Author Interviews, Heart Disease, JACC, Surgical Research / 22.05.2023

MedicalResearch.com Interview with: [caption id="attachment_60443" align="alignleft" width="125"]Aloke V. Finn MDMedical Director/Chief Scientific Officer CVPath Institute Inc. Gaithersburg, MD 20878 Dr. Finn[/caption] Aloke V. Finn MD Medical Director/Chief Scientific Officer CVPath Institute Inc. Gaithersburg, MD 20878   MedicalResearch.com: What is the background for this study? Response:Transcatheter left atrial appendageal closure (LAAC) has become an established therapeutic approach for prevention of stroke in subjects with non-valvular atrial fibrillation who are ineligible for long-term oral anticoagulation.  Device-related thrombus (DRT), developing after LAAO procedures occurs in a small proportion but patients receiving these devices but is associated with critical embolic events such as ischemic stroke. Thrombogenicity and delayed endothelialization of fabric play a role in the development of DRT.  Fluorinated polymers are known to have thromboresistant properties which may favorably modify blood biomaterial interactions of a LAAO device. In this study we compared the thrombogenicity and endothelial coverage (EC) after left atrial appendage occlusion (LAAO) between a novel fluoropolymer-coated Watchman (FP-WM (Watchman FLX PRO) and the conventional uncoated Watchman FLX (WM).
Author Interviews, Cost of Health Care, Heart Disease, JACC / 26.02.2023

MedicalResearch.com Interview with: [caption id="attachment_60080" align="alignleft" width="150"]Rishi K. Wadhera, MD, MPP, MPhilSection Head, Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research Associate Program Director, Cardiovascular Medicine Fellowship at Beth Israel Deaconess Medical Center Assistant Professor of Medicine, Harvard Medical School Dr. Wadhera[/caption] Rishi K. Wadhera, MD, MPP, MPhil Section Head, Health Policy and Equity, Richard A. and Susan F. Smith Center for Outcomes Research Associate Program Director Cardiovascular Medicine Fellowship at Beth Israel Deaconess Medical Center Assistant Professor of Medicine, Harvard Medical School @rkwadhera MedicalResearch.com: What is the background for this study? Response: High and rising prescription drug costs in the United States contribute to medication non-adherence and financial strain among adults with cardiovascular risk factors or disease. As a result, addressing prescription drug costs in patients with chronic conditions has become a national priority. In response to these growing concerns, federal policymakers passed the Inflation Reduction Act on August 16, 2022, which aims to address high out-of-pocket drug costs for adults enrolled in Medicare Part D, by placing a $2000 annual cap on out-of-pocket prescription drug costs and expanding eligibility for full low-income subsidies to individuals that reduce deductible costs and prescription copayments (among several other provisions). It is unclear how these provisions will affect Medicare beneficiaries with cardiovascular risk factors and/or conditions.
Author Interviews, Heart Disease, JACC, Kidney Disease, Transplantation / 21.02.2023

MedicalResearch.com Interview with: [caption id="attachment_60034" align="alignleft" width="130"]Shinobu Itagaki, MD, MScAssistant Professor Cardiovascular Surgery Icahn School of Medicine at Mount Sinai, New York, NY Dr. Itagaki[/caption] Shinobu Itagaki, MD, MSc Assistant Professor Cardiovascular Surgery Icahn School of Medicine at Mount Sinai, New York, NY MedicalResearch.com: What is the background for this study? Were the transplants from a single donor? Response: The heart transplantation is the gold standard therapy for end-stage heart failure patients. As the kidney is affected by the heart function, it is common that the heart transplant candidates have some degree of kidney dysfunction as well. In these cases, the candidates are considered for simultaneous heart and kidney transplantation from a same donor. Unlike isolated heart transplantation, where the indication and benefits have been well established, simultaneous heart and kidney transplantation has less clear indication and benefits. This uncertainty is also complicated by the competing interest with isolated kidney transplantation candidates who in general wait longer on the waiting list.
Author Interviews, Biomarkers, Heart Disease, JACC, University of Michigan / 21.12.2022

