heart disease Tag
17 Sep High and High-Normal Thyroid Levels Linked To Increased Risk of Sudden Cardiac Death
Posted at 21:55h
in AHA Journals, Author Interviews, Brigham & Women's - Harvard, Endocrinology, Heart Disease, Thyroid Disease
MedicalResearch.com Interview with:
[caption id="attachment_28053" align="alignleft" width="200"]
Dr. Layal Chaker[/caption]
Layal Chaker, MD, MSc
PhD candidate
Department of Endocrinology and Epidemiology
Erasmus Medical Center
Rotterdam, The Netherlands
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The association of thyroid function with coronary heart disease is well–established but not much was known about the association of thyroid function with sudden cardiac death. We conducted the study with the hypothesis that thyroid hormone levels affect cardiovascular risk factors and therefore could also affect the risk of sudden cardiac death (SCD). We were surprised to see that when we control our analyses for these cardiovascular risk factors, the association of high and high-normal thyroid function with SCD remained similar, suggesting that other pathways could play a role. Thyroid hormone has different effects on the cardiovascular systems and future studies should identify which pathway could be responsible for the increased risk of sudden cardiac death with higher thyroid hormone levels. This could lead to better assessment of individual risk and identify possible prevention targets.
15 Sep Early Menopause Linked To Increased Risk of Heart Disease and Carotid Atherosclerosis
MedicalResearch.com Interview with: Taulant Muka, MD, MPH, PhD Postdoctoral Researcher Erasmus University, Rotterdam MedicalResearch.com: What is the background for this study? What are the main findings? Response: Menopause marks a major life transition for women, resulting in the loss of ovarian follicle development. Although menopause is a universal phenomenon among women, the timing of the final menstrual period differ greatly between women, and is considered a marker of aging. By quantifying data of nearly 310,329 non-overlapping women, we found that women who experienced an early menopause (i.e. younger than 45 years) have an excess risk of CHD, CVD-mortality and all-cause mortality. Furthermore, being 45-49 years at menopause compared to ≥50 years was associated with increased risk of carotid atherosclerosis.14 Sep Study Outlines Risk Factors for Infectious Endocarditis After TAVR
MedicalResearch.com Interview with: [caption id="attachment_21314" align="alignleft" width="120"]
Dr. Rodés-Cabau[/caption]
Josep Rodés-Cabau, MD
Director, Catheterization and Interventional Laboratories
Quebec Heart and Lung Institute
Professor, Faculty of Medicine, Laval University
Quebec City, Quebec, Canada
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Infectious endocarditis (IE) is one of the most serious complications after surgical prosthetic valve replacement. There are however scarce data regarding the incidence, predictive factors, treatment, and outcomes of IE post-TAVR. To date, the present study represents the largest series of IE post-TAVR, and the main findings can be summarized as follows: (1) the incidence of infective endocarditis (IE) post-TAVR is similar to that reported for IE after surgical prosthetic valve replacement; (2) among patients undergoing TAVR, younger age, male sex, a history of diabetes mellitus, and moderate-to-severe residual aortic regurgitation were associated with a higher risk of IE, (3) Enterococci species was the most frequently isolated pathogen, (4) IE post-TAVR was associated with a very high rate of in-hospital complications and mortality during index hospitalization and at follow-up.
14 Sep Three Criteria To Identify Out-of-Hospital Cardiac Arrest Patients With No Chance of Survival
MedicalResearch.com Interview with: [caption id="attachment_27901" align="alignleft" width="150"]
Prof. Xavier Jouven[/caption]
Prof. Xavier Jouven
Service de Cardiologie
Hôpital Européen Georges Pompidou
Paris
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There are many cardiac arrests (around 300 000 per year in United States). The possibility to collect organs from a certain proportion of those cardiac arrests represents an important opportunity to fill the gap of the organ shortage.
It is absolutely mandatory to identify patients with no chance of survival. This study showed 3 criteria which allow this early identification. Several thousands of patients die every year waiting for organ transplantation.
