Heart Disease

19 Nov

Posted at 20:24h in Author Interviews, Blood Pressure - Hypertension, Heart Disease, Pediatrics, USPSTF
MedicalResearch.com Interview with: [caption id="attachment_56002" align="alignleft" width="133"]Martha Kubik, Ph.D., R.N. Professor and director of the School of Nursing College of Health and Human Services at George Mason University USPSTF Task Force Member Dr. Kubik[/caption] Martha Kubik, Ph.D., R.N. Professor and director of the School of Nursing College of Health and Human Services at George Mason University USPSTF Task Force Member MedicalResearch.com: What is the background for this study? What are the main findings? Has the recommendation changed over the last decade? Response: High blood pressure is becoming more common among children and teens in the United States and can have serious negative health effects in childhood and adulthood, such as kidney and heart disease. However, there is not enough research to know whether treating high blood pressure in young people improves cardiovascular health in adulthood. The Task Force continued to find that there is not enough evidence to recommend for or against screening for high blood pressure in children and teens who do not have signs or symptoms.

17 Nov

Posted at 23:45h in AHA Journals, Author Interviews, Heart Disease, University of Michigan
MedicalResearch.com Interview with: [caption id="attachment_55974" align="alignleft" width="125"]Sara Saberi, MD, MS Assistant Professor Inherited Cardiomyopathy Program Frankel Cardiovascular Center University of Michigan Hospital Michigan Medicine Dr. Saberi[/caption] Sara Saberi, MD, MS Assistant Professor Inherited Cardiomyopathy Program Frankel Cardiovascular Center University of Michigan Hospital Michigan Medicine MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by HCM? How common is it and whom does it affect? Response: HCM is short for hypertrophic cardiomyopathy, the most common genetic myocardial disorder. It occurs in 1:500 people worldwide and because it is inherited in an autosomal dominant fashion, it affects men and women equally. HCM is characterized by unexplained left ventricular (LV) hypertrophy, hypercontractility, myofibrillar disarray and myocardial fibrosis with associated abnormalities in LV compliance and diastolic function. In some patients, there is progressive adverse cardiac remodeling, associated with chronic heart failure and atrial fibrillation as a result of diastolic dysfunction, left ventricular outflow tract (LVOT) obstruction, or less commonly, LV systolic dysfunction. Current medical management of obstructive HCM (oHCM) is limited to the use of beta blockers and non-dihydropyridine calcium channel blockers, or disopyramide, none of which have been shown to modify disease expression or outcomes after onset. Mavacamten is a first-in-class, small molecule, selective inhibitor of cardiac myosin specifically developed to target the underlying pathophysiology of HCM by reducing actin–myosin cross-bridge formation. The phase 3 EXPLORER-HCM trial showed that mavacamten improved exercise capacity, LVOT gradients, symptoms, and health status compared with placebo in patients with symptomatic oHCM. At selected study sites, participants were enrolled in a cardiac magnetic resonance (CMR) imaging substudy. CMR is the gold standard for measurement of ventricular mass, volumes and noninvasive tissue characterization, making it an ideal imaging modality to assess the effect of mavacamten on cardiac structure and function in patients with HCM.

17 Nov

Posted at 11:38h in Author Interviews, COVID -19 Coronavirus, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_55944" align="alignleft" width="200"]Benjamin D. Horne, PhD Cardiovascular and Genetic Epidemiologist Intermoumtain Health Dr. Horne[/caption] Benjamin D. Horne, PhD Cardiovascular and Genetic Epidemiologist Intermoumtain Health MedicalResearch.com: What is the background for this study? Response: The Intermountain Mortality Risk Score (IMRS) is a risk prediction tool developed in 2009 and repeatedly validated over the last decade to predict death, major adverse health events such as heart attack and stroke, and the onset of major chronic diseases. IMRS is computed using sex-specific weightings of parameters from the complete blood count (CBC) and basic metabolic profile (BMP), and age. The CBC and BMP are commonly-ordered clinical laboratory panels that include hemoglobin, white blood cell count, glucose, creatinine, sodium, calcium, and other factors whose testing is standardized and the results are objective and quantitative with no need to know what diagnoses a patient may have. IMRS is known to be a superior predictor of death compared to comorbidity-based risk scores and has been found to predict health outcomes in people with no chronic disease diagnoses as well as patients with coronary heart disease, atrial fibrillation, heart failure, chronic obstructive pulmonary disease, chronic kidney disease, and various other diagnoses. IMRS has not been evaluated as a predictor of health outcomes for people with COVID-19, but if it does it could be useful for people to use to evaluate their own risk of poor outcomes if they are infected with SARS-CoV-2, for clinical personnel to guide the care of patients with COVID-19, and for public health professionals to use to determine who among those never diagnosed with COVID-19 is at higher risk of poor health outcomes and should be the first to receive a COVID-19 immunization. 

