration Hospital, Birmingham, Alabama Section of Gastrointestinal Surgery, Department of Surgery University of Alabama at BirminghamMedicalResearch.com Interview with Dr. Mary T Hawn MD Center for Surgical, Medical Acute Care Research and Transitions (C-SMART), Birmingham Veterans Administration Hospital, Birmingham, Alabama Section of Gastrointestinal Surgery, Department of Surgery University of Alabama at Birmingham MedicalResearch.com: What are the main findings of the study? Dr. Hawn: The risk of adverse perioperative cardiac events is elevated in patients with recent coronary stenting, but the risk does not differ by stent type and stabilizes for surgery more than 6 months following stenting. (more…)
Cancer Research, Heart Disease, MD Anderson, Ovarian Cancer / 08.10.2013

Anil K. Sood MD Department of Gynecologic Oncology The University of Texas MD Anderson Cancer Center Unit 1362, PO Box 301439, Houston, TX, 77030MedicalResearch.com Interview with: Anil K. Sood MD Department of Gynecologic Oncology The University of Texas MD Anderson Cancer Center Unit 1362, PO Box 301439, Houston, TX, 77030 MedicalResearch.com: What are the main findings of the study? Dr. Sood: For women with newly diagnosed ovarian cancer, high heart rate at diagnosis (tachycardia), venous thromboembolism (VTE) occurring after diagnosis and pulmonary hypertension post-diagnosis are independently related to reduced survival after controlling for tumor stage, grade, and extent of cytoreduction.  Women with tachycardia lived an average of 4.0 years after diagnosis compared with 5.9 years for women without tachycardia, a 32% reduction in duration of survival.  Patients who experienced VTE lived a median 4.1 years after diagnosis, compared with 6.4 yrs for patients who did not experience VTE. (more…)
Author Interviews, Heart Disease, JAMA / 03.10.2013

Mads Wissenberg, MD Department of Cardiology Gentofte Hospital, University of Copenhagen Niels Andersens Vej 65 2900 Hellerup, Denmark Post 635MedicalResearch.com Interview with: Mads Wissenberg, MD Department of Cardiology Gentofte Hospital, University of Copenhagen Niels Andersens Vej 65 2900 Hellerup, Denmark Post 635 MedicalResearch.com: What are the main findings of the study? Answer: Our main findings from this nationwide study are that during a 10-year period where several national initiatives were taken to increase bystander CPR and improve advanced care, bystander CPR increased more than a two-fold from 21 % in 2001 to 45% in 2010. In the same period survival on arrival at the hospital increased more than a two-fold from 8% in 2001 to 22% in 2010, and 30-day survival more than a three-fold from 3.5% in 2001 to 11% in 2010. (more…)
Author Interviews, Heart Disease, Medical Imaging / 30.09.2013

Dr. Afshin Farzaneh-Far, M.D. University of Illinois at ChicagoMedicalResearch.com Interview with: Dr. Afshin Farzaneh-Far, M.D. University of Illinois at Chicago MedicalResearch.com: What are the main findings of the study? Answer: Traditionally SPECT MPI has been performed with adenosine which has a significant body of published prognostic data. Regadenoson is a selective A2A receptor agonist and is now the stress agent most widely used in the United States. Unlike adenosine, regadenoson is given as a bolus rather than as an infusion, simplifying the testing protocol and is better-tolerated. However, despite increasing use of regadenoson, there is very limited data on risk prediction using this agent. This study showed that the ability of SPECT MPI to predict heart attacks and death is the same for the new stress agent Regadenoson as it is for the old agent Adenosine. (more…)
Author Interviews, Case Western, Exercise - Fitness, Heart Disease, UT Southwestern / 25.09.2013