13 Sep Body Mass Index Linked to LV Mass in Career Male Firefighters
MedicalResearch.com Interview with: [caption id="attachment_27860" align="alignleft" width="200"]
Maria Korre[/caption]
Maria Korre, ScD
Post-Doctoral Research Fellow
Environmental & Occupational Medicine & Epidemiology Program
Department of Environmental Health
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Cardiovascular disease (CVD) is the leading cause of on-duty death among firefighters (45% of on-duty fatalities) and a major cause of morbidity. It is crucial to note though, that the risk of on-duty CVD events is not evenly distributed among all firefighters, but is highly concentrated among the most susceptible individuals. Given that firefighting is an inherently dangerous occupation and many of its hazards cannot be engineered out of the job, we have concentrated our efforts on understanding what can make an individual firefighter susceptible.
As in the general population, these cardiovascular events are largely due to coronary heart disease (CHD), however, there is an increasing recognition of the role of left ventricular (LV) hypertrophy/cardiomegaly in the risk of sudden cardiac death (SCD) independent of the presence of CHD. Evidence suggests an improved prognostic value, when LV hypertrophy is based on the accurate assessment of LV mass.
LV mass is a strong predictor of CVD events and despite it’s critical prognostic significance, it’s measurement and role in clinical practice has yet to be established.
In this paper we aimed to identify the most important predictors of LV mass after indexing for height among career male firefighters as assessed by both echocardiography and cardiac magnetic resonance.
12 Sep Atrial Fibrillation Associated With Wide Range of Cardiovascular Events
MedicalResearch.com Interview with: Ayodele Odutayo, DPhil student Centre for Statistics in Medicine Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford, Oxford, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atrial fibrillation is associated with an increased risk of all cause mortality and stroke, as well as higher medical costs and a reduced quality of life. The association between atrial fibrillation and cardiovascular outcomes other than stroke is less clear. We found that atrial fibrillation is associated with a wide range of cardiovascular events, including cardiovascular mortality, major cardiovascular events, heart failure, ischaemic heart disease, chronic kidney disease, and sudden cardiac death, as well as stroke and all cause mortality. The relative and absolute risk increase associated with many of these events is greater than that of stroke. Interventions are needed to reduce the risk of non-stroke cardiovascular outcomes in adults with atrial fibrillation.11 Sep TAVR: Women Have More Short Term Complications But Better One-Year Survival
MedicalResearch.com Interview with: [caption id="attachment_27680" align="alignleft" width="152"]
Dr. Michael Gaglia[/caption]
Michael A. Gaglia Jr., MD, MSc, FACC, FSCAI
Scientific Lead, Population Research
Medstar Cardiovascular Research Network
Interventional Cardiology
Medstar Heart and Vascular Institute
Washington, DC 20010
MedicalResearch.com: What is the background for this study?
Response: Cardiovascular outcomes vary according to gender in a variety of disease states. For example, short-term mortality is higher among women presenting with an acute coronary syndrome in comparison to men. There is a similar trend for higher short-term mortality of women undergoing coronary artery bypass grafting, although this is in part due to a relatively higher burden of comorbidities. Female gender is also a well-established risk factor for bleeding complications after percutaneous coronary intervention.
In regards to women undergoing surgical aortic valve replacement for severe aortic stenosis (AS), however, the data is equivocal; some studies suggest higher mortality for women, whereas others suggest improved survival for women.
The emergence of transcatheter aortic valve replacement (TAVR) as the preferred therapeutic option for patients with severe AS at high or extreme risk for surgery offered another opportunity to examine gender disparities in outcomes. The evidence base for the impact of gender upon TAVR, however, is still evolving. A recent meta-analysis suggested improved long-term survival among women after TAVR. And in general, previous studies also suggest more vascular and bleeding complications in women when compared to men. The goal of this study was relatively simple: to compare outcomes between women and men undergoing TAVR at a single center.
08 Sep Despite Valuable Biomarkers Clinical Evaluation Still Important in Diagnosing Heart Attack
MedicalResearch.com Interview with: [caption id="attachment_27783" align="alignleft" width="95"]
Dr. Juan Sanchis[/caption]
Dr. Juan Sanchis
Full professor of Medicine
Cardiology Department, University Clinic
Hospital. Medicine Department, University of Valencia
Valencia. Spain
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Decision making in acute chest pain in the emergency departments
remains challenging despite the introduction of new troponin assays
(high-sensitivity assays) capable of detecting any amount of
myocardial damage.