MedicalResearch.com Interview with: [caption id="attachment_59873" align="alignleft" width="130"]Salim S. Hayek MDAssistant Professor Medical Director of the Frankel Cardiovascular Center Clinics University of Michigan Dr. Hayek[/caption] Salim S. Hayek MD Assistant Professor Medical Director of the Frankel Cardiovascular Center Clinics University of Michigan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Essentially, immune checkpoint myocarditis is a rare but deadly complication of immune checkpoint inhibitors – amazing drugs that are increasingly used for the treatment of various cancers. Most patients present late, and when they do, they’re very ill and have a 50% chance of death. Diagnosing ICI myocarditis is challenging, given there is no one test that can differentiate it from other causes of cardiac injury. It is important to diagnose it fast, early and accurately in order to start immunosuppressive therapy as soon as possible. What we did in this study was look at commonly measured biomarkers in all patients receiving ICI at the University of Michigan. What we found was that patients who developed ICI myocarditis had early signs of muscle destruction (rise in CPK) levels and hepatitis (rise in AST, ALT), and that all patients who had myocarditis with bad outcomes had rises in all of the aforementioned biomarkers. Creatinine phosphokinase was the most sensitive.
Author Interviews, Heart Disease, JACC, Supplements / 06.12.2022

MedicalResearch.com Interview with: [caption id="attachment_59776" align="alignleft" width="200"]Simin Liu MD MPH ScDProfessor of Epidemiology at the School of Public Health, Professor of Medicine (Endocrinology) and Professor of Surgery at the Alpert School of Medicine Brown University Dr. Simin Liu[/caption] Simin Liu MD MPH ScD Professor of Epidemiology at the School of Public Health, Professor of Medicine (Endocrinology) and Professor of Surgery at the Alpert School of Medicine Brown University MedicalResearch.com: What is the background for this study? Response: Our research team has been researching the roles of environmental and genetic determinants of chronic diseases for nearly three decades, with special emphasis on evaluating micronutrients, minerals, and trace elements in relation to cardiometabolic outcomes, and findings of which have contributed to the design of several large, randomized trials of dietary supplements in the US (Liu JAMA 1999; 2011; Diabetes Care 2005a,b; Diabetes 2006).  Several large intervention trials have consistently shown beneficial effects on clinical cardiometabolic outcomes of a diet pattern rich in micronutrients, although research on micronutrient supplementation has mainly focused on the health effects of a single or a few vitamins and minerals. We decided to take a comprehensive and systematic approach to evaluate all the publicly available/accessible studies reporting all micronutrients including phytochemicals and antioxidant supplements and their effects on cardiovascular risk factors as well as multiple CVDs.
Author Interviews, Breast Cancer, JACC, Weight Research / 18.05.2022

MedicalResearch.com Interview with: [caption id="attachment_59166" align="alignleft" width="200"]Dr. Amy Kirkham, PhD Assistant Professor of Clinical Cardiovascular Health Faculty of Kinesiology & Physical Education University of Toronto Affiliate Scientist at Toronto Rehabilitation Institute Dr. Kirkham[/caption] Dr. Amy Kirkham, PhD Assistant Professor of Clinical Cardiovascular Health Faculty of Kinesiology & Physical Education University of Toronto Affiliate Scientist at Toronto Rehabilitation Institute MedicalResearch.com:  What is the background for this study?  Response: Women who have had a breast cancer diagnosis are at least two-fold and often higher risk of cardiovascular or heart disease compared to women without a history of breast cancer. Older age, higher body mass index, and receipt of chemotherapy treatment that can injure the heart are risk factors for cardiovascular death after a breast cancer diagnosis. Time-restricted eating is a type of intermittent fasting that appears to be easy to follow and to improve some measures of metabolic health but has not been studied in populations with a cancer history. Time-restricted eating simply involves consuming all calorie intake within a specific time window, commonly 8 hours, like between 12 and 8 pm, and then only consuming water or black coffee outside of those hours. We enrolled breast cancer survivors who were aged 60 or older, had an overweight or obese mass index, and were finished chemotherapy treatment in a single-arm trial of time-restricted eating for 8 weeks. We asked participants to restrict their calorie intake between 12 and 8 pm from Monday to Friday with no restrictions on weekend and no further instructions on what to eat.
Author Interviews, Heart Disease, JACC, Statins / 17.05.2022