Dr. Satyam Sarma MD Assistant Instructor, Cardiology University of Texas, Southwestern Medical Center Inst. for Exercise and Environmental Medicine 7232 Greenville Ave. Dallas TX 75231MedicalResearch.com Interview with: Dr. Satyam Sarma MD Assistant Instructor, Cardiology University of Texas, Southwestern Medical Center Inst. for Exercise and Environmental Medicine 7232 Greenville Ave. Dallas TX 75231 MedicalResearch.com: What are the main findings of the study? Dr. Sarma: The main findings of our study were that as we age or live a sedentary lifestyle, fat tends to accumulate in the muscle of the heart. The accumulation of myocardial lipids were linked to abnormalities in diastolic function. With increasing levels of fat, the left ventricle became less distensible and had impaired tissue relaxation. (more…)
Heart Disease / 24.09.2013

MedicalResearch.com Interview with: Mackram Eleid, MD Division of Cardiovascular Diseases and Internal Medicine MedicalResearch.com: What are the main findings of the study? Dr. Eleid: Our study investigated the characteristics, outcomes and impact of aortic valve replacement in a large series of 1704 patients with severe aortic stenosis (aortic valve area < 1 cm2) and preserved ejection fraction (EF > 50%) according to the flow-gradient classification that incorporates both stroke volume index and mean aortic valve gradient.  The primary findings were that patients with low flow, low gradient AS have lower survival than other flow-gradient patterns (a 3.2-fold increase risk of mortality compared to normal flow, low gradient), and their survival is improved with aortic valve replacement.  Conversely, patients with normal flow and low gradient had a favorable survival with medical management, suggesting a less advanced stage of disease compared to the other groups.  Additionally, a novel observation from this study is that patients with low flow had a higher prevalence of atrial fibrillation and previous heart failure events compared to other groups. (more…)
Author Interviews, Environmental Risks, Heart Disease / 22.09.2013

MedicalResearch.com Interview with: Dr Anoop Shah MBChB Cardiology Research fellow Centre of Cardiovascular sciences Chancellors Building University Of Edinburgh Little France Edinburgh MedicalResearch.com: What are the main findings of the study? Answer: Many studies have shown the effect of air pollution on cardiac mortality and myocardial infarction. Less studies have shown a similar effect on patients with heart failure. We therefore systemically reviewed and pooled data across 12 countries involving over 4 million patients with heart failure. We showed that air pollution has a close temporal association with either being hospitalized or dying from heart failure. Most of the effects of air pollution on patients with heart failure were acute. Most of the data that we analyzed came from developed countries across Europe and the USA. There was a  significant paucity of data from rapidly urbanizing nations such as India and China. (more…)
Author Interviews, Baylor College of Medicine Houston, CMAJ, Heart Disease, JAMA / 16.09.2013

Faisal G. Bakaeen, MD FACS Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, TexasMedicalResearch.com Interview with: Faisal G. Bakaeen, MD FACS Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TexasThe Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas Department of Cardiovascular Surgery, The Texas Heart Institute at St. Luke’s Episcopal Hospital, Houston, Texas   MedicalResearch.com: What are the main findings of the study? Dr. Bakaeen:  The relative use of off-pump CABG peaked at 24% in 2003, followed by a slow decline after that to about 19%. In addition, the conversion rate from off- to on-pump decreased with time and has stayed below 3.5% in recent years. Perioperative mortality rates decreased over time for both on- and off-pump CABG and have stayed below 2% since 2006. The mortality associated with converted cases was high regardless of the surgery year. (more…)
Author Interviews, Heart Disease / 15.09.2013