17 Nov

Posted at 11:34h in Author Interviews, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_55919" align="alignleft" width="200"]Simon Winther, MD, PhD Associate professor Department of Cardiology, Gødstrup Hospital Herning, Denmark Dr. Winther[/caption] Simon Winther, MD, PhD Associate professor Department of Cardiology, Gødstrup Hospital Herning, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Both European and American guidelines have traditionally recommended estimating the pre-test probability (PTP) of CAD based on the classic Diamond-Forrester approach using sex, age, and type of chest complaints. However, The European Society of Cardiology (ESC) has recently suggested a novel concept of Clinical Likelihood of CAD as a more comprehensive assessment of CAD probability but no strategy has been proposed. I this study, we improve the estimation of the likelihood of obstructive coronary artery disease (CAD) by combining the classic pre-test probability model (Diamond–Forrester approach using sex, age, and symptoms) with clinical risk factors and coronary artery calcium score in symptomatic patients with suspected CAD. Hence, we propose a simple clinical tool for the individual estimation of clinical likelihood of CAD. The tool was developed by stepwise simplification of advanced machine learning models without significant loss of accuracy and the model were validated the both European and North American cohorts. 

11 Nov

Posted at 12:28h in Aging, Author Interviews, Geriatrics, Heart Disease, Lancet, Lipids
MedicalResearch.com Interview with: [caption id="attachment_55907" align="alignleft" width="128"]Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry Herlev and Gentofte Hospital Copenhagen University Hospital Herlev, Denmark Dr. Nordestgaard[/caption] Børge G. Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Dept. Clinical Biochemistry Herlev and Gentofte Hospital Copenhagen University Hospital Herlev, Denmark  MedicalResearch.com: What is the background for this study? Response: Previous studies have yielded mixed results regarding the association between elevated cholesterol levels and increased risk of atherosclerotic cardiovascular disease in individuals above age 70 years; with some studies showing no association and others only minimal association. However, these previous studies were based on cohorts recruiting individuals decades ago where life-expectancy were shorter and where treatment of comorbidities were very different from today

30 Oct

Posted at 18:30h in AHA Journals, Author Interviews, Heart Disease, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_55798" align="alignleft" width="160"]Stavros G. Drakos, MD, PhD, FACC Professor of Cardiology Univ. of Utah Healthcare & Medical School and the Salt Lake VA Medical Center. Dr. Drakos is Medical Director of the University's Cardiac Mechanical Support/Artificial Heart Program Co-Director Heart Failure & Transplant and Director of Research for the Division of Cardiology Dr. Drakos[/caption] Stavros G. Drakos, MD, PhD, FACC Professor of Cardiology Univ. of Utah Healthcare & Medical School and the Salt Lake VA Medical Center. Dr. Drakos is Medical Director of the University's Cardiac Mechanical Support/Artificial Heart Program Co-Director Heart Failure & Transplant and Director of Research for the Division of Cardiology MedicalResearch.com: What is the background for this study? Response: Heart transplantation and LVADs are first line therapies for advanced chronic heart failure. There were some earlier anecdotal observations and single center small studies from several programs in the US and overseas that left ventricular assist devices (LVADs) significantly reduce the strain on failing hearts and in some cases, using LVADs for limited periods of time has allowed hearts to “rest” and remodel their damaged structures. As a result of these repairs, described as “reverse remodeling,” heart function can improve to the point that the LVAD can be removed. The new study sought to broaden the reach of the research with a multicenter trial involving physicians and scientists at the University of Utah Health, the University of Louisville, University of Pennsylvania, the Albert Einstein College of Medicine/Montefiore Medical Center, the Cleveland Clinic, and the University of Nebraska Medical Center. 

