Author Interviews, Clots - Coagulation, Duke, Genetic Research, Heart Disease, JAMA / 30.05.2019
Does Genetic Information Encourage Doctors to Switch Anticoagulation Medications?
MedicalResearch.com Interview with:
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Dr. Povsic[/caption]
Thomas J. Povsic, MD, PhD
Interventional Cardiologist
Duke Clinical Research Institute
Duke University School of Medicine
Durham, North Carolina
MedicalResearch.com: What is the background for this study?
Response: The background for this study is that it is unknown how mandatory reporting of CYP2C19 metabolizer status affects how doctors treat patients or to what degree provision of this information would affect choice of a P2Y12 inhibitor within a clinical trial.
As part of the GEMINI-ACS trial, all patients underwent CYP2C19 metabolizer testing. This trial enrolled patients with a recent acute coronary syndrome and randomized them to aspirin or a low dose of rivaroxaban. All patients were also to be treated with ticagrelor or clopidogrel, which was at the discretion of the investigator. Investigators were given information regarding the CYP2C19 metabolizer status about a week after randomization. Importantly prior to randomization, all investigators were asked how they expected to use this information, and then we followed what they actually did.
Dr. Povsic[/caption]
Thomas J. Povsic, MD, PhD
Interventional Cardiologist
Duke Clinical Research Institute
Duke University School of Medicine
Durham, North Carolina
MedicalResearch.com: What is the background for this study?
Response: The background for this study is that it is unknown how mandatory reporting of CYP2C19 metabolizer status affects how doctors treat patients or to what degree provision of this information would affect choice of a P2Y12 inhibitor within a clinical trial.
As part of the GEMINI-ACS trial, all patients underwent CYP2C19 metabolizer testing. This trial enrolled patients with a recent acute coronary syndrome and randomized them to aspirin or a low dose of rivaroxaban. All patients were also to be treated with ticagrelor or clopidogrel, which was at the discretion of the investigator. Investigators were given information regarding the CYP2C19 metabolizer status about a week after randomization. Importantly prior to randomization, all investigators were asked how they expected to use this information, and then we followed what they actually did.


Dr. Zhong[/caption]
Victor Wenze Zhong, Ph.D.
Postdoctoral fellow
Department of Preventive Medicine
Feinberg School of Medicine
Northwestern University
Chicago, IL 60611
MedicalResearch.com: What is the background for this study?
Response: Dietary cholesterol is a common nutrient in human diet. Eggs, specially egg yolks, are the single richest source of dietary cholesterol among all commonly consumed foods. The associations between dietary cholesterol consumption and cardiovascular disease and mortality remain controversial despite decades of research. Eating less than 300 mg of dietary cholesterol per day was the guideline recommendation before 2015. However, the most recent 2015-2020 Dietary Guidelines for Americans no longer include a daily consumption limit for dietary cholesterol and recommend weekly egg consumption as part of the healthy US-style eating pattern. Whether these recommendations are appropriate have been intensely debated.
Dr. Landoni[/caption]
Dr. Giovanni Landoni
Intensive Care and Anesthesia Unit
Associate professor
Università Vita-Salute San Raffaele
MedicalResearch.com: What is the background for this study?
Response: Patients undergoing cardiac surgery are still at risk for perioperative complications. Studies to improve clinical outcomes this setting are important. Inhaled anesthetics have pharmacological properties which reduce myocardial infarction size by 50% in laboratory and animal studies and which might decrease postoperative mortality according to aggregated published randomized data.