MedicalResearch.com Interview with: Elisa Ebrille, MD Department of Cardiology, School of Medicine Fiorenzo Gaita, M.D. Director Division of Cardiology Department of Medical Sciences University of Turin, Turin, Italy MedicalResearch.com What are the main findings of the study? Answer: We evaluated 33 patients with long-standing atrial fibrillation and valvular heart disease who underwent valve surgery and concomitant cryoablation (pulmonary veins isolation, mitral isthmus and roof line lesions) from 2000 to 2002. The surgically created ablation lesion was validated with electroanatomic mapping. Percutaneous radiofrequency ablation was performed in cases with lesion incompleteness and these patients were followed for over 10 years.
  • A hybrid approach, combining surgical ablation procedure consisting of pulmonary veins isolation and creation of left atrial linear lesions (mitral isthmus and roof lines), along with endocardial ablation, when necessary, led to a significant clinical improvement in patients with long-standing atrial fibrillation and valvular heart disease during a long-term follow-up (> 10 years).
  • With the hybrid approach, pulmonary veins isolation and transmural left atrial linear lesions were obtained in a high percentage of patients (79%). When achieved and electrophysiologically demonstrated, the complete ablation scheme was effective in more than 80% of patients in maintaining sinus rhythm throughout follow-up. (more…)
Author Interviews, Heart Disease, Stroke / 13.09.2013

Dr. Eung Y. Kim Department of Radiology, Research Institute of Radiological Science, Department of Neurology, and Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, Korea;MedicalResearch.com Interview with: Dr. Eung Y. Kim Department of Radiology Gachon University Medical Center Incheon, South Korea.   MedicalResearch.com: What are the main findings of the study? Answer: The extent of calcification involving intracranial artery significantly correlates with that of coronary artery in patients with ischemic stroke. The Agatston score measured in the intracranial arteries may be an independent predictor of asymptomatic coronary artery disease in patients with ischemic stroke. (more…)
Author Interviews, Heart Disease / 12.09.2013

MedicalResearch.com Interview with: Dr. Evgeny Pokushalov, MD, PhD State Research Institute of Circulation Pathology, Rechkunovskaya 15, 630055 Novosibirsk 55, Russia MedicalResearch.com: What are the main findings of the study? Dr. Pokushalov: The main finding of this study is that after the failure of the first catheter ablation procedure for PAF, a redo ablation was more effective at eradicating recurrent AF than treatment with AAD. In this randomized controlled clinical trial, we observed that: 1. The AF progression rate was considerably higher in patients randomized to AAD (79%) use compared with patients treated with a second ablation procedure (25%). 2. The AF burden significantly increased on AAD during followup compared with patients of reablation group (18.8±11.4% versus 5.6±9.5%, respectively). 3. There was a much greater rate of progression to persistent AF if AAD was used rather than redo ablation (23% versus 4%, respectively). These findings support the need for consideration of a timely intervention in patients with PAF who have responded inadequately to an initial PVI. (more…)
Author Interviews, Exercise - Fitness, Heart Disease / 11.09.2013

Madelein Hoogwegt, MSc Promovenda Center of Research on Psychology in Somatic diseases (CoRPS) Department of Medical and Clinical Psychology Kamer P711 Tilburg University 5000 LE TilburgMedicalResearch.com Interview with: Madelein Hoogwegt, MSc Promovenda Center of Research on Psychology in Somatic diseases (CoRPS) Department of Medical and Clinical Psychology Kamer P711 Tilburg University 5000 LE Tilburg MedicalResearch.com: What are the main findings of the study? Answer: The main finding was that we found a significant relation between positive affect and mortality, and that exercise explained this relationship. With respect to the second outcome, hospitalization, we found a significant relation between positive affect and hospitalization, a significant relation between positive affect and hospitalization, but exercise did not mediate this relationship. (more…)
Author Interviews, Heart Disease, Pediatrics / 11.09.2013