27 Oct

Posted at 19:25h in Author Interviews, Heart Disease, JACC, Omega-3 Fatty Acids
MedicalResearch.com Interview with: [caption id="attachment_55755" align="alignleft" width="149"]Antoni Bayes-Genis, MD, PhD, FESC, FHFA Head, Heart Institute. Hospital Universitari Germans Trias i Pujol Full Professor, Autonomous University Barcelona Dr. Bayes-Genis[/caption] Antoni Bayes-Genis, MD, PhD, FESC, FHFA Head, Heart Institute. Hospital Universitari Germans Trias i Pujol Full Professor, Autonomous University Barcelona MedicalResearch.com: What is the background for this study? What are the main findings? Response: Omega-3 fatty acids are incorporated into the phospholipids of cellular membranes, including cardiac contractile cells, and have a wide range of demonstrated physiological effects. Several potential mechanisms have been investigated, including antiarrhythmic, anti-inflammatory, and endothelial. Omega-3 fatty acids lower heart rate and improve heart rate variability, both associated with lower sudden cardiac death risk, one of the complications that may occur after a myocardial infarction. Increased omega-3 fatty acids also enhance arterial elasticity by increasing endothelium-derived vasodilators, which is associated with blood pressure–lowering effects. They also have a cardioprotective effect on platelet-monocyte aggregation, and lower triglyceride levels.

27 Oct

Posted at 19:06h in Author Interviews, Cognitive Issues, Emory, Exercise - Fitness, Heart Disease
MedicalResearch.com Interview with: Henry Mahncke, PhD Chief Executive Officer Posit Science https://www.brainhq.com/?v4=true&fr=yDr. Mahncke earned his PhD at UCSF in the lab where lifelong brain plasticity was discovered. At the request of his academic mentor, he currently leads a global team of more than 400 brain scientists engaged in designing, testing, refining, and validating the computerized brain exercises found in the BrainHQ app from Posit Science, where he serves as CEO. MedicalResearch.com Tell us what’s important about this new study in people with heart failure? Response: Heart failure is a common condition that even when properly treated can have adverse long-term health outcomes and high medical costs. Heart failure commonly causes cognitive impairment, which can have devastating effect on patient abilities to engage in self-care, and which contributes to poor clinical outcomes, increased rehospitalizations, and higher mortality rates. What makes these results exciting is that the Emory University researchers discovered that a simple intervention – a fairly modest amount of walking and brain exercise – not only significantly improved a standard measure of cognition, but also significantly improved multiple measures that drive better health outcomes and lower costs. [caption id="attachment_55753" align="alignleft" width="165"]Dr-Henry Mahncke Dr. Mahncke[/caption] MedicalResearch.com: What is heart failure? Response: Heart failure – sometimes called congestive heart failure or congestive cardiac failure – is when the heart cannot pump sufficient blood flow to maintain the body’s needs. Common symptoms include excessive tiredness, shortness of breath and swelling particularly in legs. It’s treated with a combination of lifestyle changes, drugs, and devices. An estimated 6.5 million Americans are diagnosed with heart failure, with 960,000 new cases each year, leading some to describe it as reaching epidemic proportions. In older adults, it’s the most common cause of hospital readmissions within 30 days of discharge and among the most costly areas of Medicare expenditures.

26 Oct

Posted at 19:20h in Author Interviews, Brigham & Women's - Harvard, Heart Disease, JAMA, Lifestyle & Health, Nutrition
MedicalResearch.com Interview with: [caption id="attachment_55740" align="alignleft" width="113"]Samia Mora, MD MHS Associate Professor, Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA 02215 @SamiaMoraMD Dr. Mora[/caption] Samia Mora, MD MHS Associate Professor, Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA 02215 @SamiaMoraMD MedicalResearch.com: What is the background for this study? Response: Couples, both married couples and domestic partners, are likely to share similar environmental exposures, adopt similar behavior patterns, and have similar characteristics. However, the degree to which couples share similar levels of cardiovascular (CV) risk factors and behaviors is uncertain. If high levels of poor CV risk factor measures and behaviors are common in both members of a couple, programs that target improvement of these risk factors and behaviors may simultaneously benefit CV health in both members of the couple.

20 Oct

Posted at 15:59h in Author Interviews, COVID -19 Coronavirus, Heart Disease, Vaccine Studies
MedicalResearch.com Interview with: [caption id="attachment_55685" align="alignleft" width="174"]Douglas L. Kriner, PhD The Clinton Rossiter Professor in American Institutions Department of Government Cornell University Dr. Kriner[/caption] Douglas L. Kriner, PhD The Clinton Rossiter Professor in American Institutions Department of Government Cornell University MedicalResearch.com: What is the background for this study? Response: When a safe and effective vaccine for COVID-19 reaches the market, the world will not change overnight.  Rather, government and public health individuals will have to develop a comprehensive plan to distribute the vaccine and to convince potentially wary Americans to take it. Our study examined the influence of both specific vaccine characteristics and the politics surrounding it on public willingness to vaccinate.  Both matter in important ways.  For example, efficacy is unsurprisingly a major driver of public opinion; Americans are more willing to take a vaccine that is more efficacious.

