Heart Disease

28 Aug

Posted at 19:26h in Annals Internal Medicine, Author Interviews, Cognitive Issues, Heart Disease, Stroke
MedicalResearch.com Interview with: [caption id="attachment_51044" align="alignleft" width="133"]Gwen Windham, MD MHS Professor of Medicine Memory Impairment & Neurodegenerative Dementia (MIND) Center University of Mississippi Medical Center Dr. Windham[/caption] Gwen Windham, MD MHS Professor of Medicine Memory Impairment & Neurodegenerative Dementia (MIND) Center University of Mississippi Medical Center MedicalResearch.com: What is the background for this study? Response: Silent infarctions are a primary cause of strokes in the brain, but they are also common in people without a history of a stroke. Infarctions are generally only reported if they are larger (at least 3mm) and are ignored clinically if they are smaller (less than 3mm). We examined 20 years of cognitive decline among stroke free, middle-aged people with and without smaller, and larger infarctions. The comparison groups included participants as follows: those with (1) no infarctions, the reference group; (2) only smaller infarctions; (3) only larger infarctions 4) both smaller and larger infarctions

22 Aug

Posted at 11:25h in AHA Journals, Author Interviews, Brigham & Women's - Harvard, Heart Disease, Nutrition, Vegetarians
MedicalResearch.com Interview with: [caption id="attachment_51018" align="alignleft" width="173"]Megu Baden, MD, PhD Department of Nutrition Harvard T. H. Chan School of Public Health Boston, MA02115 Dr. Baden[/caption] Megu Baden, MD, PhD Department of Nutrition Harvard T. H. Chan School of Public Health Boston, MA02115  MedicalResearch.com: What is the background for this study? Would you give an example of healthful vs non-healthful plantbased diet? Response: Plant-based diets are recommended for health and recently also for their environmental benefits. However, most previous studies defined it as either vegetarian or non-vegetarian, and importantly, without differentiation for the quality of plant foods. As you know, not all plant foods are equally good to our health. Therefore, to capture the quality of plant-based diets, we established overall, healthful and unhealthful plant-based diet indices. A higher score on the overall plant based diet index indicates greater intake of all types of plant foods and less of animal foods. A higher score on the healthful plant based diet index indicates greater intake of only healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, tea/coffee), and less of less healthy plant foods (fruit juices, refined grains, potatoes, sugar-sweetened beverages, sweets/desserts) and animal foods. A higher score on the unhealthful plant based diet index indicates greater intake of only less healthy plant foods, and less of healthy plant foods and animal foods. In this study, we used these plant-based diet indices and investigated the associations between 12-year changes in plant-based diet quality and subsequent total and cause-specific mortality in two large US cohorts.

21 Aug

Posted at 17:44h in Author Interviews, Global Health, Heart Disease, Mental Health Research
MedicalResearch.com Interview with: Lasse Brandt, M.D. and Jonathan Henssler, M.D. Charité University Medicine Berlin, Germany MedicalResearch.com: What is the background for this study? Response: Migration has increased globally and the effect of migration on health is highly relevant for clinicians, particularly in mental health. There is no increase in the risk for nonaffective psychosis in the home countries of migrants, so environmental factors could be of key importance. Refugees are often subjected to inhuman conditions. While migration has repeatedly been identified and confirmed as a risk factor for psychosis, the impact of refugee experience on this risk of psychosis was unclear. 

14 Aug

Posted at 15:21h in Author Interviews, Blood Pressure - Hypertension, Duke, Heart Disease, JAMA, Race/Ethnic Diversity
MedicalResearch.com Interview with: [caption id="attachment_50729" align="alignleft" width="200"]Yuichiro Yano MD Assistant Professor in Family Medicine and Community Health Duke University  Dr. Yano[/caption] Yuichiro Yano MD Assistant Professor in Family Medicine and Community Health Duke University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: African Americans are disproportionally affected by hypertension-related cardiovascular disease compared with other racial/ethnic groups in the United States and have higher blood pressure levels inside and outside the clinic than whites and Asians. However, little is known, among African Americans, regarding whether higher mean blood pressure measured outside of the clinic setting on 24-hour ambulatory blood pressure monitoring is associated with an increased risk for cardiovascular disease events, independent of blood pressure measured in the clinic setting.