The upper limit of normality of high-sensitivity
troponin is established at the 99th percentile of a normal reference
population. This is the limit for the diagnosis of acute myocardial
infraction. Detectable troponin levels below the 99th percentile,
though non diagnostic of acute myocardial infarction, might be
considered as of uncertain significance since some patients might
still suffer from unstable angina. Undetectable troponin (far below
the 99th percentile), however, could rule out unstable angina meaning
that such patients could safely be discharged from the emergency
department according to some studies. Therefore, if this were fully
demonstrated, clinical evaluation could play a secondary role.
We investigated clinical data in comparison to undetectable
high-sensitivity troponin in patients with normal high-senstivity
troponin levels (below the 99th percentile).
The main findings indicate that clinical data can guide decision making and perform at
least equally well as undetectable high-sensitivity troponin for
ruling out unstable angina, in patients presenting at the emergency
department with chest pain and normal troponin.
07 Sep Stem Cells May Be Stimulated in Women With Chest Pain But Normal Coronary Arteries
[caption id="attachment_27692" align="alignleft" width="125"]
Dr. Arshed Auyyumi[/caption]
MedicalResearch.com Interview with:
Arshed A. Quyyumi MD; FRCP
Professor of Medicine, Division of Cardiology
Emory University School of Medicine
Co-Director, Emory Clinical Cardiovascular Research Institute
Atlanta GA 30322
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Circulating progenitor or stem cells were discovered in adults 15 years ago. We now know that they may be stimulated by injury or ischemia, and they go down in number and function with aging, particularly when aging is associated with risk factors.
Women with chest pain despite normal coronary arteries are thought to have ischemia because of microvascular dysfunction. We found that these women, with the worst microvascular function (measured as coronary flow reserve), had higher levels of circulating stem or progenitor cells. This implies that the mild ischemia they are having during their normal daily life, leads to stimulation of their stem cells. Also, the vascular abnormality may be a stimulus for repair.
06 Sep Athletes Should Be Checked For Ventricular Hypertrophy Before Triathalon
MedicalResearch.com Interview with: [caption id="attachment_21730" align="alignleft" width="125"]
Dr. Richard Moon[/caption]
Richard Moon, MD
Professor of Anesthesiology
Professor of Medicine
Medical Director, Center for Hyperbaric Medicine & Environmental Physiology
Duke University Medical Center
Durham, NC 27710
MedicalResearch.com: What is the background for this study?
Response: For several years we have been investigating the causes of immersion pulmonary edema (IPE, also known as swimming-induced pulmonary edema or SIPE). We determined that during exercise while immersed in cold water pulmonary artery and wedge pressures of individuals who are SIPE-susceptible are higher than normal. This demonstrated that SIPE is a form of hemodynamic pulmonary edema. It is certainly plausible that SIPE could cause death, and indeed a few fatal cases had been reported in the medical literature, mostly in scuba divers. After reading of deaths in young, apparently fit and healthy triathletes we hypothesized that some of these deaths were probably due to swimming-induced pulmonary edema . It is easy to diagnose SIPE in a living individual, using a stethoscope or chest x-ray/CT. However, since almost anyone who dies from any cause, particularly if attempted resuscitation has occurred, will have pulmonary edema at autopsy. Before concluding that death has occurred due to SIPE, other clues are therefore necessary.
04 Sep Significant Decline in Readmissions After PCI in Medicare Patients
MedicalResearch.com Interview with: [caption id="attachment_27659" align="alignleft" width="125"]
Dr. Christian McNeely[/caption]
Christian A. McNeely, M.D.
Resident Physician - Internal Medicine
Barnes-Jewish Hospital
Washington University Medical Center
MedicalResearch.com: What is the background for this study?
