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

MedicalResearch.com Interview with: Haider Aldiwani, MD Fellow in Internal Medicine and 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.  (more…)
Author Interviews, Heart Disease, Omega-3 Fatty Acids, Prostate Cancer / 20.11.2019

MedicalResearch.com Interview with: Jeffrey L. Anderson, MD FAHA FACC MACP Distinguished Research Physician Professor of Medicine with Tenure University of Utah School of Medicine MedicalResearch.com: What is the background for this study? Response: Omega-3 supplements are widely used for cardiovascular prevention. However, a study published in the Journal of the National Cancer Institute (105:1132, 2013) reported as an incidental finding in a plasma bank study that the risk of prostate cancer increased with increasing levels of docosahexaenoic acid (DHA) and trended to increase with eicosapentaenoic acid (EPA). (more…)
Author Interviews, Heart Disease, Race/Ethnic Diversity / 30.10.2019

MedicalResearch.com Interview with: Michelle Morse, MD, MPH Founding Co-Director, EqualHealth Soros Equality Fellow Assistant Professor, Harvard Medical School Co-Founder, Social Medicine Consortium  MedicalResearch.com: What is the background for this study?
  • Response: Frontline clinicians have a unique vantage point to identify and characterize inequities in care. This study was inspired by internal medicine residents’ first-hand clinical experiences of black and Latinx patients who were frequently admitted to the general medicine service, as opposed to the cardiology service, with an ultimate diagnosis of HF.
  • Research has shown that structural inequities are pervasive throughout healthcare delivery systems and across many services, within both the inpatient and outpatient arenas. We hope other institutions and clinicians will be equally committed to addressing inequities in their own contexts, systems, and care settings and that patients will identify opportunities for self-advocacy in their care.
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Author Interviews / 22.10.2019

MedicalResearch.com Interview with: Mwenya Mubanga, MD, PhD Postdoctoral Researcher Department of Medical Epidemiology and Biostatistics  | Karolinska Institutet Childhood Allergy and Asthma Stockholm MedicalResearch.com: What is the background for this study? Response: In a previous study we showed that dog ownership was associated with a lower risk of composite cardiovascular death and all-cause death as compared to non-dog owners.1 In this follow-up, we assessed the hypothesis that dog ownership was associated with better survival after either an acute myocardial infarction or an ischemic stroke. Using the rich Swedish national registers, we identified more than 300,000 adults aged 45 to 80 and linked their individual-level health records to information on socio-economic, demographic and death data. (more…)
AHA Journals, Author Interviews, Environmental Risks, Heart Disease, Stroke / 26.09.2019

MedicalResearch.com Interview with: Zara Berg, Ph.D Fort Peck Community College Poplar, Montana MedicalResearch.com: What is the background for this study? Response: This study is part of the cohort that consist of the Honolulu Heart Program (HHP) and what later became the Honolulu-Asia Aging study. HHP study cardiovascular research starting in the 1960’s, which is equivalent to the Framingham Study. This study was used to establish the epidemiology parameters for cardiovascular diseases and is one of the longest longitudinal (34 years of follow-up) study on cardiovascular diseases and other diseases that effect the elderly. The participants were all Japanese that fought in WWII which is a sample size of 8,006 participants. In additional, there is multiple studies based on this cohort for the last fifty plus years, ranging from occupational exposure, cancer, neurological diseases, and cardiovascular diseases.  (more…)
AHA Journals, Author Interviews, Brigham & Women's - Harvard, Heart Disease, Nutrition, Vegetarians / 22.08.2019

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Brigham & Women's - Harvard, Heart Disease, Red Meat / 22.04.2019

