Author Interviews, General Medicine, Heart Disease, JACC, Karolinski Institute / 23.09.2014

Agneta Åkesson Associate professor, senior lecturer Photo by Anna Persson Nutritional Epidemiology IMM Institute of Environmental Medicine Karolinska Institutet Stockholm, SwedMedicalResearch.com Interview with Agneta Åkesson Associate professor, senior lecturer                                                  Nutritional Epidemiology IMM Institute of Environmental Medicine Karolinska Institutet Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Åkesson: Our study indicates that a healthy diet together with low-risk lifestyle practices such as being physically active, not smoking and having a moderate alcohol consumption, and with the absence of abdominal adiposity may prevent the vast majority of myocardial infarctions in men. (more…)
Heart Disease, JACC / 13.09.2014

Thomas M. Maddox, MD MSc FACC FAHA Cardiology, VA Eastern Colorado Health Care System Associate Director, VA CART Program Associate Professor, Department of Medicine, University of Colorado School of MedicineMedicalResearch.com Interview with: Thomas M. Maddox, MD MSc FACC FAHA Cardiology, VA Eastern Colorado Health Care System Associate Director, VA CART Program Associate Professor, Department of Medicine, University of Colorado School of Medicine Medical Research: What are the main findings of the study? Dr. Maddox: We were curious to know if the VA, as a provider of PCI at centers without on-site CT surgery, was providing better access to its veterans without compromising their safety.  We were pleased to find that there was evidence of better access, with patients reducing their drive time to PCI facilities by, on average, 90 minutes.  In addition, there was no compromised safety.  Rates of both peri-procedural and 1-year adverse outcomes were low and no different between centers with and without on-site CT surgery. (more…)
Author Interviews, Heart Disease, JACC / 09.09.2014

MedicalResearch.com Interview with: Laura A. Graham, MPH Center for Surgical, Medical Acute Care Research, and Transitions Birmingham Veterans Affairs Medical Center Section of Gastrointestinal Surgery, Department of Surgery University of Alabama at Birmingham, Birmingham Medical Research: What are the main findings of the study? Answer: The main findings of the study are that the recommendations made in the guidelines published by the American College of Cardiology / American Heart Association in 2007 were effective at reducing postoperative major adverse cardiac events following noncardiac surgery in patients with a cardiac stent.1  These guidelines recommended the delay of noncardiac surgeries in patients with a drug-eluting stent for 365 days if the surgery was not emergent or the delay of surgery for 4 to 6 weeks among patients with a bare metal stent.1  In addition to a 26% reduction in postoperative major adverse cardiac events, we also found an increase in the time between drug-eluting stent placement and non-cardiac surgery consistent with the guideline recommendations. (more…)
Author Interviews, Heart Disease, JACC / 04.09.2014

Martin Huth Ruwald, MD, PhD Post doctoral research fellow Heart Research Follow-up Program University of Rochester Medical Center Rochester, NY, USMedicalResearch.com Interview with: Martin Huth Ruwald, MD, PhD Post doctoral research fellow Heart Research Follow-up Program University of Rochester Medical Center Rochester, NY, US Medical Research: What are the main findings of the study? Dr. Ruwald: A high percentage of biventricular pacing is required for optimal outcome in patients treated with cardiac resynchronization therapy (CRT), but the influence of ectopic beats on the success of biventricular pacing has not been well established. We found that patients with increasing amount of ectopic beats (the ectopic burden) (≥0.1%) were more likely to achieve low biventricular pacing <97% and had higher risk of heart failure or death and ventricular arrhythmias. Similarly the study identified patients with a very low amount of ectopic beats, less than 1 in 1000, who are very likely to obtain high biventricular pacing and who have very low risk of adverse outcomes. (more…)
Author Interviews, Heart Disease, JACC, JAMA / 26.08.2014