19 Oct

Posted at 19:40h in Author Interviews, Baylor College of Medicine Houston, Heart Disease, Social Issues, Tobacco Research
MedicalResearch.com Interview with: [caption id="attachment_55679" align="alignleft" width="120"]Mahmoud Al Rifai MD MPH Section of Cardiology, Department of Medicine Baylor College of Medicine Houston Dr. Al Rafai[/caption] Mahmoud Al Rifai MD MPH Section of Cardiology, Department of Medicine Baylor College of Medicine Houston [caption id="attachment_55680" align="alignleft" width="150"]Salim S. Virani, MD, PhD Section of Cardiology Michael E. DeBakey Veterans Affairs Medical Center Dr. Virani[/caption] Salim S. Virani, MD, PhD Section of Cardiology Michael E. DeBakey Veterans Affairs Medical Center Section of Cardiology, Department of Medicine Baylor College of Medicine Houston    MedicalResearch.com: What is the background for this study? Response: E-cigarettes typically cost more than combustible cigarettes and there is more variability in cost due to a wide variety of flavors, e-cigarette liquid, and vaping device that are available in the market. Therefore, use of e-cigarettes may vary depending on income with potentially higher use among higher income individuals.

21 Sep

Posted at 20:00h in Author Interviews, Cost of Health Care, Emory, Heart Disease, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_55443" align="alignleft" width="200"]David H. Howard, PhD Professor, Health Policy and Management Rollins School of Public Health Emory University, Atlanta, Georgia Dr. Howard[/caption] David H. Howard, PhD Professor, Health Policy and Management Rollins School of Public Health Emory University, Atlanta, Georgia MedicalResearch.com: What is the background for this study? Response: Application of the False Claims Act (FCA) to medically unnecessary care is controversial, both in the courts and in the Department of Justice. Although there haven’t been many FCA suits against hospitals and physicians for performing unnecessary percutaneous coronary interventions (PCIs), the suits that have occurred have been against some of the highest-volume hospitals and physicians. Some cardiologists have been sentenced to prison.

27 Aug

Posted at 22:20h in Author Interviews, Heart Disease, Lipids, PAD, Women's Heart Health
MedicalResearch.com Interview with: First Author: Dhruv Mahtta, DO, MBA Cardiovascular Disease Fellow Baylor College of Medicine Houston, TX Senior & Corresponding Author Dr. Virani Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center, Houston, TX Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Houston, TX @virani_md MedicalResearch.com: What is the background for this study? What are the main findings? What do you think accounts for the gender differences? Response: We know that women with ischemic heart disease (IHD) have lower prescription rates for statin and high-intensity statin therapy. In this study, we assessed whether the same trends hold true for women with other forms of atherosclerotic cardiovascular disease (ASCVD) i.e. women with peripheral artery disease (PAD) or ischemic cerebrovascular disease (ICVD). Maximally tolerated statin therapy is a Class-I indication in patients with clinical ASCVD which includes PAD and ICVD. We also assessed statin adherence among men and women with PAD and ICVD. Lastly, we performed exploratory analyses to assess whether statin therapy, statin intensity, and statin adherence in women with PAD and ICVD were associated with cardiovascular outcomes and/or mortality. 

25 Aug

Posted at 00:13h in Author Interviews, CDC, COVID -19 Coronavirus, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_55215" align="alignleft" width="182"]Dr-Eric Chow Dr. Eric Chow[/caption] Eric J. Chow, MD, MS, MPH Epidemic Intelligence Service Officer (completed in 2020); Influenza Division. Centers for Disease Control and Prevention  MedicalResearch.com: What is the background for this study? What are the main findings?
  • Both heart disease and influenza epidemics cause substantial morbidity and mortality every year. In some seasons, influenza virus infections alone contribute up to 810,000 hospitalizations and 61,000 deaths. There is increasing evidence that there is overlap between infections, specifically influenza, and heart disease. In our study, we sought to describe the frequency and risk factors for acute cardiac events in patients who are hospitalized with influenza.
  • In over 80,000 adults hospitalized with influenza over 8 seasons (2010-2018), almost 12% were diagnosed with acute cardiac events, with acute heart failure and acute ischemic heart disease being the most common.
  • Among patients hospitalized with influenza who experienced acute cardiac events, almost one-third were admitted to the intensive care unit and 7% died while hospitalized.
  • Our study also reaffirmed that people who are older, smoke tobacco or have underlying cardiovascular disease, diabetes and kidney disease are at increased risk for the most common acute cardiac events, acute heart failure and acute ischemic heart disease.
  • Although vaccinated persons had a lower risk of acute ischemic heart disease and acute heart failure, this study was not designed to specifically assess vaccine effectiveness.  However, this and other studies support the importance of influenza vaccines for people with underlying heart conditions. 