MedicalResearch.com Interview with: [caption id="attachment_59155" align="alignleft" width="150"]Dr. Raffaele Bugiardini, UNIBO Professor & MD Clinical cardiologist Full Professor of Cardiology at the University of Bologna Prof. Bugiardini[/caption] Dr. Raffaele Bugiardini, UNIBO Professor & MD Clinical cardiologist Full Professor of Cardiology at the University of Bologna MedicalResearch.com:  What is the background for this study?  Response: Questions about the evidence base for primary prevention with statins continue to emerge from many quarters. It has been argued that prior estimates of statin effects were mainly based on information from both individuals with and without pre-existing cardiovascular disease, which may overestimate the true benefits of statins. Some investigators attempted to quantify the impact of statins on outcomes of women versus men and reported significantly different effect estimates. Others have questioned the benefits of statins in adults 76 years and older as this age group was poorly represented in the randomized trials for primary prevention of cardiovascular disease. There is little or no information on concomitant preventive medications in prior work. Thus, how large is the incremental benefit of statin, added to other standard preventive interventions? and is cholesterol a reliable surrogate endpoint to guide prevention of cardiovascular disease?
Author Interviews, Brigham & Women's - Harvard, Fertility, Heart Disease, JACC / 19.04.2022

MedicalResearch.com Interview with: [caption id="attachment_59055" align="alignleft" width="200"]Emily Lau, MD, MPH Cardiologist Instructor in Medicine, Harvard Medical School Director, Menopause, Hormones & Cardiovascular Disease Clinic Massachusetts General Hospital Dr. Lau[/caption] Emily Lau, MD, MPH Cardiologist Instructor in Medicine, Harvard Medical School Director, Menopause, Hormones & Cardiovascular Disease Clinic Massachusetts General Hospital MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Emerging data suggest that a woman’s reproductive history influences her future risk of heart disease. Infertility is a reproductive risk factor that affects ~14% of women but has not been rigorously studied with respect to its relationship with cardiovascular disease risk. We studied over 38,000 women enrolled in the Women’s Health Initiative and found that infertility was associated with greater risk of heart failure. In particular, we found that the association was driven by greater risk of heart failure with preserved ejection fraction, a form of heart failure that is far more common among women.
Author Interviews, Cleveland Clinic, Diabetes, JACC, Surgical Research, Weight Research / 14.04.2022

MedicalResearch.com Interview with: Amgad Mentias, MD MS FACC FESC Assistant Professor, CCLCM Section of Clinical Cardiology, Heart and Vascular Institute. Cleveland, OH 44195Amgad Mentias, MD MS FACC FESC Assistant Professor, CCLCM Section of Clinical Cardiology, Heart and Vascular Institute. Cleveland, OH 44195  MedicalResearch.com:  What is the background for this study?    Response:  There is evidence that bariatric or weight loss surgery can decrease the risk of heart attack, stroke, and death in young and middle age patients with obesity and diabetes. However, the evidence is less clear for older patients and patients without diabetes. There is also no long-term data on outcomes of bariatric surgery in the Medicare beneficiaries. So, in our study, we aimed to report long-term outcomes of bariatric surgery from a contemporary nationwide cohort from the US, while also looking into outcomes in patients older than 65 years, and patients without type 2 diabetes specifically.
Author Interviews, Gender Differences, Heart Disease, JACC, Surgical Research / 06.04.2022