MedicalResearch.com Interview with: Dr. Peter Godsk Jørgensen Copenhagen City Heart Study Frederiksberg Hospital, Frederiksberg, Denmark Medical Research: What are the main findings of your study? Dr. Jørgensen: In the coming decades, a larger and larger proportion of the population will be aged 65 years or above. At present, no risk prediction models have been developed specifically for estimation of risk in this population. ECG changes are easily recognized and identify subclinical signs of end-organ disease. Our data reveal that not only are ECG changes a very frequent finding that independently predicts cardiovascular disease, they significantly improve risk prediction when added to the most used European and US risk models. Thus, our data demonstrate that adding ECG changes will correctly reclassify more than one third of the persons aged 65 years and above without cardiovascular disease. (more…)
Author Interviews, General Medicine, Heart Disease, JACC, Vitamin D / 25.08.2014

MedicalResearch.com Interview with Esther Ooi & Børge G Nordestgaard, MD, DMSc Professor, University of Copenhagen Chief Physician, Herlev Hospital, Copenhagen University Hospital Dept. Clinical Biochemistry Herlev Ringvej 75, DK-2730 Herlev, Denmark Medical Research: What are the main findings of the study? Answer: Our findings suggest that low 25(OH)D levels observationally is simply a marker for elevated atherogenic lipoproteins, and thus question a role for vitamin D supplementation in the prevention of cardiovascular disease. (more…)
Author Interviews, Heart Disease, JACC / 20.08.2014

Gregg C. Fonarow, MD, FACC, FAHA Eliot Corday Professor of Cardiovascular Medicine and Science Director, Ahmanson-UCLA Cardiomyopathy Center Co-Chief of Clinical Cardiology, UCLA Division of Cardiology Co-Director, UCLA Preventative Cardiology Program David Geffen School of Medicine at UCLA Los Angeles, CA, 90095-1679MedicalResearch.com Interview with: Gregg C. Fonarow, MD, FACC, FAHA Eliot Corday Professor of Cardiovascular Medicine and Science Director, Ahmanson-UCLA Cardiomyopathy Center Co-Chief of Clinical Cardiology, UCLA Division of Cardiology Co-Director, UCLA Preventative Cardiology Program David Geffen School of Medicine at UCLA Los Angeles, CA, 90095-1679 Medical Research: What are the main findings of the study? Dr. Fonarow: Drawing on data from the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF), 15,177 heart failure patients were followed over two years to measure the benefits of implantable device therapy on survival in community practice settings. The study demonstrated that ICD device therapy reduced the likelihood of death during the two-year period by 36 percent, with no significant differences by race or ethnicity. The study also demonstrated a 45 percent reduction in mortality during the two-year period with CRT therapy, again without any significant differences device benefit by race or ethnicity. (more…)
Blood Pressure - Hypertension, JACC, JAMA, Kidney Disease / 05.08.2014

Dr. John J. Sim Division of Nephrology and Hypertension Kaiser Permanente Los Angeles Medical Center, Los Angeles,MedicalResearch.com Interview with: Dr. John J. Sim Division of Nephrology and Hypertension Kaiser Permanente Los Angeles Medical Center, Los Angeles, Medical Research: What are the main findings of the study? Dr. Sim: Among a large diverse population of treated hypertensive people, those who achieved systolic blood pressures (SBP) in the ranges of 130-139mm Hg had the lowest risk for death and end stage renal disease (kidney failure).  Not surprisingly, those with SBP above 139 had incrementally greater risk, but somewhat surprising was that those with SBP under 130 also had a greater risk for death and kidney failure. (more…)
Author Interviews, Gender Differences, Heart Disease, JACC, Transplantation / 25.07.2014

