Author Interviews, Erectile Dysfunction, Heart Disease, JACC, Karolinski Institute / 10.04.2021
PDE5i for ED and Survival in Men with Coronary Artery Disease
MedicalResearch.com Interview with:
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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.
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.
Anne Yuk-Lam Ho, MPH
Million Veteran Program (MVP) Data Core
MVP Coordinating Center
VA Boston Healthcare System
MedicalResearch.com: What is the background for this study?
Response: Cardiovascular disease (CVD) has been the leading cause of morbidity and mortality globally. Prevalence of CVD among US population is approximately 7% which places huge burden on our healthcare systems. And prevalence of CVD is as high as 28% among veterans at the VA healthcare system as veteran users are primarily older male with more histories of comorbidities. Most CVD risk factors including lipids and blood pressure can be controlled by lifestyle modifications, such as diet.
Chocolate is among dietary factors that play a role in modulating CVD risk factors is widely consumed in the US (~2.8 billion pounds annually. Although previous studies have reported beneficial effects of chocolate and/or cacao products (rich in flavonoids) on lipids, glucose metabolism and risk of diabetes, and lipids, little is known about the association of chocolate intake with coronary artery disease (CAD) among US veterans. Thus, sought to test the hypothesis that chocolate consumption is associated with a lower risk of CAD among xxx US veterans enrolled in the Million Veteran Program.
Dr. El Khoudary[/caption]
Samar El Khoudary, PhD, MPH, BPharm, FAHA
Associate Professor of Epidemiology
University of Pittsburgh Graduate School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Research increasingly shows that it isn’t so important how much fat a woman is carrying, which doctors typically measure using weight and BMI, as it is where she is carrying that fat. To investigate this, we looked at 25 years of data on 362 women from Pittsburgh and Chicago who participated in the
Dr. Taub[/caption]
Pam R. Taub, MD, FACC, FASPC
Director of Step Family Foundation Cardiovascular Rehabilitation and Wellness Center
Associate Professor of Medicine
UC San Diego Health System
Division of Cardiovascular Medicine
MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by postural orthostatic tachycardia syndrome? Is it more common in patients who have incompletely recovered from a COVID-19 infection?
Response: Postural Orthostatic Tachycardia Syndrome (POTS) is a, complex multisystem clinical syndrome Patients experience a wide spectrum of symptoms of varying severity, which are often debilitating. Upon assuming an upright standing position from being supine, patients experience an increase in heart rate by 30 beats per minute (bpm) from supine position, This is often accompanied by lightheadedness, palpitations, dyspnea, mental clouding (“brain fog”), headaches.
POTS can occur after infections as it thought to be triggered by the immune system . The hypothesis is that when the body is fighting an infection some of the antibodies it produces can attack our regulatory systems that control heart rate and blood pressure.
We are seeing an increase in POTS cases occurring after COVID-19 infection. These patient are referred to as the “long haulers”
These long haulers have elevated heart rate, fatigue, brain fog and shortness of breath with activity consistent with POTS.
We are seeing that COVID-19 is another infection that can lead to POTS.
Some articles on this
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.
Salim S. Virani, MD, PhD, FACC, FAHA, FASPC
Professor, Section of Cardiovascular Research
Director, Cardiology Fellowship Training Program
Baylor College of Medicine
Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center
Co-Director, VA Advanced Fellowship in Health Services Research & Development at the Michael E. DeBakey VA Medical Center, Houston, TX
Investigator, Health Policy, Quality and Informatics Program
Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation
Houston, TX @virani_md
MedicalResearch.com: What is the background for this study? What are the main findings? What do you think accounts for the gender differences?
Response: We know that women with ischemic heart disease (IHD) have lower prescription rates for statin and high-intensity statin therapy. In this study, we assessed whether the same trends hold true for women with other forms of atherosclerotic cardiovascular disease (ASCVD) i.e. women with peripheral artery disease (PAD) or ischemic cerebrovascular disease (ICVD). Maximally tolerated statin therapy is a Class-I indication in patients with clinical ASCVD which includes PAD and ICVD.
We also assessed statin adherence among men and women with PAD and ICVD.
Lastly, we performed exploratory analyses to assess whether statin therapy, statin intensity, and statin adherence in women with PAD and ICVD were associated with cardiovascular outcomes and/or mortality.