AHA Journals, Author Interviews, Heart Disease / 07.10.2014

Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, The Leon H. Charney Division of Cardiology, Associate Professor of Medicine, New York University School of MedicineMedicalReseach.com Interview with: Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, The Leon H. Charney Division of Cardiology, Associate Professor of Medicine, New York University School of Medicine New York, NY 10016. Medical Research: What are the main findings of the study? Dr. Bangalore: Using data from the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial, we found that β-blocker use in patients with prior myocardial infarction but no heart failure was associated with a lower composite cardiovascular outcome, driven mainly by lower risk of recurrent myocardial infarction with no difference in mortality. However, in patients without prior myocardial infarction there was no benefit of β-blocker use with a suggestion of increase in stroke risk. (more…)
Author Interviews, Heart Disease / 01.10.2014

MedicalResearch.com Interview with: Lior Yankelson, MD PhD Tel Aviv Medical Center MedicalResearch: What are the main findings of the study? Dr. Yankelson: The main findings of the study are that new onset atrial fibrillation after TAVI does not confer a significant risk for mortality , and confers somewhat increased risk for stroke. The latter issue is expected to become less significant with new technological advancements coming into the market, such as lower profile devices and emboli protection both mechanical and pharmaceutical. The more significant and alarming finding is that patients with atrial fibrillation have more than 4 fold risk for death at 1 year post TAVI compared to patients without afib. This is very significant and raises questions regarding the benefit for the procedure in these patients. (more…)
Author Interviews, Heart Disease, JAMA / 30.09.2014

MedicalResearch.com Interview with: Marwan Badri MBChB, MRCP Cardiovascular disease fellow Lankenau Medical Center Wynnewood Pa Medical Research : What is the background for this study? Dr. Badri: Recent years witnessed increased emphasis of the role of clinical guidelines in cardiovascular care. Physicians are encouraged to practice within the framework of major society guidelines to deliver better, more cost-effective patient care. It is therefore vital that the recommendations in these guidelines are applicable to most of the patient population. Since some clinical trials have been shown in the past to unfavorably exclude women, racial minorities and elderly patients, we conducted this study to see if the clinical trials used to form the American College of Cardiology/American Heart Association adequately represent these patient groups. (more…)
AHA Journals, Author Interviews, Heart Disease, Karolinski Institute / 29.09.2014

dr_iffat_rahmanMedicalResearch.com Interview Invitation with: Dr. Iffat Rahman Ph.D. Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Rahman: Our study suggests that moderate to high level of physical activity could protect against heart failure in women. (more…)
Author Interviews, Heart Disease, JACC / 29.09.2014

MedicalResearch.com Interview with: Katharina Mayer MD Deutsches Herzzentrum München, Technische Universität München, Munich, Germany Medical Research: What are the main findings of the study? Dr. Mayer: Patients whose platelets do not respond well to aspirin carry a higher risk of death or stent thrombosis. Platelet response to aspirin is an independent predictor of ischemic events in patients undergoing percutaneous coronary interventions (PCI). (more…)
Author Interviews, Heart Disease, JACC / 23.09.2014

Jerry D. Estep, M.D., FACC Assistant Professor of Medicine, Weill Cornell Medical College Medical Director, Heart Transplant & LVAD Program Methodist DeBakey Heart & Vascular Center Houston Methodist HospitalMedicalResearch.com Interview with: Jerry D. Estep, M.D., FACC Assistant Professor of Medicine, Weill Cornell Medical College Medical Director, Heart Transplant & LVAD Program Methodist DeBakey Heart & Vascular Center Houston Methodist Hospital Medical Research: What are the main findings of the study? Dr. Estep: There were two major findings: 1-Non-invasive Doppler echocardiographic and invasive measures of mean right atrial pressure (RAP) (r = 0.863; p < 0.0001), systolic pulmonary artery pressure (sPAP) (r=0.880; p<0.0001), right ventricular outflow tract stroke volume (r=0.660; p < 0.0001), and pulmonary vascular resistance (r = 0.643; p= 0.001) correlated significantly. 2-An algorithm integrating mitral inflow velocities, RAP, sPAP, and left atrial volume index was 90% accurate in distinguishing normal from elevated left ventricular filling pressures. (more…)
Author Interviews, Diabetes / 22.09.2014