David R. Fulton, M.D. Associate Cardiologist-in-Chief for Administration Tommy Kaplan Chair in Cardiovascular Studies Chief, Cardiology Outpatient Services Department of Cardiology Children's Hospital Boston Boston, MA 02115David R. Fulton, M.D. Associate Cardiologist-in-Chief for Administration Tommy Kaplan Chair in Cardiovascular Studies Chief, Cardiology Outpatient Services Department of Cardiology Children's Hospital Boston Boston, MA 02115 MedicalResearch.com:   What are the main findings of this study? Dr. Fulton: The main findings of this study demonstrated that using a quality improvement methodology (SCAMPs), a diverse population of children and adolescents with chest pain could be managed  with relative uniformity and cost effectiveness in a multi-center collaborative.  Only 2 patients of the 1016 children who formed the basis for this review were shown to have a cardiac etiology.   The clinicians were able to screen and reach a diagnostic conclusion in a  large segment of this population using history, physical examination and ECG. (more…)
Author Interviews, Heart Disease, JAMA, Nutrition / 10.09.2013

MedicalResearch.com Interview with: Shanshan Li, MD, MSc, ScD Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts On behalf of Drs. Chuive, Flint, Pai, Forman, Hu, Willett, Mukamal and Rimm. MedicalResearch.com: What are the main findings of the study? Answer: In our prospective study of diet quality among MI survivors, we found that a higher diet quality post-MI, measured by Alternative Healthy Eating Index 2010, was associated with 24% lower death rate and 26% lower death rate from cardiovascular disease. Greater improvement of diet quality from pre- to post-MI was associated with 30% lower death rate and 40% lower cardiovascular disease death rate. In addition to reducing the bad fats intake, for example, saturated and transfat intake, MI patients also tended to reduce the good healthy polyunsaturated fats. (more…)
Author Interviews, Heart Disease / 07.09.2013

MedicalResearch.com Interview with: Jonathan Hsu, MD, MAS Cardiac Electrophysiology, Division of Cardiology University of California, San Diego (UCSD) MedicalResearch.com: What are the main findings of the study? Dr. Hsu: We found that the prevalence of cardiac perforation during modern day ICD implantation is 0.14%. We also found that specific patient and implanter characteristics predict cardiac perforation risk: older age, female sex, left bundle branch block, worsened heart failure class, higher left ventricular ejection fraction, and non-single chamber ICD implant are associated with a greater odds of perforation, whereas atrial fibrillation, diabetes, previous cardiac bypass surgery, and higher implanter procedural volume are associated with a lower odds of perforation. (more…)
Author Interviews, Duke, Heart Disease, Outcomes & Safety, Surgical Research / 05.09.2013

Marco D. Huesch, MBBS, Ph.D., Assistant professor at the USC Sol Price School of Public Policy Adjunct professor with Duke’s School of Medicine and Fuqua School of Business.MedicalResearch.com Interview with: Marco D. Huesch, MBBS, Ph.D. Assistant professor at the USC Sol Price School of Public Policy Adjunct professor with Duke’s School of Medicine and Fuqua School of Business. MedicalResearch.com: What are the main findings of the study? Answer: This study asked whether ‘learning by doing’ works backwards too, as ‘forgetting by not doing’. In an nutshell, the answer is ‘no’ among the Californian cardiac surgeons I examined with short breaks of around a month. (more…)
Author Interviews, Heart Disease, Weight Research / 03.09.2013

MedicalResearch.com Interview with: Dr Søren Skøtt Andersen and Dr Michelle Schmiegelow Study done in collaboration between Roskilde University Hospital and Gentofte University Hospital in Denmark. MedicalResearch.com: What are the main findings of the study? Answer: The main finding of this study of young women was that a body mass index above or equal to 25 kg/m2 in metabolically healthy women was not associated with an increased risk of cardiovascular events (myocardial infarction or ischemic stroke) within 5 years of follow-up. A BMI >= 25 kg/m2 in women with any metabolic disorder was associated with a 4-fold significant increased risk of the end-point. As increasing BMI is strongly associated with risk of developing metabolic disorders, the key message of this study is to stress the importance of preventing the development of metabolic disorders in overweight/obese women during this possible "window of opportunity". (more…)
Author Interviews, Heart Disease, NEJM / 02.09.2013

