Author Interviews, JAMA, Salt-Sodium, Stroke / 09.02.2025

MedicalResearch.com Interview with: Xiong Ding, MPH School of Public Health Wuhan University Wuhan, China MedicalResearch.com: What is the background for this study? Response: Stroke is one of the leading causes of death and long-term disability worldwide, particularly in low- and middle-income countries. Patients who have previously experienced a stroke are at high risk of recurrence, and in China, this risk is even higher than the global average. It is well established that high blood pressure is a major risk factor for stroke recurrence, and lowering blood pressure is an effective preventive strategy. Salt substitutes, which replace part of sodium chloride with potassium chloride, have been shown to lower blood pressure by reducing sodium intake and increasing potassium intake. However, before our study, there was limited direct evidence demonstrating whether salt substitutes could reduce the risk of stroke recurrence and death. Therefore, we conducted this research as part of the Salt Substitute and Stroke Study (SSaSS), specifically focusing on stroke survivors to determine the long-term health effects of salt substitution in this high-risk population.
Author Interviews, Heart Disease, JAMA, Lipids / 03.07.2024

MedicalResearch.com Interview with: [caption id="attachment_62223" align="alignleft" width="150"]Evan A Stein MD PhD FACCCOO/CSO LIB Therapeutics Cincinnati. OH USA 45227 Dr. Stein[/caption] Evan A Stein MD PhD FACC COO/CSO LIB Therapeutics Cincinnati. OH USA 45227 MedicalResearch.com: What is the background for this study? Response: Cardiovascular disease (CVD) remains the main cause of morbidity and mortality worldwide and is increasing in rapidly industrializing countries and is projected to cause more than >20 million deaths annually over the next 15 years. Low-density lipoprotein cholesterol (LDL-C) is well established as a major, easily modifiable, risk factor for CVD. Reductions with statins and, more recently, PCSK9 inhibitors, all agents which directly or indirectly upregulate the LDL receptor and enhance LDL-C clearance, have demonstrated CVD event reductions in cardiovascular outcome trials. Extensive data from these trials, provide a rough estimate that every 40 mg/dL reduction in LDL-C will reduce the risk of major CV cardiovascular events by 22% to 24%. Furthermore, trials with PCSK9 inhibitors added to statins which achieve substantial additional LDL-C reduction show and CVD event reduction remains linear to very low LDL-C levels without signals of adverse events. Based on this body of evidence, recent revisions to national and international guidelines, now advocate for greater LDL-C reductions and lower LDL-C treatment goals, for patients not achieving these goals on statins alone. The current consensus target goal for LDL-C in patients with CVD, or who are at very-high risk for of CVD, is now less than <55 mg/dL, and <70 mg/dL for those at high risk. This global trial of over 900 patients with CVD, or at very or high risk for CVD, on maximally tolerated statins assessed the 52-week efficacy and safety of monthly lerodalcibep.
Author Interviews, Hip Fractures, Lipids / 20.01.2023

MedicalResearch.com Interview with: [caption id="attachment_59929" align="alignleft" width="133"]Dr Monira HussainSenior Research Fellow &  ECF Clinical Research Australian Fellow  Public Health and Preventive Medicine Monash University Melbourne VIC Dr. Hussain[/caption] Dr Monira Hussain Senior Research Fellow & ECF Clinical Research Australian Fellow Public Health and Preventive Medicine Monash University Melbourne VIC MedicalResearch.com: What is the background for this study? Response:  25% of males and 44% of females aged 60 years or over experience minimal trauma fractures. Minimal trauma fractures are a clinical outcome of osteoporosis and may occur following little or no trauma i.e. fractures following a fall from standing height or less. Minimal trauma fractures are silent, people may not notice that they are at high risk of the disease until a bone is broken. I was aware of previous studies reporting that high-density lipoprotein cholesterol (HDL-C) was elevated in patients with osteoporosis. Two animal studies showing that HDL-C reduces bone mineral density by reducing osteoblast number and function provide a plausible explanation for why high HDL-C may increase the risk of fractures. Our study, the ASPirin in Reducing Events in the Elderly (ASPREE), and the ASPREE fracture substudy provide unique data that could determine whether these findings might apply to fracture risk in healthy older adults. The study collected data including HDL-C levels and fractures from more than 16,000 community-dwelling older adults. These participants were followed-up for a median of 4 years.
Author Interviews, Blood Pressure - Hypertension, Exercise - Fitness, Heart Disease, JAMA / 05.08.2021