14 Aug

Posted at 15:19h in Author Interviews, Heart Disease, JAMA, Pediatrics
MedicalResearch.com Interview with: [caption id="attachment_50819" align="alignleft" width="177"]Dr Juan Pablo Kaski MD(Res) FRCP FESC Director of the GOSH Centre for Inherited Cardiovascular Diseases Great Ormond Street Hospital, University College London Institute of Cardiovascular Science, London, UK Dr. Kaski[/caption] Dr Juan Pablo Kaski MD(Res) FRCP FESC Director of the GOSH Centre for Inherited Cardiovascular Diseases Great Ormond Street Hospital, University College London Institute of Cardiovascular Science, London, UK  MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Hypertrophic Cardiomyopathy?  Response: Hypertrophic cardiomyopathy (HCM) is a genetic condition characterised by abnormal thickening of the muscle of the heart and can affect people of all ages. It is associated with an increased risk of sudden cardiac death (SCD) and, in the last few years, a clinical risk tool that estimates the 5-year risk of SCD in adults with HCM has been developed. However, there are no similar risk models in children, where risk stratification has traditionally been based on clinical risk factors extrapolated from the adult population. We have recently shown that this approach does not discriminate risk well in children, and so the aim of this study was to develop a new risk tool to provide an individualised risk of SCD in children with HCM. 

13 Aug

Posted at 16:52h in Author Interviews, Heart Disease, Nature, Nutrition
MedicalResearch.com Interview with: apple-flavenoidsNicola Bondonno PhD National Health and Medical Research Council Early Career Research Fellow School of Medical and Health Sciences Edith Cowan University Joondalup  Perth WA   MedicalResearch.com: What is the background for this study? Response: In an aging society, there could be a huge importance in appropriate evidence-based diets to reduce mortality risk. Therefore, our main question was ‘do diets high in flavonoids reduce the risk of all-cause and cause-specific mortality and is this relationship affected by lifestyle risk factors for early mortality’? In brief, this is the largest study of flavonoid intake and mortality outcomes to date. This population based cohort study was conducted in 56,048 men and women of the Danish Diet, Cancer, and Health Cohort, followed for 23 years, with estimated intakes of 219 individual flavonoid compounds. The results provide a clarity not seen in previous smaller, often underpowered studies. 

12 Aug

Posted at 19:30h in Author Interviews, Heart Disease, Pharmaceutical Companies, Stem Cells, Technology
MedicalResearch.com Interview with: [caption id="attachment_50687" align="alignleft" width="125"]Misti Ushio, Ph.D. Chief Executive Office Dr. Ushio[/caption] Misti Ushio, Ph.D. Chief Executive Officer [caption id="attachment_50688" align="alignleft" width="125"]Michael Graziano, PhD Chief Scientific Officer TARA Biosystems Dr. Graziano[/caption] Michael Graziano, PhD Chief Scientific Officer TARA Biosystem MedicalResearch.com: What is the background for this study? Response: Almost half of all drug recalls are due to cardiac toxicity that was not picked up during early screens. These human cardiac liabilities can go undetected because historically it has been challenging to predict how human hearts will respond to potentially cardiotoxic drugs despite rigorous testing in both animals and in vitro systems throughout drug development. Traditional in vitro systems and animal models do not translate well to humans, and human donor tissue availability is limited for in vitro testing. There is great potential for human-induced pluripotent stem cell cardiomyocytes (iPSC-CMs) to bridge this human translation gap, but it’s been a challenge to train these cells to recapitulate pharmacology seen in mature human heart cells. This stems from the fact that existing experimental models utilize immature human iPSC-CMs which lack relevant physiological hallmarks of adult human cardiac muscle and therefore fail to predict drug responses seen in the clinic.

11 Aug

Posted at 20:04h in Author Interviews, Genetic Research, Heart Disease
MedicalResearch.com Interview with: Ambry GeneticsNancy Niguidula, MS, DPH Doctorate in Public Health in Toxicology Ambry Genetics   MedicalResearch.com: What is the background for this study? Response: The clinical presentations of many inherited cardiovascular conditions overlap; thus, genetic testing may clarify diagnoses, help with risk stratification, facilitate appropriate clinical management decisions, and aid in identifying asymptomatic, at-risk relatives. A large number of professional societies have developed practice guidelines and recommendations for genetic testing of cardiovascular diseases. These include international and collaborative expert panels that establish genetic screening and treatment recommendations by drawing on evidence-based medicine. To further strengthen the clinical utility of cardiovascular genetic testing, the American College of Medical Genetics and Genomics (ACMG) published a guideline for 59 genes with clinical actionability that should be reported if found on whole exome sequencing, even when unrelated to the testing indication.