21 Aug

Posted at 15:42h in Author Interviews, Heart Disease, JAMA, Lipids
MedicalResearch.com Interview with: First Author Dhruv Mahtta, DO, MBA Cardiovascular Disease Fellow Baylor College of Medicine Houston, TX Senior & Corresponding Author [caption id="attachment_55170" align="alignleft" width="150"]Dr-Salim S. Virani Dr. Virani[/caption] Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development Michael E. DeBakey VA Medical Center, Houston, TX MedicalResearch.com: What is the background for this study? Response: The incidence of atherosclerotic cardiovascular disease among young patients has been on the rise. These patients with premature and extremely premature atherosclerotic cardiovascular disease experience similar rates of mortality compared to older adults. Additionally, these young patients have a greater accrued rate of life-time morbidity. Therefore, secondary prevention measures such as use of guideline concordant statin therapy and aspirin therapy are paramount in this population. 

12 Aug

Posted at 21:20h in Author Interviews, Heart Disease, JAMA, Lipids, Metabolic Syndrome, UCSF
MedicalResearch.com Interview with: [caption id="attachment_55111" align="alignleft" width="147"]Prakash Deedwania, MD, FACC,FAHA,FASH,FHFSA,FESC Professor of Medicine, UCSF School of Medicine, San Francisco Dr. Deedwania[/caption] Prakash Deedwania, MD, FACC,FAHA,FASH,FHFSA,FESC Professor of Medicine, UCSF School of Medicine, San Francisco MedicalResearch.com: What is the background for this study? What are the main findings? Response: This paper describes the findings form the FOURIER study, a very large study evaluating the efficacy of evolocumab, a PCSK9 inhibitor in patients with metabolic syndrome and preexisting atherosclerotic cardiovascular disease (ASCVD) who were already being treated with statins. In this largest study of its kind of 27,000 patients we found that 60% of patients with ASCVD had metabolic syndrome. We also found that the presence of metabolic syndrome identified a higher risk of future cardiac & coronary events in these patients despite them receiving maximum tolerated doses of statin. Furthermore, study treatment with evolocumab was efficacious in reducing the increased risk during the median follow up of nearly 3 years . Unlike treatment with statins there was no risk of new-onset diabetes with evolocumab, which was generally well tolerated. What was interesting thatpatients without metabolic syndrome had much less benefit with PCSK9 inhibition. These findings suggest that the presence of metabolic syndrome can help the clinicians identify the ASCVD patients who are most likely to benefit from treatment with PCSK9 inhibitors. This will be of great help for the cost containment of therapeutic strategy as PCSK9 inhibitors as a class are still quite expensive drugs.

07 Aug

Posted at 15:35h in Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_55053" align="alignleft" width="160"]Ty J. Gluckman, M.D., FACC Providence St Joseph Health Portland, Oregon Dr. Gluckman[/caption] Ty J. Gluckman, M.D., FACC Providence St Joseph Health Portland, Oregon MedicalResearch.com: What is the background for this study? Response: In spite of significant decreases in the incidence of coronary artery disease, an estimated 800,000 Americans are expected to be diagnosed with an acute myocardial infarction (AMI) this year.  For large numbers of these patients, substantial benefit is afforded by early diagnosis and treatment.  Accordingly, multiple campaigns have been launched over time to increase public awareness about the symptoms and signs of AMI and the need to seek immediate medical attention. The COVID-19 pandemic has profoundly changed health care delivery worldwide.  While early attention was disproportionately focused on efforts to “flatten the curve”, recent reports have revealed a disturbing finding—a substantial decrease in the hospitalization rate for AMI.  Most worrisome among potential reasons for this has been reluctance of patients with an AMI to seek medical attention out of fear that they become infected with SARS-CoV-2. To better understand the impacts associated with this, we performed a retrospective, cross-sectional study of all AMI hospitalizations in a large multistate health care system (Providence St. Joseph Health).  We sought to define changes in AMI case rates, patient demographics, cardiovascular comorbidities, treatment approaches and in-hospital outcomes during the pandemic.