Response: Prior research has demonstrated that readmission in the first 30 days after percutaneous coronary intervention (PCI) is common, reported around one in six or seven Medicare beneficiaries, and that many are potentially preventable. Since 2000, there have been significant changes in the management of coronary artery disease and the use of PCI. Additionally, in the last decade, readmission rates have become a major focus of research, quality improvement and a public health issue, with multiple resulting national initiatives/programs which may be affecting care. Therefore, in this study, we sought to examine contemporary trends in readmission characteristics and associated outcomes of patients who underwent PCI using the Medicare database from 2000-2012.
04 Sep No Evidence of Worse STEMI Outcomes During Off-Hours
Posted at 00:37h
in Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Outcomes & Safety, Surgical Research
MedicalResearch.com Interview with:
Senthil Selvaraj, MD, MA and Deepak L. Bhatt, MD, MPH
Brigham and Women’s Hospital Heart & Vascular Center and
Harvard Medical School, Boston, MA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There has been significant controversy in the effect of off-hours presentation in ST-elevation myocardial infarction (STEMI). Off-hours presentation has been associated with longer treatment time, an independent predictor of worse outcomes in STEMI, though a number of other studies have shown no difference as well. Moreover, little data has been generated from clinical trials, which has the advantage of comprehensive and adjudicated outcomes.
In our analysis of nearly 2,000 STEMI patients from the CHAMPION PHOENIX study (a randomized, controlled trial of cangrelor in percutaneous coronary intervention), we found that off-hours presentation was not associated with worse efficacy or safety outcomes at 48 hours or 30 days. More specifically, outcomes not typically reported in registry data, such as ischemia-driven revascularization and stent thrombosis, were not significantly different between the groups. Interestingly, treatment times were actually faster in the “off-hours” group as well.
02 Sep Invasive Cardiac Therapies Linked To Better Survival Following Heart Attack
MedicalResearch.com Interview with: [caption id="attachment_27459" align="alignleft" width="163"]
Dr. Marlous Hall[/caption]
Dr Marlous Hall PhD
Senior Epidemiologist
Leeds Institute of Cardiovascular and Metabolic Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It is well known that death rates following heart attacks have fallen considerably over recent decades. Many studies have looked at the effect of medications and invasive strategies, and their association with better clinical outcomes is clear.
However, a big question remains: why have heart attack deaths fallen? Is it due to increased use of medications and treatment, is the risk of patients simply lower over time due to things like earlier diagnosis or are patients generally healthier with fewer comorbidities such as diabetes? Answering this is not straightforward - as gold standard studies like clinical trials on historic data cannot be done.
An alternative approach is to look for patterns in data observed from routine care to look at all these factors together. This study used a large and rich dataset covering heart attack care in the UK (Myocardial Ischaemia National Audit Project (MINAP)). This dataset was linked to outcome data from the Office for National Statistics to allow us to look at all the different factors that could influence the change in mortality over time.
02 Sep Comparable Diabetes and Heart Disease Care Provided By Physicians and Advanced Care Providers
Posted at 01:37h
in Author Interviews, Baylor College of Medicine Houston, Diabetes, Health Care Systems, Heart Disease
MedicalResearch.com Interview with:
Salim S. Virani, MD, PhD and
Julia Akeroyd MPH
Health Services Research and Development
Michael E. DeBakey Veterans Affairs Medical Center
Houston
MedicalResearch.com: What is the background for this study?
Response: Given the increase in the number of Americans seeking primary health care due to the Affordable Care Act, combined with current and anticipated physician shortages in the US, there is a growing need to identify other models of primary care delivery to address chronic diseases.