11 Aug

Posted at 12:01h in Author Interviews, Circadian Rhythm, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_50660" align="alignleft" width="200"]Dr. Alan Cheng, MD MBA Vice President at Medtronic Clinical Research and Therapy Development, Cardiac Rhythm Management Medtronic, Minnesota 55112. Dr. Cheng[/caption] Dr. Alan Cheng, MD MBA Vice President at Medtronic Clinical Research and Therapy Development, Cardiac Rhythm Management Medtronic, Minnesota 55112  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Ventricular arrhythmias can be life threatening among patients with certain types of heart disease. While implantable cardioverter defibrillators (ICDs) have become the primary means in managing these events, we still don’t fully understand when ventricular arrhythmias occur and whether they are just random events that occur at any time of the day. We pooled patient-level data from 6 prospective studies of ICD recipients and leveraged the continuous monitoring features of the ICD to understand when ventricular arrhythmias occur. Across almost 4000 patients with almost 2 years average follow up from the time of implant, we saw that ventricular arrhythmias aren’t randomly distributed throughout the day. In fact, there is a predilection for these events to occur during normal waking hours as compared to the times of the day when most patients are asleep. Additionally, we found that across the year, the spring season had higher rates of arrhythmia occurrence when compared to summer. We didn’t observe any differences in arrhythmia occurrence by the days of the week or months of the year. This analysis is not the first to explore this question but it is the largest to date. 

05 Aug

Posted at 20:15h in Author Interviews, Brigham & Women's - Harvard, Heart Disease, Race/Ethnic Diversity
MedicalResearch.com Interview with: [caption id="attachment_50551" align="alignleft" width="200"]Muhammad Ali Chaudhary, MD Research Scientist | Center for Surgery and Public Health Department of Surgery | Brigham and Women’s Hospital Harvard Medical School | Harvard T. H. Chan School of Public Health Dr. Chaudhary[/caption] Muhammad Ali Chaudhary, MD Research Scientist Center for Surgery and Public Health Department of Surgery Brigham and Women’s Hospital Harvard Medical School Harvard T. H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Many studies have documented disparities in cardiovascular care for minorities, specifically African Americans compared to white patients. Coronary artery bypass grafting (CABG) is a common procedure in the United States, and the outcomes and post-surgical care for African Americans tend to be worse. We examined whether patients insured through TRICARE — a universal insurance and equal-access integrated healthcare system that covers more than 9 million active-duty members, veterans and their families — experienced these disparities. We found no racial disparities in quality-of-care outcomes, providing insights about the potential impacts of universal insurance and an equal-access health care system. The study included 8,183 TRICARE patients, aged 18-64, who had undergone CABG. The study took its data from TRICARE health care claims from the Military Health System Data Repository for the years of 2006 to 2014.

02 Aug

Posted at 21:37h in Author Interviews, Heart Disease, Lancet, Mayo Clinic, Technology
MedicalResearch.com Interview with: [caption id="attachment_50536" align="alignleft" width="166"]Paul Friedman, M.D. Professor of Medicine Norman Blane & Billie Jean Harty Chair Mayo Clinic Department of Cardiovascular Medicine Honoring Robert L. Frye, M.D. Dr. Friedman[/caption] Paul Friedman, M.D. Professor of Medicine Norman Blane & Billie Jean Harty Chair Mayo Clinic Department of Cardiovascular Medicine Honoring Robert L. Frye, M.D. MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation is an irregular heart rhythm that is often intermittent and asymptomatic.  It is estimated to affect 2.7–6.1 million people in the United States, and is associated with increased risk of stroke, heart failure and mortality. It is difficult to detect and often goes undiagnosed. After an unexplained stroke, it is important to accurately detect atrial fibrillation so that patients with it are given anticoagulation treatment to reduce the risk of recurring stroke, and other patients (who may be harmed by this treatment) are not. Currently, detection in this situation requires monitoring for weeks to years, sometimes with an implanted device, potentially leaving patients at risk of recurrent stroke as current methods do not always accurately detect atrial fibrillation, or take too long. We hypothesized that we could train a neural network to identify the subtle findings present in a standard 12-lead electrocardiogram (ECG) acquired during normal sinus rhythm that are due to structural changes associated with a history of (or impending) atrial fibrillation.   Such an AI enhanced ECG (AI ECG) would be inexpensive, widely available, noninvasive, performed in 10 seconds, and immensely useful following embolic stroke of unknown source to guide therapy. To test this hypothesis, we trained, validated, and tested a deep convolutional neural network using a large cohort of patients from the Mayo Clinic Digital Data Vault.

29 Jul

Posted at 23:40h in Author Interviews, Frailty, Geriatrics, Heart Disease
MedicalResearch.com Interview with: Dr-Dalgaard MedicalResearch.com: What is the background for this study? Response: We know that having atrial fibrillation puts you at a higher risk of falls, especially if you are elderly and frail. Additionally, some of the medications used to treat it can cause bradycardia (low heart rate), which could itself increase the risk of falls. Therefore, the aim of this study was to investigate if common medications used to treat atrial fibrillation in older patients were associated with fall-related injuries and syncope (fainting). The medications investigated were rate-lowering drugs (beta-blockers, digoxin, verapamil, diltiazem) and the anti-arrhythmic drugs (amiodarone, propafenone, and flecainide).