MedicalResearch.com Interview with: Massimo Imazio, MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital-ASLTO2 via Cibrario 72 10141 Torino, Italy MedicalResearch.com: What are the main findings of the study? Dr. Imazio: In a multicenter, double-blind trial, eligible adults with acute pericarditis (idiopathic/viral, post-pericardiotomy syndromes and pericarditis related to a systemic inflammatory disease) were randomly assigned to receive either colchicine (at a dose of 0.5 mg twice daily for 3 months for patients weighing >70 kg or 0.5 mg once daily for patients weighing ≤70 kg) or placebo in addition to conventional anti-inflammatory therapy with aspirin or ibuprofen. The primary study outcome was incessant or recurrent pericarditis. After a mean follow-up of 22 months (minimum 18 months) the primary outcome occurred in 20 patients (16.7%) in the colchicine group and 45 patients (37.5%) in the placebo group (relative risk reduction in the colchicine group, 0.56; 95% confidence interval, 0.30 to 0.72; number needed to treat, 4; P<0.001). (more…)
Author Interviews, Heart Disease, Infections, JACC, Yale / 31.08.2013

Behnood Bikdeli, MD Yale/YNHH Center for Outcomes Research and Evaluation One Church St, Suite 200 New Haven CT 0651MedicalResearch.com Interview with: Behnood Bikdeli, MD Yale/YNHH Center for Outcomes Research and Evaluation One Church St, Suite 200 New Haven CT 0651 MedicalResearch.com: What are the main findings of the study?
 Dr. Bikdeli: We determined the trends in hospitalizations and mortality from endocarditis among US older adults from 1999 to 2010. Endocarditis is the most serious cardiovascular infection and our study that had a very large sample, signified the high burden of endocarditis in this time period. (more…)
Author Interviews, Diabetes, Genetic Research, Heart Disease, JAMA / 28.08.2013

Lu Qi, MD, PhD, FAHA Assistant Professor of Medicine Harvard Medical School Assistant Professor of Nutrition Harvard School of Public HealthMedicalResearch.com Interview with: Lu Qi, MD, PhD, FAHA Assistant Professor of Medicine Harvard Medical School Assistant Professor of Nutrition Harvard School of Public Health

MedicalResearch.com: What are the main findings of the study? Answer: The main findings include, we for the first time identified a genetic variant predisposing to high risk of coronary heart disease in patients with type 2 diabetes, using genome-wide association (GWA) approach. More interesting, we demonstrated that the variant may affect expression of a gene involved in metabolism of amino acid glutamic acid, which has been related to insulin secretion and heart health in previous studies. (more…)
Author Interviews, Heart Disease, JAMA / 26.08.2013

Dr Pamela N Peterson MD Denver Health Medical Center, CO MedicalResearch.com Interview with: Dr Pamela N Peterson MD Denver Health Medical Center, CO   MedicalResearch.com: What are the main findings of the study? Answer: We assessed the outcomes of mortality, rehospitalization, and procedural complications among 24,169 patients in the NCDR-ICD Registry with left ventricular systolic dysfunction receiving a cardiac resynchronization device in addition to an implantable defibrillator for the primary prevention of sudden cardiac death between 2006 and 2009. After stratification by the QRS complex morphology and duration on the ECG and adjustment for measured differences in other characteristics, patients with left bundle branch block (LBBB) and QRS durations of at least 150 msec had significantly lower rates of mortality and rehospitalization at 3 years compared with patients with non-LBBB QRS morphology and/or QRS duration of 120-149 msec. Rates of mortality and readmission were generally highest in patients with non-LBBB and QRS duration of 120-149 msec. Rates of procedural complications at 30- and 90-days were similar across strata of QRS morphology and duration. (more…)
Author Interviews, Blood Pressure - Hypertension, Heart Disease / 20.08.2013