MedicalResearch.com Interview with: Yuli Huang and Yunzhao Hu Department of Cardiology, the First People's Hospital of Shunde, Shunde District, Foshan, PR China. Medical Research: What are the main findings of the study? Response: “Prediabetes” is a general term that refers to an intermediate stage between normoglycaemia and overt type 2 diabetes mellitus (T2DM). It includes 2 groups of individuals, those with impaired glucose tolerance (IGT) and those with impaired fasting glucose (IFG). In 2003, the American Diabetes Association (ADA) redefined the fasting plasma glucose (FPG) concentration range for diagnosing IFG from 110 to 125 mg/dl to 100 to 125 mg/dl in order to better identify individuals at future type 2 diabetes mellitus risk. However, this change has been contentious and was not adopted by the World Health Organization (WHO) Expert Group or other international guidelines. In this meta-analysis, we included data from 26 prospective cohort studies with for 280,185 participants and found that, after controlling for multiple cardiovascular risk factors, the presence of prediabetes at baseline, defined as defined as IFG of 110 to 125 mg/dL(IFG 110), IGT or combined IFG 110 and/or IGT, was associated with increased risk of all-cause and cardiovascular mortality. Specifically, IFG 110 was associated with 12% and 19% increase of all-cause and cardiovascular mortality, IGT was associated with 33% and 23% increase of all-cause and cardiovascular mortality, combination of IFG110 and/or IGT was associated with 21% and 21% increase of all-cause and cardiovascular mortality, respectively. Although IFG 100 was not associated with all-cause or cardiovascular mortality in the overall analysis, the risk was greater in young and middle age males according to subgroup analyses. (more…)
Author Interviews, Heart Disease / 16.09.2014

Muthiah Vaduganathan, MD MPH Department of Medicine Massachusetts General Hospital Boston, MassMedicalResearch.com Interview with: Muthiah Vaduganathan, MD MPH Department of Medicine Massachusetts General Hospital Boston, Mass Medical Research: What are the main findings of the study? Dr. Vaduganathan: Based on data from a large, multinational randomized controlled trial of patients hospitalized for heart failure and reduced ejection fraction (HFrEF), we conducted a retrospective analyses of the clinical profiles associated with baseline serum uric acid levels. Serum uric acid was commonly elevated in patients hospitalized for heart failure and reduced ejection fraction (mean ~9 mg/dL), especially in men and black patients. Higher uric acid levels were associated with lower systolic blood pressure and EF, higher natriuretic peptides, and more impaired renal function. After accounting for 24 known baseline covariates, serum uric acid was independently predictive of post-discharge mortality and rehospitalization in patients with relatively preserved renal function, but not in those with poor renal function. (more…)
Diabetes, Heart Disease / 13.09.2014

Carlos F. Sánchez-Ferrer, M.D., Ph.D. Professor of Pharmacology Universidad Autónoma de Madrid, Spain.MedicalResearch.com Interview with: Carlos F. Sánchez-Ferrer, M.D., Ph.D. Professor of Pharmacology Universidad Autónoma de Madrid, Spain. Medical Research: What are the main findings of the study? Dr. Sánchez-Ferrer: We were studying the possible ways of interaction between high glucose levels, which are found in diabetes mellitus, with vascular damage, which is the most common and devastating consequence of this disease. An intriguing fact is that a very strict control of blood sugar in diabetic patients is not sufficient to avoid the development of such diabetes-induced cardiovascular diseases. We think our results can explain why this is happening. Using cultured smooth muscle cells from the main human artery (aorta) in the presence of high concentrations of extracellular glucose, we observed: 1. In the absence of inflammation, excess glucose in the culture fluid didn’t enter the cells. 2. When extra glucose was forced into the cells, no harm was done in the absence of inflammation. 3. When the inflammation-stimulating protein interleukin-1 (IL-1) was introduced, more glucose entered the cells. 4. With IL-1, the glucose entering the cells was metabolized via chemical pathways that spur escalating inflammation, overwhelming the cells’ ability to counteract it. 5. In the presence of the anti-inflammatory drug anakinra, which blocks the activity of IL-1, the deleterious changes didn’t occur. (more…)
AHA Journals, Author Interviews, Heart Disease, Obstructive Sleep Apnea / 11.09.2014

