Mount Sinai School of Medicine researchers presented 86 abstracts and plenary sessions at the American College of Cardiology's (ACC) 61st Annual Scientific Session, including ground-breaking research on aggressive statin therapy, the prevalence of unrecognized cardiovascular disease symptoms in women, and morbidity associated with non-adherence to medication after stent implantation. The meeting took place March 23-27, 2012 in Chicago.
•Mount Sinai Researchers Show Aggressive Statin Regimen Reduces Fat Content in Coronary Blockage That Can Lead to Acute Thrombosis: Results from the YELLOW Trial
Of 87 patients enrolled in a Mount Sinai trial, half were treated with an aggressive regimen (40 mg) of Rosuvastatin, and the other half received standard lipid therapy. After seven weeks, the group that took Rosuvastatin displayed a 22 percent reduction in the amount of fat in the blockage, while the group with standard lipid therapy showed no significant changes.
"This study provides new scientific information documenting the beneficial effects of aggressive lipid lowering therapy in high-risk patients with coronary artery disease," said Annapoorna Kini, MD, Director of the Cardiac Catheterization Laboratory and Professor of Medicine at Mount Sinai. "Furthermore, the YELLOW trial opens new avenues for evaluating the response of novel therapies in men and women in the United States and abroad."
•Mount Sinai-Led Study Finds Cardiovascular Disease Screening of 3,000 Women in OB/GYN Clinics Identifies Risk Factors and Symptoms
A multicenter study of 3,000 women in OB/GYN clinics across the United States, found that 87 percent had unrecognized cardiovascular disease risk factors and 42 percent had symptoms. More than half of women with no primary care provider were unaware that their cholesterol and weight put them at risk.
"Our study indicates that heart disease screening in OB/GYN clinics can play a crucial role in heart disease prevention and earlier intervention," says lead researcher, Roxana Mehran, MD, Professor of Cardiology, and Director of Interventional Cardiovascular Research and Clinical Trials at Mount Sinai School of Medicine. "Many of the women we screened did not have primary care physicians and were unaware that they were having symptoms of heart disease."
•Mount Sinai Develops New Imaging Approach To Visualize How Blood Flows Through The Heart
Partho Sengupta, MD, Director of Cardiac Ultrasound Research and Jagat Narula, MD, PhD, Director of Cardiovascular Imaging and Professor of Cardiology have assembled a worldwide team of researchers developing novel ways of visualizing directional flow of blood through the heart and its behavior in different disease states as portrayed in a publication that will be released in the March issue of the Journal of the American College of Cardiology-Imaging. Using the same methodology, in a study presented at ACC, they characterized the effects of abnormal electrical behavior on the blood swirling through the chambers of the failing heart. This discovery will help improve diagnosis of heart failure and help researchers identify novel ways of using pacemaker therapy for treating it.
"This new imaging approach may help us design better therapeutic options for failing hearts," said Dr. Sengupta. "Seeing how blood flows through the patient's heart will allow us to personalize valve design and interventional procedures so that patients get optimal blood flow in their heart."
Dr. Narula believes that this technology will revolutionize the ultrasound field.
Dr. Narula was also recognized by the ACC with its Gifted Educator Award at the meeting.
•People Who Do Not Take Their Anti-Clotting Medication Have an Increased Risk of Stent Thrombosis: The PARIS Registry
To avoid stent thrombosis, a devastating and often deadly complication after coronary stent implantation, patients are required to take dual antiplatelet therapy, a combination of aspirin and a blood thinner. A multinational research team led by Roxana Mehran, MD, found that patients who did not adhere to the dual antiplatelet regimen six months after stent implantation had a four-fold increased risk for stent thrombosis. The team evaluated self-reported adherence among 5,016 patients. Of these, 310 reported that their treatment course had been interrupted, or that they stopped taking the therapy altogether.