29 Jul

Posted at 23:04h in Annals Internal Medicine, Author Interviews, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_50478" align="alignleft" width="153"]Jeffrey L Jackson, MD, MPH Medical College of Wisconsin Milwaukee, Wisconsin Dr. Jackson[/caption] Jeffrey L Jackson, MD, MPH Medical College of Wisconsin Milwaukee, Wisconsin MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unfortunately,  most systematic reviews exclude non-English trials, mostly for convenience, but nearly all systematic reviews wind up excluding at least 1 non-English trial.  We looked at whether this was justified, since Google Translate is a free and easily usable platform.  We had native-language speakers in 9 languages (Chinese, French, German, Italian, Japanese, Korean, Romanian, Russian and Spanish) abstract data and had another researcher abstract all the articles using Google Translate. We found that there was over 90% agreement and that the few differences were due to human error, not to problems with the translations.

26 Jul

Posted at 21:44h in AHA Journals, Author Interviews, Cleveland Clinic, Exercise - Fitness, Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_50454" align="alignleft" width="159"]Dermot Phelan, MD, PhD Director of the Sports Cardiology Center Cleveland Clinic in Cleveland, Ohio Dr. Phelan[/caption] Dermot Phelan, MD, PhD Director of the Sports Cardiology Center Cleveland Clinic in Cleveland, Ohio MedicalResearch.com: What is the background for this study? Response: It is well recognized that long-term elite endurance athletes are at higher risk of atrial fibrillation.  We wished to evaluate whether this held true for primarily strength-type athletes. We had the opportunity to screen almost 500 former NFL athletes.  It became clear that we were seeing more atrial fibrillation than one would expect during the screenings.

23 Jul

Posted at 11:41h in Annals Thoracic Surgery, Author Interviews, Beth Israel Deaconess, Brigham & Women's - Harvard, Geriatrics, Heart Disease, Primary Care
MedicalResearch.com Interview with: [caption id="attachment_50354" align="alignleft" width="140"]Christina C. Wee, MD, MPH Associate Professor of Medicine Harvard Medical School Director , Obesity Research Program Division of General Medicine Beth Israel Deaconess Medical Center (BIDMC) Associate Program Director, Internal Medicine Program, BIDMC Deputy Editor of the Annals of Internal Medicine Dr. Wee[/caption] Christina C. Wee, MD, MPH Associate Professor of Medicine Harvard Medical School Director , Obesity Research Program Division of General Medicine Beth Israel Deaconess Medical Center (BIDMC) Associate Program Director, Internal Medicine Program, BIDMC Deputy Editor of the Annals of Internal Medicine MedicalResearch.com: What is the background for this study? Response: New research is showing that for many people without diagnosed heart disease, the risk of bleeding may outweigh the benefits of taking a daily aspirin particularly in adults over 70 years of age.  The American Heart Association and the American College of Cardiology recently updated their guidelines and now explicitly recommend against aspirin use among those over the age of 70 who do not have existing heart disease or stroke. Our study found that in 2017,  a quarter of adults aged 40 years or older without cardiovascular disease – approximately 29 million people – reported taking daily aspirin for prevention of heart disease. Of these, some 6.6. million people did so without a physician's recommendation.

18 Jul

Posted at 21:54h in Author Interviews, Geriatrics, Heart Disease, Lipids
MedicalResearch.com Interview with: [caption id="attachment_50316" align="alignleft" width="145"]Richard G. Bach, MD FACC Professor of Medicine Washington University School of Medicine Director, Cardiac Intensive Care Unit Director, Hypertrophic Cardiomyopathy Center Barnes-Jewish Hospital St. Louis, MO 63110 Dr. Bach[/caption] Richard G. Bach, MD FACC Professor of Medicine Washington University School of Medicine Director, Cardiac Intensive Care Unit Director, Hypertrophic Cardiomyopathy Center Barnes-Jewish Hospital St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? Response: Elderly patients represent the largest group of those hospitalized for an acute coronary syndrome, and age is an important marker of increased risk. The risk of death and recurrent cardiovascular events is greatest among the elderly. High intensity lipid lowering by statins has been shown to reduce the incidence of recurrent cardiovascular events after an acute coronary syndrome in general, but there remains limited data on efficacy and safety of that treatment in the elderly, and guidelines do not routinely advocate higher intensity treatment for patients older than 75 years. In practice, older age has been associated with a lower likelihood of being prescribed intensive lipid lowering therapy. IMPROVE-IT evaluated the effect of higher-intensity lipid lowering with ezetimibe combined with simvastatin compared with simvastatin-placebo among patients after ACS, and observed that ezetimibe added to statin therapy incrementally lowered LDL-cholesterol level and improved CV outcomes. IMPROVE-IT enrolled patients with no upper age limit, which gave us the opportunity to examine the effect of age on outcome on the benefit of more intensive lipid lowering with ezetimibe combined with simvastatin vs. simvastatin monotherapy.