05 Aug

Posted at 23:07h in Author Interviews, Endocrinology, Heart Disease, Women's Heart Health
MedicalResearch.com Interview with: [caption id="attachment_55030" align="alignleft" width="115"]Dr.  Clare Oliver-Williams PhD University of Cambridge Dr. Oliver-Williams[/caption] Dr.  Clare Oliver-Williams PhD University of Cambridge MedicalResearch.com: What is the background for this study? Response: Women with PCOS are known to be at greater risk of CVD, however the some symptoms (menstrual irregularity) of PCOS are specific to reproductive age women. This raises the question of whether CVD risk varies across by age, which was the focus of my research with colleagues at the University of Copenhagen. MedicalResearch.com: What should readers take away from your report? Response: Women with PCOS were at 19% higher CVD risk than women without CVD, however once the association was stratified by age, there was no  evidence for a higher CVD risk for women older than 50. 

28 Jul

Posted at 10:23h in Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_54971" align="alignleft" width="160"]Frank Wharam, MD, MPH Department of Population Medicine Harvard Medical School and Harvard Pilgrim Healthcare Institute Boston, MA 02215 Dr. Wharam[/caption] Frank Wharam, MD, MPH Department of Population Medicine Harvard Medical School and Harvard Pilgrim Healthcare Institute Boston, MA 02215 MedicalResearch.com: What is the background for this study? Response:  There is substantial concern that high-deductible health plans increase people’s risk of major adverse health events such as heart attack and stroke. No studies have examined this question. This study examines the effects of a transition to a high-deductible health plan on the risk of major adverse cardiovascular outcomes (myocardial infarction and stroke). The study group included individuals with risk factors for cardiovascular disease who were continuously enrolled in low-deductible (<$500) health plans during a baseline year followed by up to 4 years in high-deductible (≥$1000) plans after an employer-mandated switch. The matched control group included individuals with the same risk factors who were contemporaneously enrolled in low-deductible plans.  We examined time to first major adverse cardiovascular event, defined as myocardial infarction or stroke. 

28 Jul

Posted at 09:49h in Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA, MRI
MedicalResearch.com Interview with: [caption id="attachment_54938" align="alignleft" width="200"]Dr. Valentina Puntmann Dr. Puntmann[/caption] Assoc. Prof. Dr. Valentina Puntmann, MD, PhD, FRCP Deputy Head Goethe CVI Fellowship Programme Lead Consultant Physician, Cardiologist and Clinical Pharmacologist Institute for Experimental and Translational Cardiovascular Imaging DZHK Centre for Cardiovascular Imaging - Goethe CVI Department of Cardiology, Division of Internal Medicine University Hospital Frankfurt, Germany MedicalResearch.com: What is the background for this study? Response: Patients who recently recovered from COVID19 have been identified through the testing centre and invited to be screened for cardiac involvement with MRI. Importantly, they have not come to us because of having heart problems. In fact, none of them thought that they had had anything wrong with the heart.  They were mostly healthy, sporty and well prior to their illness. A considerable proportion had been infected while on skiing vacations.

14 Jul

Posted at 21:53h in Author Interviews, Heart Disease, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_54851" align="alignleft" width="127"]Mario Fl Gaudino MD Professor of Cardiothoracic Surgery Department of Cardiothoracic Surgery Weill Cornell Medicine  Dr. Gaudino[/caption] Mario Fl Gaudino MD Professor of Cardiothoracic Surgery Department of Cardiothoracic Surgery Weill Cornell Medicine  MedicalResearch.com: What is the background for this study? Response: The radial artery is currently used in less than 10% of CABG procedures in the US.  MedicalResearch.com: What are the main findings? Response: The JAMA paper provides convincing evidence that the use of the radial artery rather than the saphenous vein to complement the internal thoracic artery for CABG is associated with improved long-term outcomes. 

08 Jul

Posted at 23:47h in Author Interviews, Exercise - Fitness, Heart Disease
MedicalResearch.com Interview with: Prof. Emiliano Cè Department of Biomedical Sciences for Health University of Milan Via Giuseppe Colombo, 71(2nd Building) Milan, Italy MedicalResearch.com: What is the background for this study? Response: We investigated the effects of long-term passive stretch training of the lower limb on vascular function and stiffness of the arteries involved (femoral and popliteal) and uninvolved (brachial) in the stretching protocol. Thirty-nine healthy participants of both sexes were randomly assigned to bilateral, unilateral or control (i.e., no passive stretch training). Passive stretch training was performed on knee extensor, plantar flexor muscles, and posterior muscle chain, 5 times a week for 12 weeks. Before and after the training period, vascular function was measured by Doppler ultrasounds during single passive limb movement (i.e., passive knee flexion-extension) and flow-mediated dilation (i.e., brachial and popliteal arteries). Measures of central (carotid-femoral artery) and peripheral (carotid-radial artery) arterial stiffness were performed by applanation tonometry technique. The same technique was used to assess the pulse wave velocity at the carotid artery level. 