"While only 310 patients claimed to be non-adherent, we expect the number may be much higher," said Dr. Mehran. "These findings show a very high likelihood of a major clinical event in these patients, demonstrating that continued education and monitoring of these patients is critical."
•People With Chronic Kidney Disease Are at Greater Risk of Developing Blood Clots
Mount Sinai researchers found in two studies that people with chronic kidney disease (CKD) develop blood clots much faster than healthy adults, and as CKD gets worse, so do the blood clots. They also found people with CKD and diabetes had more pathologic features of high-risk atherosclerotic plaque in their arteries than people with diabetes alone.
"We knew that chronic kidney disease increased risk for the development of adverse cardiovascular events such as heart attacks or strokes, but our study is among the first to show that CKD substantially increases clot strength and the rate at which clots develop," said Usman Baber, MD, Assistant Professor of Medicine at Mount Sinai School of Medicine. "These results demonstrate a significant need to closely monitor the tens of millions of Americans with CKD to reduce the risk of a cardiovascular event."
•The Anticoagulant Bivalirudin Shows Promise in Significantly Reducing Complications Following Balloon Aortic Valvulplasty (BAV): The BRAVO Trial
The blood thinner bivalirudin has been associated with significant reduction in adverse events in patients undergoing percutaneous coronary intervention (PCI), also known as angioplasty, compared to heparin, but Mount Sinai is the first center in the country to study its use in balloon aortic valvuloplasty (BAV), a procedure that uses a balloon to open a narrowed aortic valve.
In a retrospective analysis led by George Dangas, MD, PhD, Professor of Medicine and presented in four abstracts at ACC by Jennifer Yu, a research fellow at Mount Sinai, the research team found that heparin caused major bleeding in 13.1 percent of cases where bivalirudin caused bleeding in only 4.9 percent of cases.
"The majority of the patients undergoing balloon aortic valvuloplasty are elderly and frail, and the larger sheath sizes required contribute to significant rates of bleeding complications," said Dr. Dangas. "The BRAVO data show that bivalirudin is a promising agent in significantly reducing bleeding events and improving clinical outcomes in BAV."
Additional Mount Sinai Presentations of Interest
In total, Mount Sinai researchers participated in 35 plenary sessions and 51 abstract presentations at the ACC meeting. Other notable presentations included:
•Data on a new cardiac nuclear imaging system that drastically reduces radiation exposure to medical staff.
•In a plenary session, Valentin Fuster, MD, PhD, Physician-in-Chief of The Mount Sinai Medical Center and Director of Mount Sinai Heart addressed the growing evidence connecting heart disease to cognitive decline and dementia.
•Two oral presentations on fibromuscular dysplasia (FMD), a disease of the arteries that generally affects women in their prime: The first showed that an S-curve in the carotid artery may indicate that the disease is present. If FMD is diagnosed appropriately it is very treatable; if not, it can lead to high blood pressure, stroke, and aneurysms. The second presentation provided the first observational data of people with FMD who have experienced an arterial dissection, a dangerous condition associated with significant morbidity including heart attack, stroke, and artery rupture, if left untreated.
"The hard work and dedication of our outstanding physician-scientists is exemplified by the enormous presence Mount Sinai has at ACC this year," said Dr. Fuster. "I am very proud of the efforts of my colleagues in Mount Sinai Heart in making such significant contributions to our field that will help change the way we practice cardiovascular medicine."
Valentin Fuster, MD, PhD, Named a "Legend of Cardiovascular Medicine" by the ACC
Dr. Fuster was named a "Legend of Cardiovascular Medicine," a lecture award established this year by the ACC that recognizes his international stature as an innovator and leader in the field of cardiovascular medicine. Dr. Fuster serves several roles at Mount Sinai, including Physician-in-Chief, The Mount Sinai Medical Center, Director of the Zena and Michael A. Wiener Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Director of Mount Sinai Heart, and the Richard Gorlin, MD/Heart Research Foundation Professor, Mount Sinai School of Medicine.
Source: The Mount Sinai Medical Center