Dr. Eileen Hsich MD Director of the Women’s Heart Failure Clinic Associate Medical Director for the Heart Transplant Program Cleveland Clinic, Cleveland, OhioMedicalResearch.com Interview Invitation  Dr. Eileen Hsich MD Director of the Women’s Heart Failure Clinic Associate Medical Director for the Heart Transplant Program Cleveland Clinic, Cleveland, Ohio Medical Research: What are the main findings of the study? Dr. Hsich: Women are dying on the heart transplant waiting list at a faster rate than men for almost a decade (see Figure 1) and few studies have even addressed this problem. The occurrence is largely driven by gender differences in survival at the most urgent status (UNOS Status 1A) but the cause remains unclear. Although data is limited our findings raise concern that women are not successfully bridged to transplantation while they remain at high status and are inactivated due to worsening condition. Figure 1. Scientific Registry of Transplant Recipients: Mortality on Waiting List For Heart Transplantation Heart waiting list by gender 2000-2009   Figure derived from table in Scientific registry of transplant recipients: Heart waiting list by gender 2000-2009. Available at: Http://srtr.Transplant.Hrsa.Gov/annual_reports/2010/1103_can-gender_hr.Htm accessed january 9, 2014. (more…)
AHA Journals, Author Interviews, Gender Differences, Heart Disease, JACC, Yale / 22.07.2014

Aakriti Gupta, MD, MBBS Center for Outcomes Research and Evaluation Yale-New Haven Hospital, New Haven, ConnecticutMedicalResearch.com Interview with: Aakriti Gupta, MD, MBBS Center for Outcomes Research and Evaluation Yale-New Haven Hospital, New Haven, Connecticut Medical Research: What were the main findings? Dr. Gupta: Using a national database, we found that heart attack hospitalization rates for patients under the age of 55 have not declined in the past decade while their Medicare-age counterparts have seen a 20 percent drop. We also found that among younger patients below 55 years of age, women fare worse because they have longer hospital stays, and are more likely to die in the hospital after a heart attack. Young women were also more likely to have higher prevalence of co-existing medical conditions including diabetes, high blood pressure and higher cholesterol levels. Overall, all patient groups in the study saw increases in these conditions including diabetes and high blood pressure in the past decade. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Heart Disease, JACC / 22.05.2014

MedicalResearch.com Interview with: Nileshkumar J. Patel MD Staten Island University Hospital Staten Island, NY, 10304 and Abhishek J. Deshmukh MD University of Arkansas Little Rock, AR MedicalResearch: What are the main findings of the study? Answer: We analyzed data from almost 4 million hospitalizations for atrial fibrillation (AF) from more than 1,200 hospitals across 45 states in last decade, and found that -   Hospitalization rates for atrial fibrillation have increased exponentially among US adults during the past 10 years, particularly in those 65 years or older. -   The most frequent coexisting conditions were hypertension (59.99%), diabetes (21.47%) and chronic pulmonary disease (20.01%). -   In terms of geographic distribution of admissions, the hospitals in the South constitute (38.5%) the highest percentage of atrial fibrillation hospitalizations, followed by Midwest (24.9%), Northeast (22.2%) and West (14.4%). -   Overall in-hospital mortality was 1%. The mortality rate was highest in >80 years age group (1.93%) and patients with concomitant heart failure (8.2%). -   The percentage of patients discharged to nursing facility increased from 8.1% in 2000 to 11.5% in 2010 and need for home health care increased from 6.7% to 13.1%. Approximately one fourth of the patients (25.83%) were discharged to long-term care institution if atrial fibrillation hospitalization was complicated by acute ischemic stroke. -   Mean cost of AF hospitalization increased significantly from $6,410 in 2001 to $8,439 in 2010 (24.04% increase, p <0.001) even after adjusting for inflation. This represents an absolute increment in annual national cost from approximate 2.15 billion dollars in 2001 to 3.46 billion dollars in 2010. The mean cost of care was highest if AF hospitalization was associated with heart failure ($33,161) and valvular disorders ($28,030). (more…)
Heart Disease, JACC / 16.04.2014