MedicalResearch.com Interview with: [caption id="attachment_58987" align="alignleft" width="200"]Left: Mario Gaudino, MD PhD; Right: Antonino Di Franco, MD Left: Mario Gaudino, MD PhD; Right: Antonino Di Franco, MD[/caption] Mario F.L. Gaudino, M.D. PhD Attending Cardiac SurgeonDepartment of Cardiothoracic Surgery Antonino Di Franco, MD Adjunct Clinical Assistant Professor of Cardiothoracic Surgery Weill Cornell Medicine   MedicalResearch.com:  What is the background for this study?  What is the aim of this review?  Response: Biological and socio-cultural differences between men and women are complex and likely account for most of the variations in the epidemiology and treatment outcomes of coronary artery disease (CAD) between the two sexes. Despite the growing recognition of sex-specific determinants of outcomes, representation of women in clinical studies remains low, and sex-specific management strategies are generally not provided in guidelines. We summarized the current evidence on sex-related differences in patients with CAD, focusing on the differential outcomes following medical therapy, percutaneous coronary interventions, and coronary artery bypass surgery.
Author Interviews, Dermatology, Heart Disease, JACC, NYU / 17.05.2021

MedicalResearch.com Interview with: [caption id="attachment_57322" align="alignleft" width="200"]Michael S. Garshick, MD Assistant Professor Department of Medicine Grossman School of Medicine NYU Dr. Garshick[/caption] Michael S. Garshick, MD Assistant Professor Department of Medicine Grossman School of Medicine NYU MedicalResearch.com: What is the background for this study? Response: Patients with psoriasis have a 50% higher risk of cardiovascular disease when compared to patients without psoriasis, the mechanisms of which are still under investigation Dyslipidemia is also highly prevalent in psoriasis including elevation in a variety of lipoproteins causal in atherosclerosis. Lipoprotein(a) is an LDL like particle which is associated with atherosclerosis, atherothrombosis, and the development of clinical cardiovascular disease. Traditionally lipoprotein(a) is felt to be inherited rather than acquired, but some evidence suggest that lipoprotein(a) is elevated in those with underlying inflammatory conditions and associated with systemic inflammation including circulating IL-6. We therefore aimed to determine if lipoprotein(a) is elevated in psoriasis and associated with underlying systemic inflammatory profiles and biomarkers of cardiovascular risk. 
Author Interviews, Heart Disease, JACC, Race/Ethnic Diversity, Transplantation, Yale / 17.05.2021

MedicalResearch.com Interview with: [caption id="attachment_57306" align="alignleft" width="107"]Michael Fuery, MD Department of Internal Medicine Yale School of Medicine Dr. Fuery[/caption] Michael Fuery, MD Department of Internal Medicine Yale School of Medicine [caption id="attachment_57307" align="alignleft" width="100"]Katherine Clark, MD MBA Division of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine Dr. Clarke[/caption] Katherine Clark, MD MBA Division of Cardiovascular Medicine Department of Internal Medicine Yale School of Medicine MedicalResearch.com: What is the background for this study?   Response: Racial and ethnic disparities affect cardiac transplantation outcomes. In cohort analyses of racial and ethnic groups from the previous three decades, Black patients were constantly at a higher risk of mortality after cardiac transplantation. In 2018, the United Network for Organ Sharing (UNOS) revised the allocation system to expand access to organs for the most medically urgent patients and reduce disparities and regional differences. We sought to evaluate contemporary trends and impact of the new 2018 allocation system.
Author Interviews, COVID -19 Coronavirus, Heart Disease, JACC, Social Issues / 12.05.2021

MedicalResearch.com Interview with: [caption id="attachment_57355" align="alignleft" width="150"]Kobina Hagan MBBS, MPH Postdoctoral Fellow Center for Outcomes Research, Houston Methodist Research Institute Dr. Hagan[/caption] Kobina Hagan MBBS, MPH Postdoctoral Fellow Center for Outcomes Research, Houston Methodist Research Institute MedicalResearch.com: What is the background for this study? Response: Before the COVID-19 vaccination roll-out, risk mitigation guidelines including respiratory hygiene, social distancing, and job flexibility, were the most effective preventive measures against coronavirus transmission. Social determinants of health scholarships had identified social circumstances to limit adherence to these mitigation guidelines. Individuals with underlying cardiovascular disease are identified as high-risk phenotypes for severe COVID-19 outcomes. In addition, research efforts during the early and middle waves of the pandemic had identified coronavirus exposure risk as a greater mediator of the observed COVID-19 disparities, compared to clinical susceptibility from comorbidities. Yet, population-based evidence on the practice of these mitigation guidelines in this high-risk group were lacking. Consequently, we believed there was a need to robustly characterize COVID-19 risk mitigation practices among adults with cardiovascular disease in the nation. The COVID-19 Household Impact Survey was a survey conducted by the National Opinion Research Center at the University of Chicago, to provide statistics about health, economic security, and social dynamics of the US adult household population nationwide and for 18 geographic areas (10 states, 8 metropolitan statistical areas) between April and June 2020. This survey complemented the Household Pulse Survey by the Census Bureau. In this study we described the COVID-19 risk mitigation practices among patients with CVD and evaluated the association between cumulative social determinants of health burden (a measure of social adversity) and adherence these measures. 
Alcohol, Author Interviews, Heart Disease, JACC / 09.05.2021