31 Aug Urinary Biomarkers Predict Progression of Acute Kidney Injury In Heart Failure
MedicalResearch.com Interview with: Xiaobing Yang, MD Division of Nephrology, Nanfang Hospital Southern Medical University MedicalResearch.com: What is the background for this study? Response: AKI is a common complication in patients with acute decompensated heart failure (ADHF) and associated with increased death and worse clinical outcomes. Early detecting which patients are going to suffer progressive AKI or proceed to death could help physicians to plan and initiate timely managements. We analyzed data and samples of 732 ADHF patients from a prospective, multicenter study in China. We demonstrated that kidney injury biomarkers, measured at the first time of AKI clinical diagnosis, could predict which patients were going to have AKI progression or worsening of AKI with death. Notably, three urinary biomarkers, including urinary angiotensinogen (uAGT), urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary IL-18 (uIL-18), were all able to forecast which patients with the earliest stages of AKI were most likely to suffer progressive AKI.31 Aug Fewer Overall New Cardiovascular Drugs, But More Biologics Researched
Posted at 18:14h
in Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Pharmacology
MedicalResearch.com Interview with:
[caption id="attachment_27299" align="alignleft" width="125"]
Dr. Aaron Kesselheim[/caption]
Aaron S. Kesselheim, M.D., J.D., M.P.H.
Associate Professor of Medicine at Harvard Medical School
Director, Program On Regulation, Therapeutics, And Law (PORTAL)
Division of Pharmacoepidemiology and Pharmacoeconomics
Brigham and Women's Hospital
Boston MA 02120
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It has been previously reported that the number of new cardiovascular drugs approved by the U.S. Food and Drug Administration (FDA) has declined in recent years. So we sought to empirically assess trends in the development of new cardiovascular therapeutics.
31 Aug Early Invasive Cardiac Treatment Provided Longterm Benefit For Patients With Non-STEMI Acute Coronary Syndrome
MedicalResearch.com Interview with: [caption id="attachment_27529" align="alignleft" width="125"]
Prof. Lars Wallentin[/caption]
Prof Lars Wallentin, MD PHD
Senior Professor Cardiology
Uppsala Clinical Research Center,
Uppsala University
MedicalResearch.com: What is the background for this study?
Response: The FRISC2 study was performed 1996 – 1998 and reported 1999 for the first time a significant reduction in death and myocardial infarction by early invasive compared to non-invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). The results at 6 months, 1, 2 and 5 years were published in The Lancet and pivotal in changing the treatment guidelines and thereby improving outcomes in patients with NSTE-ACS. These findings were within the next few years verified in the TACTICS-TIMI18 and RITA3 trials. However the later performed ICTUS trial, starting after these results were published and accordingly with a substantial early crossover to the invasive arm, showed neutral results. Recently the reduction in event rates by an early invasive strategy was again validated in patients above 80 years of age, which were less well represented in the initial trials. These benefits of an early invasive strategy have previously been shown sustained for at least five years based on results from the FRISC2, RITA3, and ICTUS trials. The FRISC2 and TACTICS-TIMI18 trials also showed that the benefits with an early invasive strategy seemed confined to patients with signs of myocardial necrosis as indicated by elevated troponin level at entry. In addition the FRISC2 trial found that the benefits were larger in patients with signs of inflammatory activity as indicated by a high level of growth differentiation factor 15 (GDF-15) at entry. These pivotal results have been the basis for the current international treatment guidelines recommending an early invasive treatment strategy in patients with NSTE-ACS and elevated troponin and/or other indicators of a raised risk.
31 Aug Drug-Eluting Stents Reduce Need for Revascularization after PCI
MedicalResearch.com Interview with: Dr. Kaare Harald Bønaa Principal investigator University of Tromsø, Norway MedicalResearch.com: What is the background for this study? Response: The NORSTENT study was designed shortly after the “Barcelona fire storm” in 2006 that raised severe safety concerns against drug-eluting stents (DES). At that time there was evidence for increased risk of stent thrombosis with DES. How this could influence long term results compared to PCI with bare metal stents (MMS) was not known. Accordingly, we designed the NORSTENT study with the primary composite endpoint of all-cause mortality and non-fatal spontaneous myocardial infarction at a medial of 5 years of follow-up.31 Aug Clinical Interventions Reduced Hospital Readmissions After PCI Stent Surgery
Posted at 02:45h
in AHA Journals, Author Interviews, Heart Disease, Hospital Readmissions, Surgical Research
MedicalResearch.com Interview with:
[caption id="attachment_27509" align="alignleft" width="200"]
Dr. Jason Wasfy[/caption]
Jason H. Wasfy, MD, MPhil
Assistant Medical Director, Massachusetts General Physicians Organization
Director of Quality and Analytics
Massachusetts General Hospital Heart Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Reducing preventable readmissions after PCI is a way to both improve the quality of care for our patients and improve value for patients with coronary artery disease. Through a variety of tactics, we were able to reduce the 30 day readmission rate for patients after PCI by nearly half. Keep in mind that this is only the readmission rate to our hospital, so we will need to confirm these results with data including patients who may have been readmitted to other hospitals after a PCI at Mass General.