Dr. Anthony Bavry, MD MPH Interventional Cardiology Assistant Professor of Medicine University of Florida 1600 SW Archer Road Gainesville, FL 32610MedicalResearch.com Interview with Dr. Anthony Bavry, MD MPH Interventional Cardiology Assistant Professor of Medicine University of Florida 1600 SW Archer Road Gainesville, FL 32610 MedicalResearch.com: What are the main findings of the study? Dr. Bavry: Among individuals with chronic stable coronary artery disease, it is possible to define a group who are at relatively low risk for adverse cardiovascular events. MedicalResearch.com:Were any of the findings unexpected? (more…)
Author Interviews, Cost of Health Care, Heart Disease, Outcomes & Safety / 20.08.2013

Dr. Finlay McAlister Division of General Internal Medicine Patient Health Outcomes Research and Clinical Effectiveness Unit University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ont.MedicalResearch.com Interview with: Dr. Finlay McAlister Division of General Internal Medicine Patient Health Outcomes Research and Clinical Effectiveness Unit University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ont. MedicalResearch.com: What are the main findings of the study? Answer: Heart Failure carries a high risk of readmission/death in the first 30 days after hospital discharge (approximately 20%) - even in this cohort of patients with first time diagnosis of heart failure who were discharged home to the community.  Patients who do not have an outpatient physician follow-up visit in the first 30 days after discharge have poorer outcomes at 30 days, 3 months, 6 months, and 12 months.  Although outcomes are similar for patients who see an unfamiliar or a familiar physician in that first 30 days, over the longer term follow-up with a familiar physician is associated with better outcomes than follow-up with unfamiliar physician(s). (more…)
Author Interviews, Gastrointestinal Disease, Heart Disease / 20.08.2013

MedicalResearch.com Interview with: John P. Cooke MD PhD Chair, Department of Cardiovascular Sciences Director, Center for Cardiovascular Regeneration Houston Methodist Research Institute 6670 Bertner St MS: R6-414, Houston, TX 77030John P. Cooke MD PhD Chair, Department of Cardiovascular Sciences Director, Center for Cardiovascular Regeneration Houston Methodist Research Institute 6670 Bertner St MS:  R6-414, Houston, TX 77030   MedicalResearch.com: What are the main findings of the study? Answer: We discovered that the proton pump inhibitors PPIs), as a class, impair vascular relaxation.  The PPIs have this effect by suppressing the activity of a key enzyme required for cardiovascular health. The enzyme is known as DDAH (for dimethylarginine dimethylaminohydrolase).  This enzyme is critical in clearing ADMA (asymmetric dimethylarginine) from tissues and the circulation.  Because ADMA is an endogenous inhibitor of nitric oxide synthase, accumulation of ADMA impairs vascular relaxation and vascular homeostasis.   Previously, we and others have found that, by inhibiting endothelium-derived nitric oxide, ADMA accelerates vascular disease in preclinical models.  In humans, ADMA is linked to the severity of vascular disease, and is an independent risk factor for major adverse cardiovascular events (MACE).  Thus, the effect of PPIs to inhibit DDAH would be anticipated to impair cardiovascular health, and to increase the risk of MACE. (more…)
Author Interviews, Heart Disease / 18.08.2013

MedicalResearch.com: Orly Vardeny, PharmD, MS Associate Professor of Pharmacy and Medicine University of Wisconsin-Madison MedicalResearch.com What are the main findings of the study? Answer: We performed a post-hoc analysis of the RALES study to assess rates of hyperkalemia and hypokalemia among African American (AA) and non-AA study participants, and examined clinical outcomes by race. We found that AA had less overall increases in potassium compared to non-AA, and exhibited less hyperkalemia with spironolactone. AA subjects were also found to have higher rates of hypokalemia, even among those randomized to spironolactone. Moreover, AA participants appeared to derive less clinical benefit from spironolactone. While non-AA demonstrated reduced risk for death and the combined endpoint of death or heart failure hospitalizations when randomized to spironolactone, African Americans did not derive benefit, and the risk of these outcomes were not different between spironolactone and placebo among AA. (more…)