MedicalResearch.com Interview with: Marcia Klein M.D., Ph.D. Adjunctive professor Rio de Janeiro State University This study was conducted at the Discipline of Clinical and Experimental Pathophysiology - Rio de Janeiro State University and the financial support of FAPERJ. Medical Research: What was the main findings of the study? Dr. Klein: The main findings were that a diet with moderate calories restriction in obese patients with obstructive sleep apnea may be able not only to reduce body fat but also to reduce obstructive sleep apnea severity and blood pressure. (more…)
Author Interviews, Gender Differences, Heart Disease / 04.09.2014

Sumeet S. Chugh MD Pauline and Harold Price Endowed Professor Associate Director, the Heart Institute Section Chief, Clinical Cardiac Electrophysiology Cedars-Sinai Medical Center, Los Angeles, CAMedicalResearch.com Interview with: Sumeet S. Chugh MD Pauline and Harold Price Endowed Professor Associate Director, the Heart Institute Section Chief, Clinical Cardiac Electrophysiology Cedars-Sinai Medical Center, Los Angeles, CA Medical Research: What are the main findings of the study? Dr. Chugh: Our study, conducted in the community, showed that there are unique alterations in sex hormone levels identified among patients who have sudden cardiac arrest. Male victims have lower testosterone and both males and females have higher estrogren levels. (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, JAMA / 31.08.2014

Massimo Imazio. MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital and University of Torino Torino, ItaliaMedicalResearch.com Interview with: Massimo Imazio on behalf of the COPPS-2 Investigators Massimo Imazio. MD, FESC Dipartimento di Cardiologia/Cardiology Department Maria Vittoria Hospital and University of Torino Torino, Italia Medical Research: What is the background for this investigation? Dr. Imazio: Post-pericardiotomy syndrome, post-operative atrial fibrillation (AF), and post-operative effusions may be responsible for increased morbidity and healthcare costs after cardiac surgery. Postoperative use of colchicine prevented these complications in a single trial (the COPPS trial published on EHJ in 2010). Here all events occurred within 3 months and colchicine was given after cardiac surgery starting from postoperative day 3 for 1 month. However most postoperative AF events are reported in the first 3 days and thus pre-treatment with colchicine may give better outcomes. Thus we performed the COPPS-2 giving colchicine 48 to 72 hours before surgery for 1 month without a loading dose and weight adjusted doses (i.e. 0.5 mg twice daily for patients >70kg or 0.5 mg once for patients <70Kg) in order to improve patients compliance.The Colchicine for Prevention of the Post-pericardiotomy Syndrome and post-operative atrial fibrillation (COPPS-2 trial) is an investigator-initiated, double-blind, placebo-controlled, randomized clinical trial. A total of 360 consecutive candidates for cardiac surgery, 180 for each arm, were enrolled in 11 Italian centers between March 2012 and March 2014. Main exclusion criteria were absence of sinus rhythm at enrollment, cardiac transplantation, and contraindications to . (more…)
Author Interviews, Heart Disease, NEJM / 30.08.2014

MedicalResearch.com Interview with: John J.V. McMurray, M.D Professor of Medical Cardiology British Heart Foundation, Cardiovascular Research Centre University of Glasgow, Glasgow, United Kingdom MedicalResearch.com Interview with: John J.V. McMurray, M.D Professor of Medical Cardiology British Heart Foundation, Cardiovascular Research Centre University of Glasgow, Glasgow, United Kingdom Medical Research: What are the main findings of the study? Dr. McMurray: That compared to an evidence-based dose of an evidence-based ACE inhibitor (enalapril 10 mg bid), LCZ696 reduced the primary composite outcome of cardiovascular death or heart failure hospitalization by 20%, both the components of that composite and all-cause mortality (the latter by 16%) - all reductions are highly statistically significant and clinically important. LCZ696 treated patients also reported fewer symptoms and physical limitations due to heart failure. We think this is a remarkable finding - to beat what has been the gold-standard, cornerstone, therapy for around 25 years. The findings show conclusively that adding neprilysin inhibition to renin-angiotensin system blockade is superior to renin-angiotensin system blockade alone in patients with heart failure and reduced ejection fraction . (more…)
Aging, Author Interviews, BMJ, Heart Disease / 28.08.2014