18 Jul

Posted at 02:12h in Author Interviews, Heart Disease, Lipids
MedicalResearch.com Interview with: [caption id="attachment_50320" align="alignleft" width="150"]Guanmin Chen MD PhD MPH Senior Biostatistician Research Facilitation, Alberta Health Services Adjunct Research Assistant Professor University of Calgary Dr. Chen[/caption] Guanmin Chen MD PhD MPH Senior Biostatistician Research Facilitation, Alberta Health Services Adjunct Research Assistant Professor University of Calgary  Co-authors: Guanmin Chen, PhD, MD, MPH, Megan S. Farris, MSc, Tara Cowling, MA, MSc, Stephen M. Colgan, PhD, Pin Xiang, PharmD, Louisa Pericleous, PhD, Raina M. Rogoza, MSc, Ming-Hui Tai, MSc, PhD, and Todd Anderson, MD  MedicalResearch.com: What are the main findings? Response:
  • Atherosclerotic cardiovascular disease (ASCVD) remains a significant cause of morbidity and mortality in Canada (and worldwide). Despite the established benefits of treatment with statins, most Canadians fail to achieve dyslipidemia targets (a risk factor for ASCVD).
  • The objective of this study was to examine current treatment patterns of lipid-lowering therapies for the management of low-density lipoprotein cholesterol (LDL-C) in patients with ASCVD.
  • This was a retrospective cohort study conducted using province-wide administrative health data from Alberta, Canada. Datasets used included health services, pharmaceutical, and laboratory data, in addition to the Alberta population registry. The study population consisted of individuals aged 18 years or older diagnosed with ASCVD between 2011-2015, based on International Classification of Diseases (ICD) codes. The cohort was then restricted to individuals with an initial (index) LDL-C measurement after ASCVD diagnosis and at least one year of pre-index data and one year of follow-up data.

17 Jul

Posted at 22:20h in Author Interviews, Biomarkers, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_50312" align="alignleft" width="100"]Dr. Fred Apple, PhD, DABCC Medical director,Clinical Laboratories, Clinical Chemistry, Clinical and Forensic Toxicology and Point of Care Testing, Hennepin HealthCare Principal investigator, Minneapolis Medical Research Foundation Professor, Department of Laboratory Medicine and Pathology University of Minnesota Dr. Apple[/caption] Dr. Fred Apple, PhD, DABCC Medical director,Clinical Laboratories, Clinical Chemistry, Clinical and Forensic Toxicology and Point of Care Testing, Hennepin HealthCare Principal investigator, Minneapolis Medical Research Foundation Professor, Department of Laboratory Medicine and Pathology University of Minnesota  MedicalResearch.com: What is the background for this study? Response: Few studies have addressed the role of high sensitivity cardiac troponin (hs-cTn) assays in ruling out myocardial infarction (MI) based on the measurement of a single baseline specimen in US patients presenting to the emergency department with symptoms suggestive of ischemia. Most studies have been published predicated on patients in Europe, Australia, and New Zealand. As US emergency departments have different ordering practices for using cTn in triaging patients, it is important to validate the role of hs-cTn assays in US practices to assure providers of appropriate utilization. We have published two papers using the Abbott ARCHITECT hs-cTnI assay, the same one used outside the US in clinical practice (as this assay is not yet FDA cleared) in a US cohort (clinicialtrials.gov trial: UTROPIA - Sandoval Y, Smith SW, Shah ASV, Anand A, Chapman AR, Love SA, Schulz K, Cao J, Mills NL, Apple FS. Rapid rule-out of acute myocardial injury using a single high-sensitivity cardiac troponin I measurement. Clin Chem 2017;63:369-76. Sandoval Y, Smith SW, Love SA,  Sexter A, Schulz K, Apple FS. Single high-sensitivity cardiac troponin I to rule out myocardial infarction. Am J Med 2017;130:1076-1083) that have shown similar rule out capacities predicated on clinical presentation, a normal ECG and the role of hs-cTnI testing.

