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AHA Journals, Author Interviews, Health Care Systems, Hospital Readmissions, Medicare / 13.05.2014

Alex Blum, MD MPH FAAP Chief Medical Officer Evergreen Health, Baltimore MD 21211MedicalResearch.com Interview with: Alex Blum, MD MPH FAAP Chief Medical Officer Evergreen Health, Baltimore MD 21211 MedicalResearch.com: What are the main findings of the study? Dr. Blum: Accounting for the social risk of patients using a measure of neighborhood socioeconomic status (SES), did not alter the hospital rankings for congestive heart failure (CHF) readmission rates. (more…)
Author Interviews, Brigham & Women's - Harvard, Calcium, Heart Disease / 13.05.2014

Dr. Julie Paik, MD MPH Instructor, Harvard Medical School Brigham and Women's Massachusetts GeneralMedicalResearch.com Interview with: Dr. Julie Paik, MD MPH MSc Instructor, Harvard Medical School Brigham and Women's Hospital MedicalResearch: What are the main findings of the study? Dr. Paik: Many women in the United States take calcium supplements. One study found that over 60% of women aged 60 and over in the United States were taking calcium supplements. However, the medical community is still not certain of the effects of calcium supplements in women, particularly on cardiovascular disease risk. For this reason, we studied 74,245 women participating in the Nurses' Health Study over a 24-year follow-up period for their risk of developing cardiovascular disease (heart disease or stroke). We found that there was no increased risk of heart disease or stroke among women taking calcium supplements during the 24-year follow-up period. Our paper has several distinct strengths compared to prior studies including the large sample size, long follow-up period, cases of cardiovascular disease that were confirmed by medical record review, detailed and repeated assessment of calcium supplement use, and detailed information about other risk factors for cardiovascular disease. (more…)
Author Interviews, BMJ, Emergency Care, Heart Disease / 03.05.2014

Dr. Richard Body Emergency Department Manchester Royal Infirmary Manchester UKMedicalResearch.com Interview with:  Dr. Richard Body Emergency Department Manchester Royal Infirmary Manchester UK   MedicalResearch.com: What are the main findings of the study? Dr. Body: This paper actually reports the findings of two consecutive, separate studies.  We aimed to derive and then externally validate a clinical decision rule to risk stratify patients with suspected acute coronary syndromes in the Emergency Department (ED).  This rule could then be used to reduce unnecessary hospital admissions while also making judicious use of specialist high dependency resources. In the first study we derived a clinical decision rule that incorporates 8 variables: high sensitivity troponin T, heart-type fatty acid binding protein; ECG ischaemia; worsening angina; hypotension (systolic blood pressure <100mmHg on arrival); sweating observed in the ED; pain associated with vomiting; and pain radiating to the right arm or shoulder.  When we validated the rule at a different centre, we found that its use could have avoided hospital admission for over a quarter of patients while effectively risk stratifying others.  Of the 10% of patients who were identified as 'high risk', approximately 95% had a major adverse cardiac event within 30 days.  The findings suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule could be used to 'rule in' and 'rule out' acute coronary syndromes immediately, using information gathered at the time of initial presentation to the ED.  Before clinical implementation, we recommend that effect of using the MACS rule in practice should first be evaluated in a trial setting.  This will enable us to determine: (a) whether physicians and patients are likely to comply with (and be satisfied with) the MACS rule; (b) the safety of the MACS rule when used in practice; and (c) whether use of the MACS rule leads to cost savings for the health service. (more…)
Heart Disease, Vitamin D / 01.05.2014

Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner HospitalMedicalResearch.com Interview with: Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital MedicalResearch.com: What are the main findings of the study? Dr. Lewis: We tested the hypothesis raised by others that calcium supplementation with or without vitamin D increases coronary heart disease and mortality risk in elderly women. To do this we undertook a meta-analysis of published and unpublished data from patient level and cluster randomized controlled trials of calcium supplements with or without vitamin D in elderly women. Importantly all events included in this large meta-analysis were verified by clinical review, hospital record or death certificate. We did not observe any significant increase in all-cause mortality or coronary heart disease events that included myocardial infarction, angina pectoris and acute coronary syndromes and chronic coronary heart disease. (more…)
Author Interviews, Diabetes, Heart Disease / 24.04.2014

Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K.MedicalResearch.com Interview with: Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K. MedicalResearch.com: What are the main findings of the study? Prof. Heller: We explored the potential to hypoglycaemia to cause cardiac arrhythmias since we have previously shown that a low glucose can alter the electrocardiogram.  We had a hypothesis that alterations in heart rhythm or ectopic beats might contribute to cardiac mortality and in part explain the association between intensive diabetic therapy and increased mortality.  We therefore undertook continuous glucose monitoring and 12 lead EKG monitoring for a period of 5 days in individuals with Type 2 diabetes at increased CV risk.  We found that hypoglycaemia was fairly common and that nocturnal episodes in particular, were generally marked by a pattern whereby glucose levels dropped to low levels for some hours during which patients slept.  These periods of hypoglycemia were associated with a high risk of marked slow heart rates (bradycardia) accompanied by ectopic beats.  Our data suggest that this was due to overactivity of the vagus nerve.  We have therefore identified a mechanism which might contribute to increased mortality in individuals with Type 2 diabetes and high CV risk during intensive insulin therapy. (more…)
AHA Journals, Author Interviews, Cannabis, Heart Disease / 23.04.2014

Emilie Jouanjus, PharmD, PhD Risques, maladies chroniques et handicaps Facult_e de M_edecine, Guesde, Toulouse 31073, France.MedicalResearch.com Interview with: Emilie Jouanjus, PharmD, PhD Risques, maladies chroniques et handicaps Facult_e de M_edecine, Guesde, Toulouse 31073, France. MedicalResearch.com: What are the main findings of the study? Dr. Jouanjus: Our study emphasizes that cardiovascular complications make up 1.8 percent of cannabis-related health complications reported in France. These were cases of peripheral arteriopathies, and cardiac and cerebrovascular disorders, some of which resulted in the death. These findings conducted us to conclude that marijuana is a possible risk factor for cardiovascular disease in young adults. (more…)
Heart Disease, JACC / 16.04.2014

Rine Nakanishi, MD, PhD Los Angeles Biomedical Research Institute MedicalResearch.com Interview with: Rine Nakanishi, MD, PhD Los Angeles Biomedical Research Institute MedicalResearch.com: What are the main findings of the study? Dr. Nakanishi: With growing evidence that a measurement of the buildup of calcium in coronary arteries can predict heart disease risk, Los Angeles Biomedical Research Institute (LA BioMed) researchers found that the process of "calcium scoring" was also accurate in predicting the chances of dying among adults with little or no traditional risk factor of heart disease. The study conducted by LA BioMed researchers examined 5,593 adults with no known heart disease and zero or minimal risk factor of heart disease -- including hypertension, dyslipidemia, diabetes, current smoking and family history of heart disease -- who had undergone coronary artery calcium screening by non-contrast cardiac computed tomography from 1991-2011. Among the adults in the study, even those with low coronary artery calcium scores of 1-99 were 50% more likely to die of heart disease than adults with a calcium score of zero. Adults with moderate scores of 100-399 were 80% more likely to die from heart disease than those with a score of zero, and those with scores of 400 or more were three times more likely to die from heart disease, when compared to adults with no calcified plaque buildup, or a score of zero. (more…)
Accidents & Violence, Author Interviews / 20.03.2014