28 Jun

Posted at 15:42h in Author Interviews, Emergency Care, Heart Disease, Social Issues
MedicalResearch.com Interview with: [caption id="attachment_54728" align="alignleft" width="200"]Sriman Gaddam The University of Texas at Austin Austin, TX 78705 Sriman Gaddam[/caption] Sriman Gaddam The University of Texas at Austin Austin, TX 78705 MedicalResearch.com: What is the background for this study? Response: The quality of care that patients receive from the US healthcare system continues to be influenced by socioeconomic status (SES). Given that cardiac arrest is one of the most common causes of death in the US and that the prehospital setting has an especially high mortality for cardiac arrest, we wanted to determine if the socioeconomic disparities found in the overall US healthcare system continued into the prehospital cardiac arrest setting. MedicalResearch.com: What are the main findings? Response: We found that socioeconomic disparities were present in the prehospital cardiac arrest setting. As the SES of a patient declines, so does the patient's likelihood of achieving return of spontaneous circulation (ROSC). Between the most and least wealthy patients, there was nearly a 13% difference in the probability of achieving ROSC. However, we recognized that not all patients who achieve ROSC are equal as patients can have significantly different neurological functioning depending on the length of time spent in cardiac arrest. Consequently, this paper analyzed cardiac arrest outcomes not only through the occurrence of ROSC but also through the duration of time spent in cardiac arrest. In line with the socioeconomic disparities found in ROSC occurrence, it was found that as a patient's SES declines, the duration of time spent in cardiac arrest before ROSC is achieved increases. This indicates that patients with a low SES are both more likely to not achieve ROSC and if ROSC is achieved more likely to have neurological impairment due to longer time spent in cardiac arrest compared to patients with a high SES.

24 Jun

Posted at 23:10h in Author Interviews, COVID -19 Coronavirus, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_54655" align="alignleft" width="200"]Spyridon G. Deftereos MD PhD Section of Cardiovascular Medicine Yale University Dr. Deftereos[/caption] Spyridon G. Deftereos MD PhD Prof. of Cardiology, Medical School National and Kapodistrian University of Athens Greece MedicalResearch.com: What is the background for this study? Response: Research on COVID-19 early revealed that inflammation plays a crucial role in the pathophysiology of the disease. Therefore, we designed GRECCO-19 study in order to evaluate the effect of colchicine, a relatively safe drug with known anti-inflammatory properties, in patients hospitalized for SARS-CoV-2 infection.

20 Jun

Posted at 15:08h in Author Interviews, Heart Disease, JAMA, Opiods, Surgical Research, University of Pennsylvania
MedicalResearch.com Interview with: [caption id="attachment_54628" align="alignleft" width="150"]MedicalResearch.com Interview with: Chase Brown, MD Associate Fellow, Leonard Davis Institute of Health Economics Integrated Cardiac Surgery Resident Hospital of the University of Pennsylvania Dr. Brown[/caption] Chase Brown, MD Associate Fellow, Leonard Davis Institute of Health Economics Integrated Cardiac Surgery Resident Hospital of the University of Pennsylvania [caption id="attachment_54629" align="alignleft" width="111"]Nimesh D. Desai, MD, PhD Director, Thoracic Aortic Surgery Research Program Associate Professor of Surgery Hospital of the University of Pennsylvania Dr. Desai[/caption] Nimesh D. Desai, MD, PhD Director, Thoracic Aortic Surgery Research Program Associate Professor of Surgery Hospital of the University of Pennsylvania MedicalResearch.com: What is the background for this study? Dr. Chase Brown:  Opioid use in the United States is a public health emergency. We know that opioids prescribed after general surgery operations to patients who never received them within the year prior to their surgery are at increased risk for continuing to take opioids months later. However, this has not been studied in patients undergoing cardiac surgery, who often times have more severe post-operative pain. Our goal in this study was to determine how many patients after cardiac surgery and are opioid naive are continuing to take opioids within 90-180 days after their surgery.  

14 Jun

Posted at 21:35h in Author Interviews, Gout, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_54552" align="alignleft" width="200"]Brian LaMoreaux, M.D., M.S. Medical Director, Medical Affairs Horizon Therapeutics Dr. LaMoreaux[/caption] Brian LaMoreaux, M.D., M.S. Medical Director, Medical Affairs Horizon Therapeutics MedicalResearch.com: What is the background for this study? Response: This is an independent study by Dr. Gurkipal Singh for which Horizon provided support and funding. Heart failure is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017. Dr. Gurkirpal Singh conducted this analysis on heart failure hospitalization rates in patients with gout in the US to estimate their clinical and economic impact. Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure, but there is little nationwide data on the clinical and economic consequences of these comorbidities.