MedicalResearch.com Interview with: [caption id="attachment_57864" align="alignleft" width="200"]Fernando Ribeiro Dr. Ribeiro[/caption] Fernando Ribeiro PhD School of Health Sciences Institute of Biomedicine - iBiMED University of Aveiro Aveiro, Portugal MedicalResearch.com: What is the background for this study? What are the main findings? Response: Resistant hypertension is a puzzling problem without a clear solution. The available treatment options to lower blood pressure, namely medication and renal denervation, have had limited success, making nonpharmacological strategies good candidates to optimize the treatment of this condition. Exercise training is consistently recommended as adjuvant therapy for patients with hypertension, yet, it is with a great delay that the efficacy of exercise training is being tested in patients with resistant hypertension. Having that in mind, the EnRicH trial was designed to address whether the benefits of an exercise intervention with proven results in hypertensive individuals are extended to patients with resistant hypertension, a clinical population with low responsiveness to drug therapy. Exercise training was safe and associated with a significant and clinically relevant reduction in 24-hour, daytime ambulatory, and office blood pressure compared with control (usual care).
Author Interviews, CDC, COVID -19 Coronavirus, Heart Disease, JAMA, UCSD / 01.07.2021

MedicalResearch.com Interview with: [caption id="attachment_57736" align="alignleft" width="180"]Margaret Ryan Dr. Margaret Ryan[/caption] Margaret Ryan MD MPH Medical Director of Defense Health Agency Immunization Healthcare Division Pacific Region Office, San Diego CA Clinical Professor at the University of California San Diego MedicalResearch.com: What is the background for this study? What are the main findings? Response: Military clinicians, especially those in the Defense Health Agency Immunization Healthcare Division, first became aware of a few cases of myocarditis following COVID-19 vaccination in early Feb 2021.  These cases included young men who presented with chest pain a few days after 2nd dose of mRNA (Pfizer or Moderna) vaccine.  As more young people became eligible for 2nd doses of vaccine, more cases were identified.  By late April, the military had identified 23 cases of myocarditis, with remarkably similar presentations, after COVID-19 vaccination.  This case series is described in the current issue of JAMA Cardiology.
Author Interviews, Gender Differences, Heart Disease, JAMA / 22.04.2021

MedicalResearch.com Interview with: First Author [caption id="attachment_57208" align="alignleft" width="150"]Michelle Lee, MD, PharmD Fellow-in-training, Health Services Research & Development Michael E. DeBakey VA Medical Center, Houston, TX Dr. Lee[/caption] Michelle Lee, MD, PharmD Fellow-in-training, Health Services Research & Development Michael E. DeBakey VA Medical Center, Houston, TX   [caption id="attachment_57209" align="alignleft" width="128"]Dr-Virani Dr. Virani[/caption] Senior & Corresponding Author Salim S. Virani, MD, PhD, FACC, FAHA, FASPC Professor, Section of Cardiovascular Research Director, Cardiology Fellowship Training Program Baylor College of Medicine Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Co-Director, VA Advanced Fellowship in Health Services Research & Development Michael E. DeBakey VA Medical Center, Houston, TX Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Houston, TX MedicalResearch.com: What is the background for this study? Response: Atherosclerotic cardiovascular disease (ASCVD), defined as ischemic heart disease (IHD), ischemic cerebrovascular disease (ICVD), or peripheral arterial disease (PAD), is the leading cause of death globally. Particularly in young ASCVD patients, secondary prevention with antiplatelet therapy and statins are extremely important in reducing disease burden.
Author Interviews, Emergency Care, Heart Disease, JAMA, UT Southwestern / 22.04.2020