30 Aug Study Finds CPAP Improved Quality of Life But Did Not Reduce Cardiovascular Risk
Posted at 18:23h
in Author Interviews, Heart Disease, NEJM, Obstructive Sleep Apnea, Sleep Disorders
MedicalResearch.com Interview with:
Prof. Craig Anderson, PhD
Professor of Stroke Medicine and Clinical Neuroscience
Medicine, The George Institute for Global Health
University of Sydney
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We wished to prove whether treatment of obstructive sleep apnea with continuous positive airway pressure (CPAP ) can modify the risk of cardiovascular disease. The is a lot of association data from epidemiological and clinical studies but no large scale international clinical trials assessing the effects of CPAP on the prevention of serious cardiovascular events like heart attack and stroke.
Our study in nearly 3000 adults with prior heart attack or stroke and moderate to severe obstructive sleep apnea showed that CPAP treatment did not prevent recurrent cardiovascular events or major cardiovascular risk factors. However CPAP did improve wearers' sense of wellbeing, mood and work productivity.
30 Aug Current Allocation System for Heart Transplantation Might Disfavor Adults with Congenital Heart Disease.
Posted at 11:37h
in Author Interviews, Brigham & Women's - Harvard, Heart Disease, JACC, Transplantation
MedicalResearch.com Interview with:
[caption id="attachment_27286" align="alignleft" width="125"]
Dr. Laith Alshawabkeh[/caption]
Dr. Laith Alshawabkeh MD
Senior Fellow
Brigham & Women's and Boston Childrens Hospitals / Harvard Medical School
MedicalResearch.com: What is the background for this study?
Response: As the number of adults living with congenital heart disease continues to increase, there is paucity of evidence on the trajectories and patterns of their comorbidities. In all, heart failure is the leading cause of death in this group of patients. Unfortunately, landmark trials and advances in medical therapy which promoted increase survival in patients with the usual heart failure (non-congenital) has not been translated into those with congenital heart disease. Heart transplantation remains one of the (if not the only) sustainable option for many patients with congenital heart disease at the end stage of heart failure. Recent studies have shown that adults with congenital heart disease who underwent transplantation experienced higher risk of postoperative mortality compared to their non-congenital counterparts; however, patients with congenital heart disease who survived the first year post-transplantation enjoyed significantly better long-term survival, indicating that with careful selection those patients might benefit tremendously from transplantation. Much less is known about the outcome of these patients while they are waiting for an organ. As such, this study sought to examine the outcomes of patients with congenital heart disease while listed for heart transplantation and to investigate correlates of adverse outcomes (mortality and delisting due to clinical worsening).
30 Aug IV Administration of Stem Cells Viable and More Practical Than Direct Cardiac Implantation
MedicalResearch.com Interview with: [caption id="attachment_27294" align="alignleft" width="125"]
Dr. Javed Butler[/caption]
Javed Butler, M.D., MPH, FACC, FAHA
Chief of the Cardiology Division and Co-Director of the Heart Institute at Stony Brook University
Stony Brook Heart Institute
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It was previously assumed that stem cells must be delivered directly to the myocardium to improve patient outcomes. However, this delivery mechanism – either in the coronary artery or the myocardium – may not be feasible for millions of patients and for repeat injections. This study represents the first clinical trial to observe the effects of intravenous (IV) administration of ischemia-tolerant mesenchymal stem cells (itMSCs) in patients with chronic heart failure. Results show that an IV injection strategy is safe and well-tolerated.In addition, the data illustrate statistically significant improvement in 6-minute walk test, quality-of-life scores as assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ) and favorable immune modulatory benefits.