MedicalResearch.com Interview with: [caption id="attachment_57388" align="alignleft" width="150"]Kenechukwu Ndubisi Mezue, M.D Fellow in Nuclear Cardiology  Massachusetts General Hospital Dr. Mezue[/caption] Kenechukwu Ndubisi Mezue, M.D Fellow in Nuclear Cardiology  Massachusetts General Hospital MedicalResearch.com: What is the background for this study? Response: Observational studies have shown that moderate alcohol intake may have beneficial effects on cardiovascular disease. However, the mechanisms through which this benefit occurs is mostly unknown. Chronic stress is also known to associate with increased risk of cardiovascular disease and our group has shown in previous work that increased activity in the stress-associated regions of the brain (such as the amygdala) is significantly associated with increased bone marrow activity, arterial inflammation, and cardiovascular events. Our current study hypothesizes that moderate alcohol intake reduces cardiovascular events by reducing chronic stress-associated brain activity. 
Author Interviews, Erectile Dysfunction, Heart Disease, JACC, Karolinski Institute / 10.04.2021

MedicalResearch.com Interview with: [caption id="attachment_56968" align="alignleft" width="128"]Martin J Holzmann MD PhD Department of Emergency Medicine Karolinska University Hospital Stockholm, Sweden Dr. Holzmann[/caption] Martin J Holzmann MD PhD Department of Emergency Medicine Karolinska University Hospital Stockholm, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​We published a paper 2007 in Heart where we showed that PDE5i lower mortality in men with a recent myocardial infarction. With this study we wanted to investigate if PDE5i led to a beneficial outcome in men with stable coronary artery disease.
Author Interviews, Heart Disease, JACC / 05.02.2021

MedicalResearch.com Interview with: [caption id="attachment_56538" align="alignleft" width="149"]Dr-Paaladinesh Thavendiranathan.jpg Dr. Thavendiranathan[/caption] Paaladinesh Thavendiranathan MD, SM Ted Rogers Centre for Heart Research and the Division of Cardiology Peter Munk Cardiac Center, University Health Network, Joint Department of Medical Imaging, , University Health Networ Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? Response: Anthracyclines are a common class of chemotherapy drugs used to treat patients with blood, breast, and many other cancers. Patients receiving anthracycline based cancer therapy who are deemed to be high cardiovascular risk either based on their age or presence of cardiovascular risk factors are at risk of developing heart failure. In high risk patients this risk of heart failure could be between 5-10% over a 5 year period depending on the treatment regimens used. Therefore it is possible that the cancer patient of today can become a heart failure patient of tomorrow. These cancer treatments are however very effective against the cancer.  So it is important to find strategies to prevent the development of heart failure.  Usually oncologists and cardiologists work together to monitor patients during and after cancer therapy using surveillance strategies. One such strategy is to repeat heart ultrasounds to identify heart dysfunction early followed by initiation of cardioprotective therapy.  Traditional approaches measure left ventricular ejection (LVEF) as a metric of heart function.  However, we have learned that with this approach it may be too late when a change in LVEF is identified. Global longitudinal strain (GLS) is a newer echocardiography method that appears to identify heart dysfunction earlier before a major change in LVEF occurs. However, whether initiation of cardioprotective therapy when a change in GLS is identified can prevent a reduction in heart function and development of cardiotoxicity (significant change to heart function) is unknown. The SUCCOUR trial is an international, multicenter randomized controlled trial that compared using an LVEF based approach to surveillance (arm 1) versus the addition of GLS based surveillance (arm 2) in high risk patients receiving anthracycline based therapy. The study enrolled 153 patients in the LVEF arm and 154 patients in the GLS arm. Majority of the patients (~90%) had breast cancer.  
Author Interviews, Cost of Health Care, CT Scanning, Heart Disease, JACC, Statins / 14.01.2021