23 May

Posted at 15:28h in Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, Heart Disease, JACC, Lipids
MedicalResearch.com Interview with: [caption id="attachment_54285" align="alignleft" width="133"]Robert P. Giugliano, MD, SM Senior Investigator, TIMI Study Group Cardiovascular Medicine Brigham and Women's Hospital Professor of Medicine Harvard Medical School Boston, MA Dr. Giugliano[/caption] Robert P. Giugliano, MD, SM Senior Investigator, TIMI Study Group Cardiovascular Medicine Brigham and Women's Hospital Professor of Medicine Harvard Medical School Boston, MA  MedicalResearch.com: What is the background for this study? Response: Some prior studies had suggested that lipid lowering therapies were associated with impaired cognition.  We sought to explore this question in a prospectively designed substudy of the large FOURIER randomized, double-blind clinical trial utilizing patient self-surveys administered the end of the study to determine whether patients themselves noticed any changes in cognition over the duration of the trial. The survey tool was a shortened version of the Everyday Cognition Questionnaire (see attached) that asks patients 23 questions that assess memory and executive function (including subdomains of planning, organization, and divided attention). The questions are in the format of "Compared to the beginning of the study, has there been any change in .....", and are graded as 1=better/no change, 2=questionable/occasionally worse, 3=consistently a little worse, 4=consistently much worse.

14 May

Posted at 15:14h in Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Heart Disease, Race/Ethnic Diversity, Statins
MedicalResearch.com Interview with: [caption id="attachment_54182" align="alignleft" width="200"] Dr. Pandya[/caption] Dr. Ankur Pandya, PhD Assistant Professor of Health Decision Science Department of Health Policy and Management Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: The 2013 ACC-AHA cholesterol treatment guidelines greatly expanded statin medication eligibility for individuals between the ages of 40-75 years without known cardiovascular disease, and there was some concern that African Americans at "intermediate risk" per those guidelines could be (arguably) overtreated with statins. The 2018 ACC-AHA guidelines included coronary artery calcium assessment for individuals at intermediate cardiovascular disease risk; those with a "zero" calcium score and no other risk factors would now change the eligibility (from indicated statin to not indicated).

22 Apr

Posted at 21:26h in Author Interviews, Emergency Care, Heart Disease, JAMA, UT Southwestern
MedicalResearch.com Interview with: [caption id="attachment_53969" align="alignleft" width="200"]Rebecca Vigen, MD, MSCS Assistant Professor of Internal Medicine UT Southwestern Dr. Vigen[/caption] Rebecca Vigen, MD, MSCS Assistant Professor of Internal Medicine UT Southwestern MedicalResearch.com: What is the background for this study? Response: Emergency department overcrowding is an urgent health priority and chest pain is a common reason for emergency department visits.  We developed a new protocol that uses high sensitivity cardiac troponin testing with a risk assessment tool that guides decisions on discharge and stress testing for patients presenting with chest pain. The protocol allows us to rule out heart attacks more quickly than the protocols utilizing an older troponin assay.

12 Apr

Posted at 21:06h in Author Interviews, COVID -19 Coronavirus, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_53875" align="alignleft" width="143"]Santiago Garcia, MD FACC Interventional Cardiologist, Minneapolis Heart Institute® Researcher, Minneapolis Heart Institute Foundation® Dr. Garcia[/caption] Santiago Garcia, MD FACC Interventional Cardiologist, Minneapolis Heart Institute® Researcher, Minneapolis Heart Institute Foundation® MedicalResearch.com: What is the background for this study?  Response: We analyzed and quantified ST-segment elevation myocardial infarction (STEMI) activations for 9 high-volume (>100 primary percutaneous angioplasties per year) cardiac catheterization laboratories in the US. These centers represent different geographic areas and levels of COVID-19 exposure in the US. The data analyzed was from January 1, 2019 to March 31, 2020. Participating centers included 1-Minneapolis Heart Institute, Minneapolis, MN, 2- Beaumont Hospital Royal Oak, Royal Oak, MI, 3- The Christ Hospital, Cincinnati, OH, 4- Massachusetts General Hospital, Boston, MA, 5- UMass Memorial Medical Center, Worcester, MA, 6- Iowa Heart, Des Moines, IA, 7- Northwell Health Hospital, Manhasset, NY, 8- Prairie Cardiovascular, Springfield, IL, and 9- Swedish Medical Center, Seattle, WA.