30 Aug Complex Stent Procedures May Require Longer Period of Antiplatelet Therapies
MedicalResearch.com Interview with: [caption id="attachment_27419" align="alignleft" width="160"]
Dr. Gennaro Giustino[/caption]
Gennaro Giustino MD
Resident Physician - Department of Medicine
The Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: A period of dual antiplatelet therapy (DAPT) is required after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). The pathophysiological rationale for DAPT after DES-PCI is predicated on the need to prevent stent-related thrombotic complications while vascular healing and platform endothelialization are ongoing, a process that seems to last between 1 and 6 months with new-generation DES. Whether to extend DAPT after this mandatory period in order to provide a broader atherothrombotic risk protection (for stent-related and non-stent-related atherothrombotic events) is currently a matter of debate. Current guidelines recommend at least 6 months of DAPT after PCI in patients with stable coronary artery disease (CAD) and at least 12 months of DAPT in patients presenting with acute coronary syndrome (ACS). While, several risk scores have been developed to guide clinical decision making for DAPT intensity and duration (namely the DAPT score and the PARIS risk scores) little attention has been payed so far to PCI complexity and the extent of CAD to guide duration of DAPT. In fact irrespective of clinical presentation, patients undergoing more complex PCI procedure (likely due to greater coronary atherosclerotic burden) may remain at greater risk for ischemic events and therefore may benefit of prolonged, or more intense, DAPT.
25 Aug Model Developed For Prediction of Sudden Cardiac Death
MedicalResearch.com Interview with: [caption id="attachment_27344" align="alignleft" width="133"]
Dr. Alvaro Alonso[/caption]
Alvaro Alonso, MD, PhD
Associate Professor
Department of Epidemiology
Rollins School of Public Health
Emory University
Atlanta, GA
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Sudden cardiac death (SCD) is a major public health problem. Each year, 300,000-400,000 Americans experience SCD and, in more than half of these cases, sudden cardiac death is the first manifestation of heart disease. To date, however, we lack effective strategies to identify those at higher risk of developing sudden cardiac death so targeted preventive strategies can be applied.
In this study, we develop and validate the first model for the prediction of SCD in ~18,000 adults without a prior history of cardiovascular disease. We show that information on demographic variables (age, sex, race), some traditional cardiovascular risk factors (smoking, elevated blood pressure, diabetes, HDL cholesterol) as well as some factors more specifically related to SCD causes (electrocardiogram QT interval) and novel biomarkers (albumin, potassium in blood, kidney function) can be leveraged to predict risk of SCD and identify individuals more likely to suffer this event.
25 Aug HIV Patients With Depression Have Greater Risk of Myocardial Infarction
MedicalResearch.com Interview with: Matthew S Freiberg, MD, MSc Cardiovascular Medicine Division, Vanderbilt University School of Medicine Tennessee Valley Geriatric Research Education and Clinical Center, Nashville TN Tasneem Khambaty, PhD Department of Psychology, University of Miami, Coral Gables, Florida Jesse C. Stewart, PhD Department of Psychology, Indiana University–Purdue University , Indianapolis, Indianapolis MedicalResearch.com: What is the background for this study? Response: Due to highly effective antiretroviral therapy, people with HIV are living longer. Unfortunately, these HIV-infected individuals remain at a higher risk for other chronic diseases, with cardiovascular disease (CVD) being one of the leading cause of death in this population. In the general population, depressive disorders, such as major depressive disorder (MDD) and dysthymic disorder, are associated with increased risk of new-onset CVD. Given that roughly 24-40% of HIV-infected individuals have a depressive disorder, we examined whether MDD and dysthymic disorder are also associated with an increased risk of new-onset CVD in people with HIV.25 Aug Technetium Cardiac Imaging Predicts Prognosis of Cardiac Amyloidosis
MedicalResearch.com Interview with: [caption id="attachment_27269" align="alignleft" width="100"]
Dr. Adam Castano[/caption]
Adam Castano, M.D., M.S.
Division of Cardiology
Columbia University Medical Center
New York Presbyterian Hospital
MedicalResearch.com: What is the background for this study?