MedicalResearch.com Interview with: Marta Guasch-Ferre, PhD Research Scientist, Dept of Nutrition Harvard TH Chan School of Public Health Instructor of Medicine, Channing Division of Network Medicin Harvard Medical School Boston, MA, 02115   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Previous findings from randomized controlled trials evaluating the effects of red meat on cardiovascular disease risk factors have been inconsistent. But our new study, which makes specific comparisons between diets high in red meat versus diets high in other types of foods, shows that substituting red meat with high-quality protein sources lead to more favorable changes in cardiovascular risk factors. That is, to properly understand the health effects of red meat, it’s important to pay attention to the comparison diet. People do not simply eat more or less meat – it will almost always be in substitution with other foods.  (more…)
AHA Journals, Author Interviews, Clots - Coagulation, Heart Disease, Stroke / 19.04.2019

MedicalResearch.com Interview with: Martine Jandrot-Perrus MD, PhD. Emeritus Research Professor Inserm University Paris Diderot Acticor Biotech Hôpital Bichat France  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Blood platelets are key actors in thrombosis a leading cause of global mortality estimated to account for 1 in 4 death worldwide in 2010. Thrombosis is associated with cardiovascular diseases (myocardial infarction, stroke, lower limb ischemia, venous thromboembolism), and with numerous pathologies such as cancer, infections or inflammatory diseases. Currently available antiplatelet drugs are the cornerstone of therapy for patients with acute coronary syndromes. However, these drugs all carry an inherent risk of bleeding that restricts their use in sensitive populations and when arterial thrombosis occurs in the cerebral territory. At present the only acute treatment option available for ischemic stroke consists in revascularization by thrombolysis, and/or mechanical thrombectomy. But the number of patients eligible to these treatments is low (» 15% of all patients) and the success rate does not exceed 50%. The responsibility of platelets in the failure for thrombolysis / thrombectomy to restore vascular patency is strongly suspected. There is thus a clear medical need for new antiplatelet drugs with an improved safety profile. We set out to develop ACT017, a novel, first in class, therapeutic antibody to platelet glycoprotein VI with potent and selective antiplatelet effects. The interest of GPVI resides in the fact that it's a receptor involved in the development of occlusive thrombi but that it is not strictly required for physiological hemostasis. (more…)
AHA Journals, Author Interviews, Heart Disease, Karolinski Institute / 02.04.2019

MedicalResearch.com Interview with: Gabriel Riva, Graduate Student Department of Medicine, Solna (MedS), Karolinka Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: During the last decade there has been a gradual adoption of compression-only CPR, as an option to conventional CPR with chest compressions and rescue breaths, in international CPR guidelines. The simplified technique is recommended for bystanders who are untrained and in "telephone assisted CPR". One of the reasons was the assumption that more people would actually do CPR with the simplified technique.  We could in this nationwide study running over 3 guideline periods demonstrate a 6-fold higher proportion of patients receiving compression-only CPR and a concomitant almost doubled rate of CPR before emergency medical services arrival over time. This very large increase in simplified CPR was surprising to us, especially considering there has never been any public campaigns promoting compression-only CPR in Sweden and training still include compressions and ventilations.  (more…)
Author Interviews, Stroke / 19.02.2019