MedicalResearch.com Interview with: [caption id="attachment_53969" align="alignleft" width="200"]Rebecca Vigen, MD, MSCS Assistant Professor of Internal Medicine UT Southwestern Dr. Vigen[/caption] Rebecca Vigen, MD, MSCS Assistant Professor of Internal Medicine UT Southwestern MedicalResearch.com: What is the background for this study? Response: Emergency department overcrowding is an urgent health priority and chest pain is a common reason for emergency department visits.  We developed a new protocol that uses high sensitivity cardiac troponin testing with a risk assessment tool that guides decisions on discharge and stress testing for patients presenting with chest pain. The protocol allows us to rule out heart attacks more quickly than the protocols utilizing an older troponin assay.
Author Interviews, Compliance, Electronic Records, JAMA, University of Pennsylvania / 05.03.2020

MedicalResearch.com Interview with: [caption id="attachment_53388" align="alignleft" width="180"]Alexander C. Fanaroff, MD, MHS Assistant Professor of Medicine, Division of Cardiovascular Medicine University of Pennsylvania Dr. Fanaroll[/caption] Alexander C. Fanaroff, MD, MHS Assistant Professor of Medicine, Division of Cardiovascular Medicine University of Pennsylvania MedicalResearch.com: What is the background for this study? Response: This is a secondary analysis of the ARTEMIS, a cluster randomized trial of copayment assistance for P2Y12 inhibitors in patients that had myocardial infarction. One of the primary endpoints of ARTEMIS was persistence with P2Y12 inhibitors: Did the patient continue to take a P2Y12 inhibitor over the entire 1 year following MI? In ARTEMIS, we captured persistence data in two ways, patient report and pharmacy fill records. What we did in this study was to look at the agreement between persistence as measured by these two methods.
Author Interviews, Emory, Heart Disease / 13.09.2019

MedicalResearch.com Interview with: [caption id="attachment_51234" align="alignleft" width="200"]Viola Vaccarino, MD, PhD Professor and Chair, Department of Epidemiology Rollins School of Public Health Professor, Division of Cardiology Emory School of Medicine Dr. Vaccarino[/caption] Viola Vaccarino, MD, PhD Wilton Looney Professor and Chair in Cardiovascular Research Dept. of Epidemiology, Rollins School of Public Health Professor, Dept. of Medicine, School of Medicine Emory University MedicalResearch.com: What is the background for this study? Response: Psychological stress has been linked to increased risk for cardiovascular disease. The mechanisms have not been clear. One hypothesis has been that chronic or repeated exposure to psychological stress can cause a phenomenon of “wear-and-tear” of the vascular system due to activation of the neuroendocrine stress systems, eventually leading to accelerated plaque formation and adverse cardiovascular events. However, this has never been demonstrated in humans. In some individuals, psychological stress can induce a transitory impairment of the endothelium, a phenomenon known as endothelial dysfunction. A healthy endothelium is essential in blood flow regulation and in maintaining cardiovascular health.
Author Interviews, Heart Disease, JAMA / 10.09.2019

MedicalResearch.com Interview with: [caption id="attachment_51215" align="alignleft" width="200"]Nariman Sepehrvand, MD Research Associate & PhD Candidate Canadian VIGOUR Centre, and Department of Medicine, University of Alberta, Edmonton, Canada Dr. Sepehrvand[/caption] Nariman Sepehrvand, MD Research Associate & PhD Candidate Canadian VIGOUR Centre, and Department of Medicine, University of Alberta, Edmonton, Canada Medical Research: Can you tell us a little bit about the background of this study? Dr. Sepehrvand: As you know the traditional randomized clinical trials (RCT) have been criticized from time to time for the lack of generalizability, high costs and lengthy processes. Pragmatic trials with the primary goal of informing patients, clinicians, healthcare administrators and policy-makers about the effectiveness of biomedical and behavioral interventions have the potential to address those shortcomings by enrolling a population representative of the populations in which the intervention will be eventually applied to and by streamlining and simplifying the trial-related procedures. We knew about the challenges that trialists encounter in the design and implementation of pragmatic trials, so we were wondering how pragmatic or explanatory are cardiovascular (CV) RCTs and if there has been any change over time!
Author Interviews, Heart Disease, JAMA, Surgical Research / 04.06.2019