Judy A. Stevens PhD National Center for Injury Prevention and Control Centers for Disease Control and Prevention Atlanta GA 30341MedicalResearch.com Interview with: Judy A. Stevens PhD National Center for Injury Prevention and Control Centers for Disease Control and Prevention Atlanta GA 30341 MedicalResearch.com: What are the main findings of the study? Dr. Stevens: The fall death rate among persons aged 65 and older has been increasing rapidly. We used vital statistics data to examine the circumstances and contributing conditions to fall deaths. We found that of 21,649 fall deaths in 2010, the largest proportion (35%) occurred from falling on the same level, followed by falling on stairs or steps (6.5%).  From 1999 to 2010, there was a trend toward more specific reporting of falls circumstances. However, information about the circumstances of 49% of the 2010 fall deaths was not available. In 2010, 49% of fall deaths involved a head injury and 30% involved a hip fracture. The most important contributing causes to fall deaths were circulatory diseases, especially hypertension, and respiratory diseases. Factors that may partially explain the rapid increase in the fall death rate include changing trends in the death rates for underlying chronic diseases strongly associated with falls, such as reductions in cardiovascular disease deaths, as well as better reporting on death certificates of falls as the underlying cause of death. (more…)
Author Interviews, Heart Disease, JAMA, NIH, Omega-3 Fatty Acids / 19.03.2014

MedicalResearch.com Interview with: Denise Bonds, MD, MPH National Heart, Lung, and Blood Institute (NHLBI)  MedicalResearch.com: What are the main findings of the study? Dr.Bonds: We found no cardiovascular benefit to supplementation of the diet with either omega-3 fatty acids or with the macular xanthophyll’s lutein and zeaxanthin. (more…)
AHA Journals, Author Interviews, Diabetes, Heart Disease, OBGYNE / 18.03.2014

Erica P. Gunderson, PhD, MS, MPH Senior Research Scientist, Cardiovascular and Metabolic Section Division of Research, Kaiser Permanente Northern California Oakland, CA 94612-2304MedicalResearch.com Interview with: Erica P. Gunderson, PhD, MS, MPH Senior Research Scientist, Cardiovascular and Metabolic Section Division of Research, Kaiser Permanente Northern California Oakland, CA 94612-2304 MedicalResearch.com: What are the main findings of the study? Dr. Gunderson: The study found that: -   Gestational diabetes is a pregnancy complication that reveals a woman’s greater risk of future heart disease. -   Women who experience gestational diabetes face an increased risk of subclinical atherosclerosis (early heart disease) even if they do not develop type 2 diabetes or the metabolic syndrome years after pregnancy. -   Study participants with a history of gestational diabetes who did not develop diabetes or metabolic syndrome showed a greater carotid artery wall thickness (marker of early atherosclerosis) compared to those who never experienced gestational diabetes.  The vessel narrowing also could not be attributed to obesity or other risk factors for heart disease that were measured before pregnancy. -   Weight gain and blood pressure elevations in women with gestational diabetes were responsible for these differences in the artery wall thickness. (more…)
Heart Disease, Orthopedics / 16.03.2014

Bheeshma Ravi, MDMedicalResearch.com Interview with: Bheeshma Ravi, MD Orthopedic Surgery University of Toronto Medical Center   MedicalResearch.com: What are the main findings of the study? Dr. Ravi:  This study suggests that in persons with moderate-severe osteoarthritis of the hip or knee, total joint replacement is associated with a significant reduction in the risks for serious cardiovascular events. (more…)
AHA Journals, Heart Disease, Karolinski Institute, Kidney Disease / 13.03.2014

Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden.MedicalResearch.com Interview with: Martin Holzmann, MD, PhD Department of Emergency Medicine, Karolinska University Hospital Stockholm Sweden. MedicalResearch.com: What are the main findings of the study? Dr. Holzmann: The main finding is that patients with renal dysfunction are at increased risk of cardiovascular events after undergoing CABG for acute coronary syndromes. (more…)
Author Interviews, Heart Disease, JAMA, Nutrition, Sugar / 03.02.2014

MedicalReseach.com Interview with: Quanhe Yang, PhD Division for Heart Disease and Stroke Prevention Centers for Disease Control and Prevention, Atlanta, GA 30341 MedicalReseach.com: What are the main findings of the study? Dr. Yang: The majority of US adults consume more added sugar than is recommended for a healthy diet. On average, Americans consume about 15% of daily calories from added sugar.  About 70% of adults consume more than 10%of calories from added sugar and another 10% consume more than 25% of calories from added sugar. When you compare those who consume 7.5% (lowest quintile) of calories from added sugar with participants who consume between 17%-21% (quintile 4) of calories from added sugar, the latter group has a 38% higher risk of CVD mortality. But the risk of CVD death more than doubles  for those who consume  ≥21% (highest quintile) of calories from added sugar. (more…)
Author Interviews, BMJ, Heart Disease, Nutrition / 15.01.2014