MedicalResearch.com Interview with: Prasanna Venkataraman MBBS Thomas H. Marwick MBBS, PhD Baker Heart and Diabetes Research Institute Monash University, Melbourne Melbourne, Australia   MedicalResearch.com: What is the background for this study?
  • Coronary artery calcium score (CAC) quantifies coronary calcium as determined by computed tomography and is a good surrogate marker for overall coronary plaque burden. It can help to reclassify patients at intermediate risk – many of whom are actually at low risk and can be reassured. Conversely, the finding of coronary calcium can also motivate patients (and their clinicians) to more aggressively control their cardiovascular risk factors. This is particularly problematic in those with a family history of premature coronary artery disease, where standard risk prediction tools are less accurate. However, CT CAC does not routinely attract third party payer support limiting its access and utilisation.
  • We screened 1084 participants who have a family history of premature coronary disease and a 10-year Pooled cohort Equation (PCE) cardiovascular risk >2% with CAC. We then assessed the cost-effectiveness of commencing statins in those with any coronary calcium compared to a strategy of no CAC testing and commencing statins if their PCE risk was ≥7.5% consistent with current guidelines. 
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Heart Disease, JACC / 11.01.2021

MedicalResearch.com Interview with: [caption id="attachment_56374" align="alignleft" width="200"]Rishi K. Wadhera, MD, MPP, MPhil Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center Associate Program Director, Cardiovascular Medicine Fellowship Assistant Professor of Medicine, Harvard Medical School  Dr. Wadhera[/caption] Rishi K. Wadhera, MD, MPP, MPhil Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center Associate Program Director, Cardiovascular Medicine Fellowship Assistant Professor of Medicine, Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: The direct toll of the novel coronavirus disease 2019 (COVID-19) in the U.S. has been substantial, but concerns have also arisen about the indirect effects of the pandemic on higher-risk patients with chronic medical conditions, such as cardiovascular disease. Hospitalizations for acute cardiovascular conditions, including myocardial infarction, heart failure, and stroke precipitously declined during the early phase of the pandemic. These patterns have raised concern that patients may be avoiding hospitals due to fear of contracting SARS-CoV-2, and that some have died from cardiovascular conditions without seeking medical care. In addition, there has been growing concern about the the effects of health-care system strain and the deferral of semi-elective procedures on patients with cardiovascular conditions.
Author Interviews, Heart Disease, JACC / 17.11.2020

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. 
Author Interviews, Heart Disease, JACC, Omega-3 Fatty Acids / 27.10.2020

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.
Author Interviews, Brigham & Women's - Harvard, Cognitive Issues, Heart Disease, JACC, Lipids / 23.05.2020

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.
Author Interviews, Heart Disease, JACC, Women's Heart Health / 26.02.2020