MedicalResearch.com Interview with: Philip Haycock, PhD Post-Doctoral Research Assistant MRC Integrative Epidemiology Unit University of Bristol Bristol, BS8 2BN, UK Medical Research: What are the main findings of the study? Dr. Haycock: We found that shorter telomeres were significantly associated with risk of coronary heart disease and that the association was independent of conventional vascular risk factors, including age, sex, body mass index, smoking, history of diabetes, blood pressure and lipid markers. (more…)
Author Interviews, Diabetes, Diabetes Care, Heart Disease, Pharmacology / 27.08.2014

Dr. Frank B. Hu Department of Nutrition Harvard School of Public Health Boston, MAMedicalResearch.com Interview with: Dr. Frank B. Hu Department of Nutrition Harvard School of Public Health Boston, MA Medical Research: What are the main findings of the study? Dr. Hu: in this study among approximately 5000 patients with type 2 diabetes followed for up to 10 years, longer duration of sulfonylurea therapy was associated with a higher risk of coronary heart disease. The continuous sulfonylurea therapy for 10 years was associated with almost two times greater risk of coronary heart disease compared with nonusers. However, given the observational nature of the study, we cannot make causal inference from these findings. (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, JAMA / 26.08.2014

Steven M. Bradley, MD, MPH Veterans Affairs Eastern Colorado Health CareSystem Denver, ColoradoMedicalResearch.com Interview with Steven M. Bradley, MD, MPH Veterans Affairs, Eastern Colorado Health CareSystem Denver, Colorado Medical Research: What are the main findings of the study? Dr. Bradley: In 539 hospitals participating in the CathPCI Registry that performed elective coronary angiography on more than 500,000 patients, 22% of patients were asymptomatic at the time of coronary angiography. We observed marked variation in the hospital rate of angiography performed in asymptomatic patients, ranging from 0.2% to 66.5%, suggesting broad variation in the quality of patient selection for coronary angiography across hospitals.  Additionally, hospitals with higher rates of asymptomatic patients at diagnostic angiography also had higher rates of inappropriate PCI, due to greater use of PCI in asymptomatic patients. These findings suggest that patient selection for diagnostic angiography is associated with the quality of patient selection for PCI as determined by Appropriate Use Criteria. By addressing patient selection upstream of the catheterization laboratory, we may improve on the optimal use of both angiography and PCI. (more…)
Author Interviews, Heart Disease, JAMA / 26.08.2014

Michael B. Rothberg, MD, MPH Department of Internal Medicine Medicine Institute, Vice Chair for Research Cleveland Clinic, Cleveland, OhioMedicalResearch Interview with: Michael B. Rothberg, MD, MPH Department of Internal Medicine Medicine Institute, Vice Chair for Research Cleveland Clinic, Cleveland, Ohio Medical Research: What are the main findings of the study? Dr. Rothberg: In this randomized study we found that when people are presented with no information about the benefits of elective PCI, most assumed that it would prevent a heart attack. Unfortunately, this is incorrect, so people may choose to have the procedure based on false information.  We also found that simply telling them that PCI would not prevent a heart attack successfully dispelled this belief for most,  but not all, participants.  Explaining why PCI does not prevent heart attacks in this circumstance was the most effective way to change people's beliefs.  We also found that most people were willing to take medications, but when they were told that PCI does not prevent heart attacks, they were more likely to agree to medication. (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, Stem Cells / 21.08.2014