Dr Victoria J Burley Senior Lecturer in Nutritional Epidemiology School of Food Science and Nutrition University of Leeds Biostatistics, University of Leeds, UKMedicalResearch.com Interview with: Prof. Victoria J Burley Senior Lecturer in Nutritional Epidemiology School of Food Science and Nutrition University of Leeds Biostatistics, University of Leeds, UK MedicalResearch.com: What are the main findings of the study? Prof. Burley: Although it’s been suggested for a long time that foods rich in dietary fiber may protect individuals from having a heart attack or stroke because they lower some of the risk factors for these diseases, trying to determine how much dietary fibre might be beneficial and whether these benefits are apparent in all populations around the world has been less easy to research. Our research at the University of Leeds has pooled the results of published large-scale follow-up studies and has demonstrated a consistent lowering of risk of cardiovascular and coronary heart disease with increasing dietary fiber intake. This dose-response trend suggests that even small additional increments in intake may be beneficial in the long term. (more…)
Author Interviews, Calcium, Gender Differences, Heart Disease / 09.11.2013

Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital Hospital Avenue, Nedlands 6009MedicalResearch.com Interview with: Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital Hospital Avenue, Nedlands 6009 www.boneandvascularresearch.org.au MedicalResearch.com: What are the main findings of the study? Dr. Lewis: The paper reports the findings from an ancillary study of the effects of 1200 mg per day of calcium supplementation on a major predictor of heart disease risk, carotid artery intima-medial thickness and atherosclerosis. The principle study was a large five-year double blind randomized controlled trial of calcium supplements or a placebo. After 3 years of calcium supplementation or placebo measures of carotid artery intima-medial thickness were identical in the placebo and calcium treated patients.  Atherosclerotic plaque was reduced in calcium treated patients when analysed as total calcium intake. These findings argue strongly against an adverse effect of high dose calcium tablets on cardiovascular risk. (more…)
Author Interviews, Heart Disease, Mayo Clinic, Rheumatology / 30.10.2013

Eric Matteson, M.D. Rheumatology Chair Mayo Clinic in Rochester, Minn.MedicalResearch.com Interview with: Eric Matteson, M.D. Rheumatology Chair Mayo Clinic in Rochester, Minn. MedicalResearch.com:   What are the main findings of the studies? Dr. Matteson: “The main finding is that patients with severe rheumatoid arthritis have a higher risk of heart disease.  Further, women who experience early menopause also have a higher risk of heart disease.” (more…)
Author Interviews, Heart Disease, Rheumatology / 29.10.2013

MedicalResearch.com Interview with: Lotta Ljung, MD, PhD Umeå University, Umeå and Karolinska  Institute Stockholm, Sweden MedicalResearch.com: What are the main findings of the study? Dr. Ljung:  In this observational study we observed a lower risk of acute coronary syndromes in a cohort of patients with rheumatoid arthritis (RA) exposed to tumor necrosis factor inhibitors (TNFi) compared with the risk among patients without this exposure. The adjusted relative risk (HR) was 0.73-0.82  among TNFi exposed patients compared with the biologics-naive RA cohort, depending on the time frame evaluated, which can be concluded as a moderately lower risk. Compared with the risk in the general population, the risk in RA patients was higher, whether exposed to TNFi or not. (more…)
Diabetes, Diabetes Care, Heart Disease / 28.10.2013

