AHA Journals, Author Interviews, McGill, Stroke / 14.11.2015

MedicalResearch.com Interview with: Sophie Vincent, Medical Student McGill University and Kristian Filion, PhD FAHA Assistant Professor of Medicine Division of Clinical Epidemiology Jewish General Hospital/McGill University Medical Research: What is the background for this study? What are the main findings? Response: Patients with carotid atherosclerosis causing vascular stenosis are at increased risk of stroke, which is the third leading cause of death in the United States and in Canada. Carotid artery stenting and carotid endarterectomy are the primary surgical options for the treatment of carotid stenosis. With the assumption that an endovascular approach would offer a more favorable safety profile than open surgical procedure, the use of stenting increased significantly following its entry into the market in the 1990s. However, despite this observed increase in use, the long-term safety and efficacy of stenting relative to endarterectomy remained unclear, which is why we decided to conduct this study. Although carotid artery stenting has more favorable periprocedural outcomes with respect to myocardial infarction, hematoma, and cranial nerve palsy, the observed increased risk of stroke throughout follow-up with stenting suggests that endarterectomy remains the treatment of choice for the management of carotid stenosis. (more…)
Author Interviews, Compliance, Heart Disease / 13.11.2015

MedicalResearch.com Interview with: Dr. Tracy Wang MD MHS MSc Assistant Dean, Continuing Medical Education Director, Center for Educational Excellence Fellowship Associate Program Director Associate Professor of Medicine, Cardiology Duke Clinical Research Institute Medical Research: What is the background for this study? What are the main findings? Response: Medication non-adherence is a known challenge in the management of patients with coronary artery disease. Barriers to adherence are multifactorial, attributed to patient, healthcare provider, and social determinants. However, whether patient medication adherence varies across different hospitals is unknown. In this study, we sought to determine whether inter-hospital differences exist in the degree of patient adherence to secondary prevention medications after discharge. Moreover, we assessed whether these hospital-specific variations in medication adherence, if any, correspond to downstream patient outcomes. We observed that the majority of post-MI patients were prescribed guideline-recommended secondary prevention medications at discharge. However, among those prescribed, we see a significant decline in the use of these medications within just 90 days after discharge. Medication adherence rates varied markedly across U.S. hospitals, with the widest variation seen for post-discharge use of beta-blockers. Hospitals with high post-discharge  medication adherence were associated with significantly lower risk of major adverse cardiovascular events and death or all-cause readmissions when compared with hospitals with low adherence rates, even after adjustment for differences in patient case-mix. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Heart Disease / 12.11.2015

MedicalResearch.com Interview with: Carrie C. Lubitz, MD, MPH Assistant Professor of Surgery, Harvard Medical School Senior Scientist, Institute for Technology Assessment Attending Surgeon, Mass General/North Shore Center for Outpatient Care Danvers, Massachusetts Medical Research: What is the background for this study? What are the main findings? Dr. Lubitz: Given reported estimates of resistant hypertension and the proportion of resistant hypertensive patients  with primary hyperaldosteronism (PA) - the most common form of secondary hypertension caused by a nodule or hyperplasia of the adrenal glands – we estimate over a million Americans have undiagnosed PA. Furthermore, it has been shown that patients with PA with the same blood pressure as comparable patients with primary hypertension have worse outcomes. In our study, we found that identifying and appropriately treating patients with PA can improve long-term outcomes in patients in a large number of patients who have resistant hypertension. (more…)