MedicalResearch.com Interview with: Sunil A. Sheth, MD Department of Neurology McGovern Medical School at UTHealth Houston, TX 77030 MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is no country in the world where the absolute number of people living with or died from stroke has declined between 1990 and 2013. In the US, approximately 795,000 people experience a stroke each year with nearly 90% being acute ischemic stroke (AIS), which remains the leading cause of adult disability in the US. In 2015 landmark clinical trials demonstrated that endovascular stroke treatments (EST) for patients with large vessel occlusion (LVO) leads to dramatic improvements in patient outcomes. However, in the wake of these results, stroke systems of care around the globe are now faced with the daunting task of ensuring that patients with AIS have access to appropriate screening and therapy. The evidence of benefit for endovascular stroke that emerged from these trials was derived from treatments rendered almost exclusively at high volume stroke centers, with specialized neuro-imaging, neuro-intensive care, neuro-rehabilitation and neuro-nursing. However, since the publication and adoption of these findings into guidelines, it has become well-established that the likelihood of good neurologic outcome for these patients remains dependent on minimizing delays in treatment. Even 15-minute delays in endovascular reperfusion have been associated with quantifiable decrements in clinical outcomes. As such, there has been an increase in demand for the procedure as well as calls for the dissemination of the treatment away from tertiary-care referral centers into the community, to avoid the costly delays associated with inter-hospital transfer (IHT). On the other hand, transferring endovascular stroke patients to higher volume centers has also been associated with reduced mortality. In the absence of clear data on the relative efficacy of EST in lower volume centers, this lack of clarity on the optimal distribution of endovascular stroke resources had led to considerable confusion, with stroke center certifying agencies such as The Joint Commission initially requiring physician and hospital minimal EST volume requirements for certification, and then very recently revoking and then reinstating that criterion. Given the need to structure stroke systems of care in the modern endovascular stroke era, as well as the poorly characterized effect on EST outcomes away from tertiary-care referral centers, understanding the trends in treatment patterns as well as outcomes in relation to treatment volumes and IHT is of vital importance. The study described here provides for the first time large-scale data on the utilization of the procedure as well as the finding that its outcomes are directly tied to annual volumes. (more…)
AHA Journals, Author Interviews, Heart Disease / 16.01.2019

MedicalResearch.com Interview with: JAY H. Traverse, MD, FACC, FAHA Director of Research Minneapolis Heart Institute Foundation Associate Professor of Medicine Cardiovascular Division University of Minnesota School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Reperfusion injury may contribute a significant amount to final infarct size in setting of ST-elevation myocardial infarction (STEMI). Several studies from Europe and Asia have suggested that modifying reperfusion with an angioplasty balloon of an occluded artery called postconditioning can reduce infarct size. However, not all studies show a benefit. We hypothesized that patient selection of STEMI patients could contribute to these inconsistent findings so we performed the first postconditioning study in the US sponsored by the NIH using the strictest enrollment criteria of any study to minimize factors that influence infarct size (ischemic time, collaterals, pre-infarction angina, TIMI 0 flow) designed to maximize the benefit of postconditioning to see if it can actually reduce infarct size. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension / 20.11.2018

MedicalResearch.com Interview with: Adam Bress, Pharm.D Department of Population Health Sciences School of Medicine University of Utah MedicalResearch.com: What is the background for this study? What are the main findings? o   The background here is that the new 2017 ACC/AHA BP guidelines lowered the threshold for antihypertensive medication initiation and intensification from <140 mmHg in most patients to <130 mm Hg. o   We used contemporary, population-based studies of US adults to estimate the potential population health impact of achieving and maintaining the lower treatment targets recommended in the 2017 ACC/AHA BP guidelines compared to previous guidelines. o   We found that achieving and maintain the lower thresholds recommended in the 2017 ACC/AHA BP guidelines over 10 years would:
  • Prevent 3.0 million CVD events compared to currently blood pressure and treatment levels
  • Prevent 0.5 million more events compared to achieving and maintain JNC7 goals
  • Prevent 1.4 million more events compared to achieving and maintain JNC7 goals
o   We estimated the size of the population health impact of achieving and maintaining the lower blood pressure treatment targets in the 2017 ACC/AHA BP guidelines compared to previous guidelines.
  • Achieving and maintaining the lower blood pressure thresholds for antihypertensive medication initiation and titration by the 2017 guidelines, are projected to prevent ~20% and ~90% more CVD events over ten years compared to achieving and maintaining JNC7 or JNC8 goals respectively.
o   Although we estimated more adverse events with the lower treatment goal, what our analysis found is that the benefits of achieving and maintaining the 2017 high blood pressure treatment recommendations far outweighs the risks. Many adverse events from high blood pressure treatment can be managed medically – and the lower threshold for treatment could potentially help millions of Americans lower their chances of developing heart disease or dying from heart attacks, strokes and other cardiovascular events, (more…)