16 Jul

Posted at 19:29h in Annals Internal Medicine, Author Interviews, Clots - Coagulation, Heart Disease, Kidney Stones
MedicalResearch.com Interview with: [caption id="attachment_50193" align="alignleft" width="84"]Sunil Badve MBBS, MD, DNB, FRACP, PhD, FASN Senior Research Fellow, Renal & Metabolic Division Staff specialist nephrologist | St George Hospital University of New South Wales The George Institute for Global Health Australia Dr. Badve[/caption] Sunil Badve MBBS, MD, DNB, FRACP, PhD, FASN Senior Research Fellow, Renal & Metabolic Division Staff specialist nephrologist | St George Hospital University of New South Wales The George Institute for Global Health Australia MedicalResearch.com: What is the background for this study? Response: Despite the high prevalence of cardiovascular thrombotic events and venous thromboembolism (VTE) in chronic kidney disease (CKD), oral anticoagulant therapy is often underutilized in patients with advanced CKD and dialysis-dependent end-stage kidney disease (ESKD) due to uncertainty of benefit and potential bleeding complications. This comprehensive systematic review was performed to study the benefits and harms of oral anticoagulant therapy in patients with CKD.

12 Jul

Posted at 12:11h in Author Interviews, Genetic Research, Heart Disease, Imperial College, JAMA
MedicalResearch.com Interview with: [caption id="attachment_50228" align="alignleft" width="112"]Ben Cordon, PhD NIHR Post-doctoral Academic Clinical Fellow Specialist Registrar training in cardiology Dr. Cordon[/caption] Ben Cordon, PhD NIHR Post-doctoral Academic Clinical Fellow Specialist Registrar training in cardiology  [caption id="attachment_50229" align="alignleft" width="112"]James S. Ware, PhD, MRCP  Reader in Genomic Medicine Group head within the Cardiovascular Genetics & Genomics Unit Imperial College London Dr. Ware[/caption] James S. Ware, PhD, MRCP  Reader in Genomic Medicine Group head within the Cardiovascular Genetics & Genomics Unit Imperial College London     MedicalResearch.com: What is the background for this study?   Response: Non-ischaemic dilated cardiomyopathy is a common cause of heart failure and carries the risk of life-threatening ventricular arrhythmia. An implantable cardioverter defibrillator (ICD) can be life-saving in this condition. However, the decision to implant an ICD is not one that can be taken lightly - ICD insertion carries its own risks, such as infection or inappropriate shocks, and our ability to predict who will benefit from a device is currently far from perfect. Genetic sequencing is affordable and widely available and for DCM, like many diseases, it is hoped that genetic stratification may one day help deliver personalised management. In DCM, variants in the Lamin A/C gene for example are known to cause a phenotype with early and severe arrhythmias and, as a result, international guidelines advocate a lower threshold for ICD insertion in these patients. However, Lamin A/C is an infrequent cause of DCM. The commonest known genetic cause of DCM are protein-truncating variants in the gene encoding Titin (TTNtv), accounting for ~15% of DCM cases. We wanted to know if this group had a higher risk of arrhythmia than the general DCM population. Earlier work from our group on this topic found that patients with TTNtv-associated DCM were more likely to have a clinical history of arrhythmia (composite of atrial and ventricular arrhythmia, including NSVT), at the time of their initial DCM diagnosis. But it was unclear if this was driven by ventricular arrhythmia, atrial arrhythmia, or both or if it would translate into a long-term risk of potentially dangerous ventricular arrhythmia of the sort for which an ICD can be life-saving. In another study we analysed a larger cohort of ambulant DCM patients but did not find an increased risk of ventricular arrhythmia – but this was a relatively low-risk group, with comparatively mild symptoms (NHYA I/II heart failure) and moderately impaired LV function. As a result, the overall arrhythmic event rate was low, meaning that the power to detect differences between the TTNtv and non-TTNtv groups was reduced.

12 Jul

Posted at 12:07h in Author Interviews, Blood Pressure - Hypertension, Heart Disease, JAMA
MedicalResearch.com Interview with: [caption id="attachment_50160" align="alignleft" width="200"]Prof-Kazem Rahimi Prof. Rahimi[/caption] Dr Kazem Rahimi Deputy Director of the George Centre for Healthcare Innovation James Martin Senior Fellow in Essential Healthcare Honorary Consultant Cardiologist at the John Radcliffe Hospital Deputy Director of the George Institute for Global Health MedicalResearch.com: What is the background for this study? Response: In the last century, we have witnessed a dramatic change in the spectrum of valvular heart disease and the prevalence of this condition has been rapidly increasing, due to population ageing, with poor patient outcomes and high healthcare costs associated with the only effective treatment available, which is valve repair or replacement. However, modifiable risk factors for valvular heart disease remain largely unknown, which limits prevention and treatment. We used a state-of-the-art, gene-based method called Mendelian randomization to determine the causality of the association between systolic blood pressure and risk of valvular heart diseases. 