Rine Nakanishi, MD, PhD Los Angeles Biomedical Research Institute MedicalResearch.com Interview with: Rine Nakanishi, MD, PhD Los Angeles Biomedical Research Institute MedicalResearch.com: What are the main findings of the study? Dr. Nakanishi: With growing evidence that a measurement of the buildup of calcium in coronary arteries can predict heart disease risk, Los Angeles Biomedical Research Institute (LA BioMed) researchers found that the process of "calcium scoring" was also accurate in predicting the chances of dying among adults with little or no traditional risk factor of heart disease. The study conducted by LA BioMed researchers examined 5,593 adults with no known heart disease and zero or minimal risk factor of heart disease -- including hypertension, dyslipidemia, diabetes, current smoking and family history of heart disease -- who had undergone coronary artery calcium screening by non-contrast cardiac computed tomography from 1991-2011. Among the adults in the study, even those with low coronary artery calcium scores of 1-99 were 50% more likely to die of heart disease than adults with a calcium score of zero. Adults with moderate scores of 100-399 were 80% more likely to die from heart disease than those with a score of zero, and those with scores of 400 or more were three times more likely to die from heart disease, when compared to adults with no calcified plaque buildup, or a score of zero. (more…)
Author Interviews, Biomarkers, Emergency Care, Heart Disease, JACC, Karolinski Institute / 04.04.2014

Martin J. Holzmann, MD, PHD Department of Emergency Medicine Karolinska University Hospital, HuddingeMedicalResearch.com Interview with: Martin J. Holzmann, MD, PHD Department of Emergency Medicine Karolinska University Hospital, Huddinge   MedicalResearch.com: What are the main findings of the study? Dr. Holzmann: In a cohort of 8900 consecutive patients who sought medical attention for chest pain, we found that an undetectable high-sensitivity cardiac troponin level (<5 ng/l), and an ECG with no ischemic changes has a negative predictive value of 99.8% (95%, 99.7-99.9%). Thus, this will rule out MI with nearly 100% accuracy, and independent of when the troponin was measured in relation to onset of chest pain, and independent of any risk factors for cardiovascular disease. (more…)
Author Interviews, Blood Pressure - Hypertension, JACC, Kidney Disease / 25.02.2014

Dr. Csaba P. Kovesdy, MD FASN Clinical Associate Professor of Medicine Chief of Nephrology, Salem VA Medical CenterMedicalResearch.com Interview with: Dr. Csaba P. Kovesdy, MD FASN Clinical Associate Professor of Medicine Chief of Nephrology, Salem VA Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Kovesdy: We describe significantly lower all-cause mortality rates in 141,413 non-dialysis dependent CKD (chronic kidney disease) patients who were de-novo users of ACEI/ARB. (more…)
Author Interviews, Blood Pressure - Hypertension, Compliance, JACC, Outcomes & Safety, UT Southwestern / 10.12.2013

Dr. Wanpen Vongpatanasin, MD Professor of Medicine Director, Hypertension Section Cardiology Division UT Southwestern Medical CenteMedicalResearch.com Interview with; Dr. Wanpen Vongpatanasin, MD Professor of Medicine Director, Hypertension Section, Cardiology Division UT Southwestern Medical Center MedicalResearch.com: What are the main findings of the study? Dr. Vongpatanasin: We found that more than 50% of patients with resistant hypertension were non-adherent to at least one drug prescribed by their primary care physicians for blood pressure control. When we provided this information back to the patients, as part of care in our hypertension specialty clinic, we found that many patients report difficulty taking prescribed medications due to either associated side effects or cost of the medication. When we adjusted patient's medications to fit their needs, BP levels were substantially improved during subsequent visits without increasing the number of medications. (more…)
Author Interviews, Heart Disease, Hospital Readmissions, JACC, Outcomes & Safety / 18.10.2013