MedicalResearch.com Interview with: Rajat Kalra, MBCh Cardiovascular Division University of Minnesota, Minneapolis MedicalResearch.com: What is the background for this study? Response: New-onset atrial fibrillation after aortic valve procedures is thought to occur frequently after aortic valve procedures, such as transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (AVR). However, the incidence estimates and implications of this new-onset atrial fibrillation in the contemporary era are unclear. We sought to examine the incidence of atrial fibrillation after aortic valve procedures, compare the incidence between TAVI and AVR, and evaluate the associated morbidity and mortality implications using a ‘big data’ approach. This big data approach employed the National Inpatient Sample and was validated in the New York State Inpatient Database. Both are publicly available datasets that are developed as part of the Healthcare Cost and Utilization Project, a federal-state-industry partnership that is sponsored by the Agency for Healthcare Research and Quality. 
Author Interviews, Genetic Research, Heart Disease, JAMA, Lipids / 25.04.2019

[caption id="attachment_48766" align="alignleft" width="130"]Florian Kronenberg Dr. Kronenberg[/caption] MedicalResearch.com Interview with: Florian Kronenberg, MD Division of Genetic Epidemiology Department of Medical Genetics, Molecular and Clinical Pharmacology Medical University of Innsbruck, Innsbruck, Austria MedicalResearch.com: What is the background for this study? Response: Lp(a) is one of the most prevalent lipoprotein risk factors for cardiovascular disease. Roughly 20% of the general Caucasian population have concentrations above 50 mg/dL and the 10% with the highest concentrations have a 2 to 3-fold increased risk for myocardial infarction. There is strong evidence from genetic studies that high Lp(a) concentrations are causally related to cardiovascular outcomes. Until recently there was no drug available which lowers Lp(a) without any effects on other lipoproteins. This has recently changed by the development of drugs that block the production of Lp(a) in an impressive way. These drugs have to be studied in randomized controlled trials whether they not only lower Lp(a) concentrations but also cardiovascular outcomes. For the planning of such studies it is crucial to estimate the amount of Lp(a) lowering required to show a clinical benefit.
Author Interviews, Heart Disease, JAMA, Surgical Research / 15.02.2019

MedicalResearch.com Interview with: JOÃO L. CAVALCANTE, MD, FASE, FACC, FSCCT, FSCMR Director, Cardiac MRI and Structural CT Labs Director, Cardiovascular Imaging Research Core Lab Minneapolis Heart Institute Abbott Northwestern Hospital Minneapolis, MN, 55407 MIHO FUKUI MD Division of Cardiovascular Diseases, Department of Internal Medicine, Heart & Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota MedicalResearch.com: What is the background for this study? Response: Recent study by Généreux et al (1), using the Placement of Aortic Transcatheter Valves (PARTNER) 2A and 2B data, provided the first framework of a staging system for severe aortic stenosis (AS) that quantifies the extent of structural and functional cardiac change associated with AS and importantly its association with 1-year mortality in patients receiving either surgical or transcatheter AVR (TAVR):
  • Stage 0: No other cardiac damage;
  • Stage 1: LV damage as defined by presence of LV hypertrophy, severe LV diastolic, or LV systolic dysfunction;
  • Stage 2: Left atrium or mitral valve damage or dysfunction;
  • Stage 3: Pulmonary artery vasculature or tricuspid valve damage or dysfunction; and
  • Stage 4: right ventricular damage.