11 Jul

Posted at 11:44h in Anemia, Author Interviews, Heart Disease, JAMA, Karolinski Institute
MedicalResearch.com Interview with: [caption id="attachment_50211" align="alignleft" width="200"]Dr. Niels Grote Beverborg, MD PhD Post-doctoral research fellow Department of experimental cardiology University Medical Center Groningen, Groningen, The Netherlands Integrated CardioMetabolic Center Karolinska Institutet, Stockholm Sweden Dr. Grote Beverborg[/caption] Dr. Niels Grote Beverborg, MD PhD Post-doctoral research fellow Department of experimental cardiology University Medical Center Groningen, Groningen, The Netherlands Integrated CardioMetabolic Center Karolinska Institutet, Stockholm Sweden  MedicalResearch.com: What is the background for this study?   Response: Iron deficiency is very prevalent worldwide and a significant cause of morbidity and mortality, especially in vulnerable populations such as patients with heart failure. It is well known that iron deficiency can be a consequence of an insufficient iron uptake or increased iron loss (termed low iron storage), or of a chronic low inflammatory state (defective iron utilization). However, so far, we had no tools to distinguish these causes from each other in patients and have not been able to assess their potential consequences.

02 Jul

Posted at 15:22h in Author Interviews, Biomarkers, Geriatrics, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_50008" align="alignleft" width="149"]Martin Bødtker Mortensen, læge PhD Afdelingen for Hjertesygdomme Aarhus Universitetshospital Danmark Dr. Mortensen[/caption] Martin Bødtker Mortensen, læge PhD Afdelingen for Hjertesygdomme Aarhus Universitetshospital Danmark  MedicalResearch.com: What is the background for this study?   Response: The background for the study is a combination of two things: First, the proportion and number of elderly people 65 years of age or older are increasing fast worldwide. Second, given the dominant impact of age on estimated risk for cardiovascular disease, nearly all elderly individuals eventually become statin eligible under current guidelines – just because of aging alone. Thus, to limit overtreatment of elderly individuals, we wanted to find “negative” risk markers that can be used to identify elderly individuals at truly low cardiovascular risk who are less likely to benefit from statin therapy despite advancing age.

17 Jun

Posted at 16:16h in Author Interviews, Cost of Health Care, Heart Disease, JAMA, Medical Imaging
MedicalResearch.com Interview with: [caption id="attachment_49804" align="alignleft" width="142"]Quinn R Pack, MD Assistant Professor of Medicine at University of Massachusetts Medical School - Baystate Adjunct Assistant Professor of Medicine Tufts University School of Medicine Dr. Pack[/caption] Quinn R Pack, MD Assistant Professor of Medicine University of Massachusetts Medical School - Baystate Adjunct Assistant Professor of Medicine Tufts University School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Because echocardiograms are non-invasive, very low risk, and nearly universally available, it is easy to over-use this technique.  In myocardial infarction, echo is also recommended in guidelines. However, in our lab, we frequently find echocardiograms that are ordered purely out of routine, without any thought as to the likelihood of finding an abnormality.   Prior studies also suggested that as many as 70% of echocardiograms provide no additional diagnostic value. When spread across the approximate 600,000 patients in the United States each year, this low diagnostic yield represents an opportunity to reduce costs by reducing echocardiograms. 

16 Jun

Posted at 12:04h in Author Interviews, Heart Disease, JAMA, Surgical Research
MedicalResearch.com Interview with: [caption id="attachment_49721" align="alignleft" width="198"]Fausto Biancari, Professor of Surgery, University of Turku, Finland Professor of Cardiothoracic Surgery, University of Oulu, Finland Heart Center, T-Hospital, Hämeentie Turku, Finland Prof. Biancari[/caption] Fausto Biancari, MD, PhD Professor University of Turku and University Oulu, Finland MedicalResearch.com: What is the background for this study? Response: Current data is scarce regarding the short- and midterm benefit of transcatheter aortic valve replacement (TAVR) compared to surgical aortic valve replacement (SAVR) in low-risk patients with severe aortic valve stenosis. MedicalResearch.com: What are the main findings? Response: In this observational study on 2841 low-risk patients with aortic valve stenosis from the Finnish nationwide FinnValve registry, propensity score matching analysis showed similar 30-day and three-year survival after TAVR and SAVR.

12 Jun

Posted at 21:08h in Author Interviews, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_49654" align="alignleft" width="200"]J.L. Mehta, MD, PhD Distinguished Professor of Medicine and Physiology and Biophysics Stebbins Chair in Cardiology University of Arkansas for Medical Sciences Central Arkansas Veterans Healthcare System Little Rock, AR 72205 Dr. Mehta[/caption]

J.L. Mehta, MD, PhD

Distinguished Professor of Medicine and Physiology and Biophysics

Stebbins Chair in Cardiology

University of Arkansas for Medical Sciences

Central Arkansas Veterans Healthcare System

Little Rock, AR 72205

MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Aspirin is commonly used for primary prevention of cardiovascular disease events in a variety of subjects around the world. Recent studies, however, show that routine use of aspirin without assessment of risk for cardiovascular disease events may not be appropriate, and may even be harmful. 