MedicalResearch.com Interview with: Marcin Sadowski Świętokrzyskie Cardiology Center, Kielce, Poland MedicalResearch.com: What are the main findings of the study? Dr. Sadowski: In multivariable analysis, diabetes was an independent risk factor of in-hospital and 1-year mortality in women treated for STEMI. In women with STEMI and diabetes one-year mortality was significantly lower in those treated with primary percutaneous coronary intervention than in those on optimal medical therapy. Early and long-term prognoses after STEMI were the worst in diabetic women, compared with non-diabetic women and diabetic men. (more…)
Author Interviews, Cancer Research, Heart Disease, Radiology / 16.10.2013

Prof. Dr. Gunnar Brix Division of Medical and Occupational Radiation Protection Federal Office for Radiation Protection Institut für Med. Strahlenhygiene 85764 NeuherbergMedicalResearch.com: Prof. Dr. Gunnar Brix Division of Medical and Occupational Radiation Protection Federal Office for Radiation Protection Institut für Med. Strahlenhygiene 85764 Neuherberg MedicalResearch.com:  What are the main findings of the study? Answer: We investigated the cumulative radiation exposure and cancer risk of more than 1200 patients with ischemic heart diseases (IHD) from diagnostic and therapeutic imaging procedures performed 3 month before and 12 month after the date of diagnosis. The major findings were:
  • ­    87% of patient exposure resulted from heart catheter procedures.
  • ­    The average cumulative effective dose was 13.3 mSv in males and 10.3 mSv in females. The highest dose was nearly 100 mSv.
  • ­    The estimated average attributable life-time risk of male and female patients to develop a radiation-induced cancer in their remaining life was 0.09 % and  0.07 %, respectively. This correspond to 1 excess cancer in about 1100 male and 1400 female IHD patients. The highest risk was 0.9 %.
  • ­ The effective dose is inadequate to characterize individual radiation risks, since neither the age nor the sex of the patient is taken into account. According to our results, cancer risks can vary by a factor of more than 10 for comparable values of the effective dose. (more…)
Cancer Research, Heart Disease, MD Anderson, Ovarian Cancer / 08.10.2013

Anil K. Sood MD Department of Gynecologic Oncology The University of Texas MD Anderson Cancer Center Unit 1362, PO Box 301439, Houston, TX, 77030MedicalResearch.com Interview with: Anil K. Sood MD Department of Gynecologic Oncology The University of Texas MD Anderson Cancer Center Unit 1362, PO Box 301439, Houston, TX, 77030 MedicalResearch.com: What are the main findings of the study? Dr. Sood: For women with newly diagnosed ovarian cancer, high heart rate at diagnosis (tachycardia), venous thromboembolism (VTE) occurring after diagnosis and pulmonary hypertension post-diagnosis are independently related to reduced survival after controlling for tumor stage, grade, and extent of cytoreduction.  Women with tachycardia lived an average of 4.0 years after diagnosis compared with 5.9 years for women without tachycardia, a 32% reduction in duration of survival.  Patients who experienced VTE lived a median 4.1 years after diagnosis, compared with 6.4 yrs for patients who did not experience VTE. (more…)
Author Interviews, Diabetes, MRI, Nature, Stroke / 13.09.2013

Fabian Bamberg, MD, MPH Department of Clinical Radiology Ludwig Maximilians University, Klinikum Grosshadern Marchioninistrasse 15, 81377 Munich, GermanyMedicalResearch.com Interview with: Fabian Bamberg, MD, MPH Department of Clinical Radiology Ludwig Maximilians University, Klinikum Grosshadern Marchioninistrasse 15, 81377 Munich, Germany  MedicalResearch.com: What are the main findings of the study?  Dr. Bamberg: Our study shows that there is a substantial and heterogenous degree of subclinical cardiovascular disease burden in patients with diabetes undergoing whole-body MRI. These whole-body MRI findings have significant prognostic relevance. For instance, our results show that patients without any pathologic findings experience no adverse cardiovascular event over a period of six years while the risk for a heart attack or stroke increases with the degree of disease burden. (more…)
Author Interviews, Heart Disease, Stroke / 13.09.2013