Antonis Hatzopoulos, PhD, FAHA Associate Professor of Medicine- Division of Cardiovascular Medicine Associate Professor of Cell & Developmental Biology Vanderbilt Center for Stem Cell Biology Vanderbilt University Nashville, TN 37232-6300MedicalResearch.com Interview with: Antonis Hatzopoulos, PhD, FAHA Associate Professor of Medicine- Division of Cardiovascular Medicine Associate Professor of Cell & Developmental Biology Vanderbilt Center for Stem Cell Biology Vanderbilt University Nashville, TN 37232-6300 Medical Research: What are the main findings of the study? Dr. Hatzopoulos: Using cell tracking in the normal adult mouse heart, we found that endothelial cells can function as cardiac stem cells to generate new heart muscle.  Our results show that besides heart muscle, endothelial cells produce quiescent and proliferating cardiac progenitor cells that reside in the media and adventitia layers of the coronary arteries, respectively. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease, Stanford / 21.08.2014

Marco Perez, MD Instructor in Cardiovascular Medicine Director, Inherited Cardiac Arrhythmia Clinic Stanford University Medical Center Cardiac Electrophysiology & Arrhythmia Service Stanford, CA 94305-5233MedicalResearch.com Interview with Marco Perez, MD Instructor in Cardiovascular Medicine Director, Inherited Cardiac Arrhythmia Clinic Stanford University Medical Center Cardiac Electrophysiology & Arrhythmia Service Stanford, CA 94305-5233 Medical Research: What are the main findings of the study? Dr. Perez: It was already known that obesity is an important risk factor for atrial fibrillation.  We studied over 80,000 postmenopausal women enrolled in the Women’s Health Initiative who were followed for the onset of atrial fibrillation, an irregular heart rhythm associated with stroke and death.  We found that those who exercised more than 9 MET-hours/week (equivalent to a brisk walk of 30 minutes six days a week) were 10% less likely to get atrial fibrillation than those who were sedentary.  Importantly, the more obese the women were, the more they benefited from the exercise in terms of atrial fibrillation risk reduction. (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…)
AHA Journals, Author Interviews, Heart Disease / 18.08.2014

MedicalResearch.com Interview with: Sylvie S.L. Leung Yinko, RD MSc Epidemiology '14 Division of Clinical Epidemiology Research Institute of McGill University Health Centre (RI MUHC) Montreal (QC) H3A 1A1 Medical Research: What are the main findings of the study? Answer: Our study indicates that young female patients with premature acute coronary syndrome (ACS) have lower health-related quality of life (HRQL) than their male counterparts. Whereas “sex” refers to whether an individual is biologically male or female, “gender” is a more complex term that refers to social norms, roles, and expectations that are traditionally ascribed to males and females in a society. We found that gender, rather than sex, may larger explain the differences in health-related quality of life between men and women. Particularly, higher femininity score, lower social support and greater housework responsibilities appear to be important gender-related factors linked with poorer HRQL post-ACS. (more…)
AHA Journals, Author Interviews, Heart Disease / 16.08.2014

Ryan T. Borne MD University of Colorado Anschutz Medical Campus Division of Cardiology Aurora, CO 80045MedicalResearch.com Interview with: Ryan T. Borne MD University of Colorado Anschutz Medical Campus Division of Cardiology Aurora, CO 80045 Medical Research: What are the main findings of the study? Dr. Borne: Using the NCDR ICD Registry, we identified Medicare beneficiaries aged 65 years and older with low left ventricular ejection fraction (≤ 35%) who underwent primary prevention implantable cardioverter defibrillator implantation, including those receiving cardiac resynchronization therapy with defibrillator, between 2006 and 2010 who could be matched to Medicare claims. We found that while there were modest changes in the patient characteristics undergoing ICD implantation, there were significant improvements over time in mid-term outcomes including 6-month mortality, re-hospitalization, and device-related complications. (more…)
AHA Journals, Author Interviews, Heart Disease, UT Southwestern / 13.08.2014

MedicalResearch.com Interview with: Hurst M. Hall, MD and Sandeep Das, MD, MPH Division of Cardiology University of Texas Southwestern Medical Center Dallas, TX Medical Research: What are the main findings of the study? Answer: Most patients treated for a heart attack in the United States during this study period were discharged home on 325 mg of aspirin a day.  This was true even among subgroups expected to be at high bleeding risk. In addition, there was tremendous variability in the proportional use of this higher dose aspirin across hospitals, suggesting a prominent local influence on prescribing patterns. (more…)
AHA Journals, Author Interviews, Heart Disease / 13.08.2014