11 Jun

Posted at 18:37h in Author Interviews, Clots - Coagulation, Heart Disease, JACC
MedicalResearch.com Interview with: [caption id="attachment_49698" align="alignleft" width="200"]Prof. Dr. med. Dirk Sibbing, MHBA, FESC Oberarzt, Medizinische Klinik und Poliklinik I Ludwig-Maximilians-Universität (LMU) München Chairperson ESC Working Group on Thrombosis München, Germany Prof. Sibbing[/caption] Prof. Dr. med. Dirk Sibbing, MHBA, FESC Oberarzt, Medizinische Klinik und Poliklinik I Ludwig-Maximilians-Universität (LMU) München Chairperson ESC Working Group on Thrombosis München, Germany  MedicalResearch.com: What is the background for this consensus statement? What are the main findings that led to these conclusions? Response: The availability of different P2Y12 receptor inhibitors (clopidogrel, prasugrel, ticagrelor) with varying levels of potency has enabled physicians to contemplate individualized treatment concepts. Such concepts may include escalation or de-escalation of P2Y12 inhibiting therapy. Alternative DAPT strategies may be chosen according to the clinical setting (stable coronary artery disease vs. acute coronary syndrome), the stage of the disease (early vs. chronic treatment) and patient risk for ischemic and bleeding complications. As always in clinical medicine, guidance by means of biomarkers or risk scores is always helpful and warranted. Here specifically, a tailored DAPT approach may be potentially guided by platelet function (PFT) or genetic testing.

10 Jun

Posted at 19:34h in Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Lung Cancer, Radiation Therapy
MedicalResearch.com Interview with: [caption id="attachment_49629" align="alignleft" width="200"]Raymond H Mak, MD Assistant Professor of Radiation Oncology Harvard Medical School Dr. Mak[/caption]   Raymond H Mak, MD Assistant Professor of Radiation Oncology Harvard Medical School Radiation Oncology Brigham and Women's Hospital     [caption id="attachment_49693" align="alignleft" width="200"]Dr-Katelyn M. Atkins Dr. Atkins[/caption]   Katelyn M. Atkins MD PhD Harvard Radiation Oncology Program Dana-Farber Cancer Institute Brigham and Women’s Hospital Boston, Massachusetts     MedicalResearch.com: What is the background for this study? What are the main findings? 
  • Lung cancer remains the leading cause of cancer-related death worldwide and nearly half of patients will require radiation therapy as part of their care.
  • Cardiac toxicity following radiotherapy has been well-studied in breast cancer and lymphomas, however the impact of cardiac toxicity following lung cancer radiotherapy has historically been under-appreciated due to the high risk of lung cancer death.
  • Recent studies highlighting cardiac toxicity following lung cancer radiotherapy have been limited by small numbers of patients and, to our best knowledge, have not included validated cardiac event endpoints defined by the American Heart Association (AHA)/American College of Cardiology (ACC).

07 Jun

Posted at 11:38h in Author Interviews, Cost of Health Care, Heart Disease, JAMA, University of Pennsylvania
MedicalResearch.com Interview with: [caption id="attachment_49581" align="alignleft" width="180"]Sameed Khatana, MD, MPH Fellow, Cardiovascular Medicine, Perleman School of Medicine Associate Fellow, Leonard Davis Institute of Health Economics University of Pennsylvania Dr. Khatana[/caption] Sameed Khatana, MD, MPH Fellow, Cardiovascular Medicine, Perleman School of Medicine Associate Fellow, Leonard Davis Institute of Health Economics University of Pennsylvania  MedicalResearch.com: What is the background for this study?   Response: The Affordable Care Act (ACA) led to the largest increase in Medicaid coverage since the beginning of the program. However, a number of states decided not to expand eligibility. Studies of prior smaller expansions in Medicaid, such as in individual states, have suggested evidence of improved outcomes associated with Medicaid expansion. Additionally, studies of Medicaid expansion under the ACA of certain health measures such as access to preventive care and medication adherence have suggested some improvements as well. However, there have been no large, population-level studies to examine whether Medicaid expansion under the ACA led to changes in mortality rates. Given, a high burden of cardiovascular risk factors in the uninsured, we examined whether states that had expanded Medicaid had a change in cardiovascular mortality rates after expansion, compared to states that have not expanded Medicaid.