Dr. Eung Y. Kim Department of Radiology, Research Institute of Radiological Science, Department of Neurology, and Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul, Korea;MedicalResearch.com Interview with: Dr. Eung Y. Kim Department of Radiology Gachon University Medical Center Incheon, South Korea.   MedicalResearch.com: What are the main findings of the study? Answer: The extent of calcification involving intracranial artery significantly correlates with that of coronary artery in patients with ischemic stroke. The Agatston score measured in the intracranial arteries may be an independent predictor of asymptomatic coronary artery disease in patients with ischemic stroke. (more…)
Author Interviews, Exercise - Fitness, Heart Disease / 11.09.2013

Madelein Hoogwegt, MSc Promovenda Center of Research on Psychology in Somatic diseases (CoRPS) Department of Medical and Clinical Psychology Kamer P711 Tilburg University 5000 LE TilburgMedicalResearch.com Interview with: Madelein Hoogwegt, MSc Promovenda Center of Research on Psychology in Somatic diseases (CoRPS) Department of Medical and Clinical Psychology Kamer P711 Tilburg University 5000 LE Tilburg MedicalResearch.com: What are the main findings of the study? Answer: The main finding was that we found a significant relation between positive affect and mortality, and that exercise explained this relationship. With respect to the second outcome, hospitalization, we found a significant relation between positive affect and hospitalization, a significant relation between positive affect and hospitalization, but exercise did not mediate this relationship. (more…)
Author Interviews, Heart Disease, JAMA / 26.08.2013

Dr Pamela N Peterson MD Denver Health Medical Center, CO MedicalResearch.com Interview with: Dr Pamela N Peterson MD Denver Health Medical Center, CO   MedicalResearch.com: What are the main findings of the study? Answer: We assessed the outcomes of mortality, rehospitalization, and procedural complications among 24,169 patients in the NCDR-ICD Registry with left ventricular systolic dysfunction receiving a cardiac resynchronization device in addition to an implantable defibrillator for the primary prevention of sudden cardiac death between 2006 and 2009. After stratification by the QRS complex morphology and duration on the ECG and adjustment for measured differences in other characteristics, patients with left bundle branch block (LBBB) and QRS durations of at least 150 msec had significantly lower rates of mortality and rehospitalization at 3 years compared with patients with non-LBBB QRS morphology and/or QRS duration of 120-149 msec. Rates of mortality and readmission were generally highest in patients with non-LBBB and QRS duration of 120-149 msec. Rates of procedural complications at 30- and 90-days were similar across strata of QRS morphology and duration. (more…)
Author Interviews, Heart Disease, JAMA, Kidney Stones / 27.07.2013

Dr. Pietro Manuel Ferraro Division of Nephrology–Renal Program, Department of Internal Medicine and Medical Specialties, Columbus-Gemelli Hospital, Rome, ItalyMedicalResearch.com Interview with Dr. Pietro Manuel Ferraro Division of Nephrology–Renal Program, Department of Internal Medicine and Medical Specialties, Columbus-Gemelli Hospital, Rome, Italy MedicalResearch.com: What are the main findings of the study? Dr. Ferraro: We analyzed three large cohorts over time to see if those with prevalent or incident kidney stones might have a higher risk of developing coronary heart disease (fatal or non fatal myocardial infarction or the need for coronary revascularization). The cohorts consisted of over 200,000 participants without any prior history of coronary heart disease. After a median follow-up of over 8 years, we observed that women affected with stones seem to have a greater risk of developing coronary heart disease independent of a number of other known cardiovascular risk factors such as diabetes or high blood pressure. We did not observe a significant association among men. (more…)
Author Interviews, Heart Disease, OBGYNE / 18.07.2013