Susan Cheng MD Cardiovascular Division, Brigham and Women's Hospital Boston, MA 02115MedicalResearch.com Interview with: Susan Cheng MD Cardiovascular Division, Brigham and Women's Hospital Boston, MA 02115   Medical Research: What are the main findings of the study? Dr. Cheng: We've known for some time that smoking, high cholesterol, high blood pressure, diabetes, and obesity all contribute to a person’s risk of being at risk for heart disease. The goal of our study was to look back over the last two decades and see how we've been doing in reducing the impact of these major cardiovascular risk factors on the actual risk for developing heart and vascular disease. We found that, not surprisingly, we've been doing generally better over time at lowering the overall impact of some risk factors such as smoking and high cholesterol. On the other hand, the impact of hypertension and diabetes has been high and has remained high over time. (more…)
Author Interviews, Heart Disease / 13.08.2014

Professeur Philippe Gabriel Steg Département de Cardiologie Hôpital Bichat, Assistance Publique - Hôpitaux de Paris Université Paris-Diderot, Sorbonne Paris Cité, Paris, FranceMedicalResearch.com Interview with: Professeur Philippe Gabriel Steg Département de Cardiologie Hôpital Bichat, Assistance Publique - Hôpitaux de Paris Université Paris-Diderot, Sorbonne Paris Cité, Paris, France Medical Research: What are the main findings of this study? Prof. Philippe Steg:
  • Due to increasing use of angiography and revascularization, as well as improved drug therapy, the prevalence of angina and ischemia has diminished.
  • Most of the events (Cardiovascular death or Myocardial Infarction) occur in patients without angina or ischemia. This is very novel and important and stresses the importance of proper secondary prevention over "testing". We cannot be reassured by having a negative test for angina and ischemia.
  • Additionally, angina appears associated with a consistently greater risk than ischemia alone (having both is worse), so we need to pay attention to angina as a dire prognostic marker.
  • Findings should be no different in the US.
  • Most studies of silent ischemia antedate the advent of modern effective therapies or used very liberal definitions for "silent ischemia". (see our discussion)
(more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity / 10.08.2014

MedicalResearch.com Interview with: Sahil Khera, MD and Dhaval Kolte, MD, PhD Department of Medicine, Division of Cardiology New York Medical College, NY Medical Research: What are the main findings of the study? Answer: We used the publicly available Nationwide Inpatient Sample (NIS) databases for our study. We analyzed data on 6.5 million patients with heart attack (all types) from 2002 to 2011 in United States. Out of these 3.98 million were admitted with a diagnosis of non-ST elevation myocardial infarction (NSTEMI). Our objective was to describe how the care for patients with NSTEMI has changed over the past 10 years and whether this has resulted in better patient outcomes. We looked at the proportion of patients with NSTEMI who underwent cardiac catheterization each year. We also studied how many patients died in the hospital, how long was the hospital stay, and what was the total cost of hospitalization for this condition. Lastly, we determined if the changes in treatment and outcomes over the years were similar for different age- groups, men and women, and for different racial/ethnic groups. In this analysis, we looked at cardiac catheterization trends after NSTEMI for both within 24 hours and within 48 hours. This is the first study of its kind to analyze two different time frames of early catheterization simultaneously. Although there was an increase in the proportion of patients with NSTEMI with increase in utilization of early cardiac catheterization and decrease in in-hospital death and length of stay, age-, sex-, and race/ethnicity-specific differences in the management and outcomes of NSTEMI were observed, and further studies are needed to develop strategies to ensure more equitable care for patients with this type of heart attack. (more…)
AHA Journals, Author Interviews, Biomarkers, Heart Disease / 08.08.2014

MedicalResearch.com Interview with: Rakesh K. Mishra, MD San Francisco Veterans Affairs Medical Center San Francisco, CA 94121. Medical Research: What are the main findings of the study? Dr. Mishra: Increased levels of both BNP and NT-proBNP are associated with elevated risk of adverse cardiovascular events in patients with stable coronary artery disease. However, when added to existing clinical models of risk, NT-proBNP is superior to BNP for risk reclassification. (more…)