Response: Transthyretin cardiac amyloidosis (ATTR-CA) is an increasingly recognized cause of heart failure with preserved ejection fraction (HFpEF). Traditionally, the gold standard for diagnosis has required an endomyocardial biopsy coupled with either immunohistochemistry or mass spectroscopy. These specialized tests are only performed at centers with experienced satff, do not yield prognostically useful information, may be inadvisable for frail older adults, and often present logistical challenges that lead to delayed care.
Fortunately, single center studies have demonstrated excellent diagnostic accuracy using technetium 99m pyrophosphate (Tc99mPYP) cardiac imaging for noninvasively detecting ATTR-CA and differentiating it from another major type of cardiac amyloidosis called light chain (AL). But the diagnostic accuracy of this technique in a multicenter study and the association of Tc99mPYP myocardial uptake with survival were not known prior to this study.
Therefore, we assessed in a multicenter study Tc99mPYP cardiac imaging as a diagnostic tool and its association with survival. We conducted a retrospective cohort study of 229 patients evaluated at 3 academic specialty centers for cardiac amyloidosis and also underwent Tc99mPYP cardiac imaging. We measured retention of Tc99mPYP in the heart using a semiquantitative visual score (range 0-3) and a more quantitative heart-to-contralateral (H/CL) ratio calculated as total counts in a region of interest over the heart divided by background counts in an identical size region of interest over the contralateral chest. The outcome measured was time to death after Tc99mPYP imaging.
24 Aug Patients With Psoriasis Have Coronary Calcium Scores Comparable to Diabetes
Posted at 21:00h
in Author Interviews, Dermatology, Diabetes, Heart Disease, JAMA, Medical Imaging, NIH
MedicalResearch.com Interview with:
Nehal N. Mehta, .MD., M.S.C.E. F.A.H.A.
Lasker Clinical Research Scholar
Section of Inflammation and Cardiometabolic Diseases
NIH
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Psoriasis is associated with accelerated cardiovascular (CV) disease; however, screening for CV risk factors in psoriasis remains low. Coronary artery calcium (CAC) score estimates the total burden of atherosclerosis. Psoriasis has been associated with increase CAC score, but how this compares to patients with diabetes, who are aggressively screened for CV risk factors, is unknown.
20 Aug Gallstones Linked With Increased Risk of Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_27217" align="alignleft" width="200"]
Dr. Lu Qi[/caption]
Lu Qi, MD, PhD
HCA Regents Distinguished Chair and Professor
Director,Tulane University Obesity Research Center
Department of Epidemiology
Tulane University School of Public Health and Tropical Medicine
1440 Canal Street, Suite 1724
New Orleans, LA 70112
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Gallstone disease has been related to various risk factors of cardiovascular disease, and several previous studies suggest potential link between gallstone disease and heart disease. Our study, for the first time, provide consistent evidence for the association between gallstone disease and an increased risk of cardiovascular disease.
19 Aug Genes Responsible For Cardiometabolic Diseases Identified
MedicalResearch.com Interview with: [caption id="attachment_27194" align="alignleft" width="130"]
Dr. Johan Björkegren[/caption]
Johan LM Björkegren, MD, PhD
Professor, Chief Clinical Science Officer
Department of Genetics and Genomic Sciences
Icahn Institute for Genomics and Multiscale Biology
Icahn School of Medicine at Mount Sinai
New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The STARNET (Stockholm-Tartu Atherosclerosis Reverse Network Engineering Task) study was launched in 2007 by myself and Dr. Arno Ruusalepp MD, PhD, Chief Cardiac Surgeon at Tartu University Hospital in Estonia, and senior co-author on the study. Unlike similar studies, STARNET obtained samples of several key tissues from 600 clinically well-characterized patients with CAD during coronary artery bypass surgery. By using sophisticated data analysis techniques, the researchers found that the gene expression data from STARNET were highly informative in identifying causal disease genes and their activity in networks not only in CAD but also for other cardiometabolic diseases as well as Alzheimer’s disease.
By analyzing gene-expression data from multiple tissues in hundreds of patients with coronary artery disease, we were able to identify disease-causing genes that either were specific to single tissues or acted across multiple tissues in networks to cause cardiometabolic diseases.