Saul Blecker, MD, MHS Department of Population Health, NYU School of Medicine, New York, NY Department of Medicine, NYU School of Medicine, New York, NYMedicalResearch.com Interview with: Saul Blecker, MD, MHS Department of Population Health, NYU School of Medicine Department of Medicine, NYU School of Medicine, New York, NY   MedicalResearch.com: What are the main findings of the study? Dr. Blecker: Inpatient quality of care has focused primarily on patients with acute heart failure, commonly identified by principal discharge diagnosis code. However, patients with heart failure are commonly hospitalized for other causes and should benefit from many of the same treatments. We found that in our sample, as compared to patients with a principal diagnosis of heart failure, heart failure patients hospitalized with a non–heart failure diagnosis had lower rates of guideline-concordant care, including assessment of left ventricular function and prescription for an ACE inhibitor or ARB, at time of discharge. This is important as our study suggests that these therapies were associated with reduced mortality for patients hospitalized with heart failure, regardless of the reason for hospitalization. (more…)
Author Interviews, Heart Disease, Infections, JACC, Yale / 31.08.2013

Behnood Bikdeli, MD Yale/YNHH Center for Outcomes Research and Evaluation One Church St, Suite 200 New Haven CT 0651MedicalResearch.com Interview with: Behnood Bikdeli, MD Yale/YNHH Center for Outcomes Research and Evaluation One Church St, Suite 200 New Haven CT 0651 MedicalResearch.com: What are the main findings of the study?
 Dr. Bikdeli: We determined the trends in hospitalizations and mortality from endocarditis among US older adults from 1999 to 2010. Endocarditis is the most serious cardiovascular infection and our study that had a very large sample, signified the high burden of endocarditis in this time period. (more…)
Author Interviews, JACC, Kidney Disease, Vitamin C / 30.08.2013

MedicalResearch.com Interview with: Umar Sadat, MD, PhD Addenbrooke’s Hospital Cambridge, United Kingdom MedicalResearch.com: What are the main findings of the study? Dr. Sadat: Vitamin C offers significant nephroprotection against contrast induced-acute kidney injury (CI-AKI) in patients undergoing coronary angiography. Patients receiving Vitamin C were observed to have 33% less risk of CI-AKI compared to those receiving placebo or other treatment. (more…)
Author Interviews, Blood Pressure - Hypertension, JACC, Nature / 23.08.2013

Dr. Axel Bauer, MD, FESC, F-ISHNE Prof. Dr. med. Axel Bauer is head of the coronary care and chest pain unit and primary investigator in the research group of biosignal analysis and sudden death of the cardiology department of the Eberhard-Karls-Universität Tübingen, Germany.MedicalResearch.com Interview with: Dr. Axel Bauer, MD, FESC, F-ISHNE Prof. Dr. med. Axel Bauer is head of the coronary care and chest pain unit and primary investigator in the research group of biosignal analysis and sudden death of the cardiology department of the Eberhard-Karls-Universität Tübingen, Germany. MedicalResearch.com: What are the main findings of the study? Dr. Bauer: Catheter-based renal sympathetic denervation is a promising treatment option in patients with resistant arterial hypertension. However, it is invasive and might have presently unknown adverse side effects in the long-term. Therefore, identification of patients who benefit from RDN and, equally importantly, those who do not is of great importance.  With assessment of baroreflex sensitivity (BRS) we found a way to do that. Patients with resistant hypertension and impaired BRS at baseline benefited the most from RDN in terms of reduction of mean systolic BP on (ABPM) while RDN had no effect in patients with preserved BRS. (more…)
Author Interviews, Cancer Research, CT Scanning, Heart Disease, JACC, Lung Cancer, Medical Imaging / 08.07.2013

Dr. Pim A. de Jong, Department of Radiology University Medical Center Utrecht, Heidelberglaan 100, E.01.132, 3508GA Utrecht, the Netherlands. MedicalResearch.com: What are the main findings of the study? Dr. de Jong: The main findings of the study is that lung cancer screening CT scans can predict future cardiovascular events. MedicalResearch.com: Where any of the findings unexpected? Dr. de Jong: The unexpected aspect is that the CT scans were not-ECG gated, but even these non-gated scans were good enough to quantify arterial calcifications and predict risk. (more…)