MedicalResearch.com Interview with: [caption id="attachment_53308" align="alignleft" width="150"]Haider Aldiwani, MD Fellow in Internal Medicine Dr. Aldiwani[/caption] Haider Aldiwani, MD Fellow in Internal Medicine and [caption id="attachment_53309" align="alignleft" width="150"]C. Noel Bairey Merz, MD, FACC, FAHA Director Barbra Streisand Women’s Heart Center Smidt Heart Institute, Cedars-Sinai Medical Center Los Angeles, CA, 90048 Dr. Bairey Merz[/caption] C. Noel Bairey Merz, MD, FACC, FAHA Director Barbra Streisand Women’s Heart Center Smidt Heart Institute, Cedars-Sinai Medical Center Los Angeles, CA, 90048   MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease is the leading cause of death in women in the United States. Women are found to have a higher prevalence of ischemia but no obstructive coronary artery disease (INOCA) compared to men. These women are often labeled as “normal” and their symptoms and cardiovascular risk are not managed appropriately. Women with INOCA are higher risk of developing major adverse cardiovascular events including death, myocardial infarction (MI), stroke and heart failure hospitalization. Presenting symptoms of ischemia are variable and more often labelled “atypical” in women. 
Author Interviews, Cannabis, Columbia, Heart Disease, JACC / 21.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52888" align="alignleft" width="200"]Ersilia DeFilippis, MD Second-year cardiology fellow Columbia University Irving Medical Center and NewYork-Presbyterian  Dr. DeFilippis[/caption] Ersilia DeFilippis, MD Second-year cardiology fellow Columbia University Irving Medical Center and NewYork-Presbyterian MedicalResearch.com: What is the background for this study? Response: Marijuana use has been increasing significantly and is the most commonly illicit drug used in the United States. In recent years, more states have been legalizing its use for both recreational and medicinal purposes. We have all seen news reports regarding the rise of vaping-related health hazards. Yet, data are limited regarding the cardiovascular effects of marijuana which is what drove us to explore this topic.
Aging, Author Interviews, Exercise - Fitness, Heart Disease, JACC / 08.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52632" align="alignleft" width="80"]Dr Charlotte Manisty PhD MRCP Senior Lecturer Consultant Cardiologist Barts Heart Centre and University College University College Hospitals, London Dr. Manisty[/caption] Dr Charlotte Manisty PhD MRCP Senior Lecturer Consultant Cardiologist Barts Heart Centre and University College University College Hospitals, London MedicalResearch.com: What is the background for this study? Response: The normal ageing process results in vascular stiffening which in turn contributes to adverse cardiovascular events including heart attacks and strokes.  We know that trained athletes have more compliant blood vessels than their peers, and previous small studies of supervised exercise training have shown that such interventions can reduce blood pressure. We aimed to assess the impact of unsupervised exercise training on cardiovascular physiology in novice runners preparing for a first-time marathon using advanced noninvasive imaging in order to better understand whether it is possible to ‘reverse’ vascular ageing.
Author Interviews, Circadian Rhythm, Heart Disease, JACC / 11.08.2019

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. 
Author Interviews, Biomarkers, Heart Disease, JACC / 17.07.2019

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.
Author Interviews, Biomarkers, Geriatrics, Heart Disease, JACC / 02.07.2019

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.
Author Interviews, JACC, Kidney Disease, NYU / 13.06.2019

MedicalResearch.com Interview with: [caption id="attachment_49703" align="alignleft" width="225"]David Charytan, MD MSc Chief, Nephrology Division NYU Langone Medical Center New York, NY 10010 Dr. Charytan[/caption] David Charytan, MD MSc Chief, Nephrology Division NYU Langone Medical Center New York, NY 10010  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Cardiovascular events are much more frequent in patients with impaired kidney function (chronic kidney disease), and cardiovascular disease is the most common cause of death in advanced chronic kidney disease. This risk remains high despite the use of standard medical therapies including statins, the most commonly used cholesterol lowering agents. The PCSK9 inhibitor evolocumab is a new class of highly potent cholesterol lowering medications that can further reduce the risk of cardiovascular events in patients already taking statins. We analyzed data from the FOURIER trial, which randomized study patients with clinically evident atherosclerosis and an LDL cholesterol level >=70 mg/dL or HDL cholesterol level >= while on a statin, to assess the safety and efficacy of evolocumab, a PCSK9 inhibitor, compared with placebo in individuals with mild to moderate chronic kidney disease. There were several major findings
  • a) evolocumab appears to be equally safe in individuals with preserved and mild to moderately impaired kidney function
  • b) evolocumab appears to have preserved efficacy at preventing cardiovascular events as kidney function declines.
  • c) We were unable to detect any significant impact on kidney function.
  • In addition, because the baseline risk of cardiovascular events is much higher in individuals with  chronic kidney disease, the absolute benefits of treatment with evolocumab appear  to be magnified as kidney function declines. 
Author Interviews, Heart Disease, JACC / 12.06.2019

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.