MedicalResearch.com Interview with Prof. Eyal Sheiner MD PhD Senior Obstetrician

Soroka Medical Center, Israel

MedicalResearch.com: What are the main findings of the study? Dr. Sheiner: The study was aimed to investigate whether a history of preterm delivery (PTD) poses a risk for subsequent maternal long-term cardiovascular morbidity. During the study period 47,908 women met the inclusion criteria; 12.5% (n=5992) patients delivered preterm. During a follow-up period of more than ten years, patients with PTD had higher rates of simple as well as complex cardiovascular events and higher rate of total cardiovascular related hospitalizations. A linear association was found between the number of previous PTD and future risk for cardiovascular hospitalizations (5.5% for two or more PTD, 5.0% for one PTD vs. 3.5% in the comparison group; P<0.001). The association remained significant for spontaneous vs. induced PTD and for early (<34 weeks) as well as late (34-36+6 weeks) PTD. In a Cox proportional hazards model that adjusted for pregnancy confounders such as labor induction, diabetes mellitus, preeclampsia and obesity, PTD was independently associated with cardiovascular hospitalizations (adjusted HR 1.4, 95% CI 1.2-1.6). (more…)
Author Interviews, Heart Disease, JAMA, Yale / 25.06.2013

Dr. Kumar Dharmarajan MD MBA Yale School of Medicine Center for Outcomes Research & Evaluation (CORE)Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart FailureMedicalResearch.com  Interview with Dr. Kumar Dharmarajan MD MBA

Yale School of Medicine Center for Outcomes Research & Evaluation (CORE)Contraindicated Initiation of β-Blocker Therapy in Patients Hospitalized for Heart Failure MedicalResearch.com: What are the main findings of the study? We found that among a large contemporary cohort of heart failure hospitalizations, beta blockers are frequently started in patients with markers of clinical instability such as residence in an intensive care unit (ICU), volume overload requiring intravenous diuresis, and poor cardiac output requiring intravenous inotropes. Approximately 40% of patients in whom a beta blocker is started has at least one of these three potential contraindications to treatment. This finding is concerning, as recent performance measures for heart failure recommend that a beta blocker be started during hospitalization for heart failure among patients with left ventricular systolic dysfunction. However, these performance measures also state that persons in whom a beta blocker is started "should not be hospitalized in an ICU, should have no or minimal evidence of fluid overload or volume depletion, and should not have required recent treatment with an intravenous positive inotropic agent." Moving forward, we are concerned that the unselective application of the new performance measure may lead to the further use of beta blocker therapy in patients at higher risk for adverse consequences of therapy. (more…)
Author Interviews, Heart Disease, Lifestyle & Health / 04.06.2013

MedicalResearch.com eInterview with: Haitham Ahmed, MD, MPH The Ciccarone Center for the Prevention of Heart Disease Johns Hopkins Hospital MedicalResearch.com: What were the main findings of the study? Dr. Ahmed: Everyone knows that healthy lifestyle habits are major factors that protect you from heart disease. What we don’t know is which habits are most important, and how exactly these habits prevent disease progression along the causal biological pathway over years and years. So we followed 6,200 men and women of various ethnic backgrounds from 6 university locations across the US. We looked at their eating habits, exercise, weight, and smoking history. We did CT scans on them at the start of the study and then a few years later (mean 3 years) and found that healthier people had lower calcium deposition in their coronaries. We then kept following them and found that these same healthy people had a trend towards less cardiovascular events. We then kept following them further and found that these same healthy people died less, by an 80% lower rate, compared to people that were unhealthy, which was incredible. So what we took away from this is that you have enormous power in changing your risk of atherosclerosis, heart disease, and death by changing your lifestyle behaviors. (more…)
Author Interviews, Exercise - Fitness, Heart Disease, JAMA, Smoking, Tobacco Research / 16.04.2013

MedicalResearch.com Author Interview with Dr. Koon Teo, MB, PhD Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada MedicalResearch.com: What are the main findings of the study? Dr. Teo: In this study we examined the prevalence of smoking cessation or avoidance, eating a healthy diet and undertaking regular physical activities in nearly 8000 individuals who had previously experienced a coronary heart disease event or stroke, on average 5 years after their events. The individuals were recruited from over 600 communities in 17 countries with varying incomes and economic development.  We found that although these healthy lifestyle activities could reduce the risk of further heart or stroke events, about one fifth of individuals continued to smoke, only one third undertook regular leisure or work related physical activities and about two fifths ate a healthy diet. (more…)