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Archives for Heart & Vascular

Physicians and Researchers Present at the American College of Cardiology (ACC) 66th Annual Scientific Session

The UPMC Heart and Vascular Institute will be well-represented at the American College of Cardiology (ACC) 66th Annual Scientific Session in Washington, DC. Faculty research will be featured in both oral and poster presentations throughout the conference, including:

 

Friday, March 17

Session 1120: Novel Echocardiographic Methods for Assessing Cardiac Function

Racial Differences in Left Ventricular Recovery in Patients With Peripartum Cardiomyopathy Assessed by Global Longitudinal Strain

Presented by: Masataka Sugahara, Dennis McNamara, Joan Briller, Leslie Cooper, Julie Damp, Mark H. Drazner, James Fett, Eileen Hsich, Navin Rajagopalan, John Gorcsan

 

Session 1130: Innovations in Practice Management and Social Media

Formal CPR Status Policy and Process Increased Documentation Rates

Presented by: Joshua E. Levenson, Aken Desai, Karen Kelly, Emilie Prout, Joon Lee, Mark Schmidhofer, Winifred Teuteberg

 

Session 1149: Arrhythmias and Clinical EP: Devices 2

Persistent Gender Disparities in Implantable Cardioverter-Defibrillator Therapy

Presented by: Amber E. Johnson, Shubash Adhikari, Andrew Althouse, Floyd Thoma, Oscar Marroquin, Stephen Koscomb, Leslie Hausmann, Larissa Myaskovsky, Samir Saba

 

Session 1150: Arrhythmias and Clinical EP: AF Ablation

Characterization of Pulmonary Vein Reconnection Post Cryoballoon Ablation

Presented by: Shivang Shah, Wenjie Xu, Evan Adelstein, Andrew Voigt, Samir Saba, Sandeep Jain

 

Session 1157: Complex Coronary Intervention: Left Main/Bifurcations and Multivessel Disease

Multivessel Versus Culprit-Only PCI in Patients With Non-ST Segment Elevation Myocardial Infarction and Multivessel Disease: Results From the PROMETHEUS Study

Presented by: Birgit Vogel, Usman Baber, Samantha Sartori, Jaya Chandrasekhar, Serdar Farhan, Michela Faggioni, Sabato Sorrentino, Annapoorna Kini, William Weintraub, Sunil Rao, Samir Kapadia, Sandra Weiss, Craig Strauss, Catalin Toma, J. Muhlestein, Anthony C. DeFranco, Mark Effron, Stuart Keller, Brian Baker, Stuart Pocock, Timothy Henry, Roxana Mehran

 

Session 4101: Advanced heart Failure and VAD Therapy
Presented by: Jeffrey Teuteberg

 

Saturday, March 18

Session 904: Highlighted Original Research: Pulmonary Hypertension and Venous Thrombo-embolic Disease and the Year in Review

Simplified Measures of Right Ventricular and Atrial Remodeling Are Predictive of Outcomes in Patients With Pulmonary Hypertension

Presented by: Masataka Sugahara, Keiko Ryo-Koriyama, Akiko Goda, Omar Batal, Marc Simon, John Gorcsan

 

Session 1196: Nuclear Cardiology: Beyond Perfusion

Regional Right Ventricular (RV) Function as Determined by Gated Blood Pool SPECT (GBPS) Provides Additive Value to Evaluation of Patients Undergoing Left Ventricular Assist Device (LVAD) Implantation

Presented by: Christopher B. Link, Aditi Nayak, Robert Kormos, Marc Simon, Jeffrey Teuteberg, Luigi Lagazzi, Andrew Althouse, Prem Soman

 

Session 1201: Advances in HCM, PPCM and Other Cardiomyopathies

Extended Course of Recovery in Patients With Peripartum Cardiomyopathy Assessed by Left Ventricular Wall Distensibility

Presented by: Masataka Sugahara, Dennis McNamara, Lori Blauwet, Rami Alharethi, Paul Mather, Kalgi Modi, Richard Sheppard, Vinay Thohan, Gretchen Wells, John Gorcsan

 

Session 669: Distinct Phenotypes in HFpEF: Beyond Ejection Fraction

669-03 – Diagnostic Evaluation of Patients with Dyspnea and Normal LVEF
Presented by: John Gorcsan

 

Session 1226: Put Your Codon! Genetic Insights Into Heart Failure

G-Protein Receptor Kinase 5 Polymorphisms and Outcomes in the African American Heart Failure Trial: Results From the Genetic Risk Assessment of Heart Failure in African-Americans Sub-Study

Presented by: Amber E. Johnson, Karen Hanley-Yanez, Clyde Yancy, Anne Taylor, Arthur Feldman, Dennis McNamara

 

Session 1242: Timely Topics in Acute Coronary Syndromes

Use of Potent P2y12 Inhibitors in African-American Patients Treated With Percutaneous Coronary Intervention for Acute Coronary Syndromes

Michela Faggioni, Usman Baber, Jaya Chandrasekhar, Birgit Vogel, Samantha Sartori, Melissa Aquino, Annapoorna Kini, William Weintraub, Samir Kapadia, Sandra Weiss, Craig Strauss, Clayton Snyder, Catalin Toma, J. Muhlestein, Anthony C. DeFranco, Mark B. Effron, Stuart Keller, Brian Baker, Stuart Pocock, Timothy Henry, Sunil Rao, Roxana Mehran

 

Session 1257: FIT Clinical Decision Making: Heart Failure and Pulmonary Hypertension

1257-408 / 408 – When the Liver Gets Sacked by the Heart Sac: A Diagnostic Challenge of Mixed Heart and Liver Pathology
Presented by: Ahmad Masri, John Gorcsan

 

Session 1245: New Technologies in Echocardiography

1245-219 / 219 – Assessment of Right Ventricular Energy Loss and Efficiency Using Novel Vector Flow Mapping

Presented by: Masataka Sugahara, Nina Hasselberg, Marc Simon, John Gorcsan

 

Session 1246: Nuclear Cardiology: Quality

Repeatability of Appropriateness Category Allocation by Trained Physicians

Presented by: Daniel Nguyen, Aditi Nayak, Christopher Pray, Christopher Link, Andrew Althouse, Prem Soman

 

Session 702: The Forgotten Chamber: The Right Ventricle in Heart Failure

RV Failure After LVAD: Predictable and Preventable?
Presented by: Jeffrey Teuteberg

 

Session 1235: Innovations in Cardiovascular Risk Assessment and Reduction

Ideal Cardiovascular Health Metrics in Couples: A Community-Based Population Study

Presented by: Oluremi Ajala, Sebhat Erqou, Claudia Bambs, Michael Sharbaugh, Andrew Althouse, Aryan Aiyer, Kevin Kip, Steven Reis

 

Session 1230: Predicting the Future: Observations and Discoveries From Registries and Databases

Pulmonary Vascular Resistance Predicts Mortality in End-Stage Renal Disease Patients With Pulmonary Hypertension

Presented by: Jonathan Wolfe, Gavin Hickey, Andrew Althouse, Michael Sharbaugh, Deepak Kumar Pasupula, Dustin Kliner, Michael Mathier, Prem Soman

 

Session 727: Aortic Stenosis: Overview of the Hemodynamics and Ventricular Response

Expanding the Diagnostic Toolbox for Aortic Stenosis
Presented by: João Cavalcante

 

Session 716: Pregnancy and Heart Disease

Peripartum Cardiomyopathy – Long term Outcomes and Management Options
Presented by: Dennis McNamara

 

Session 4103: Advanced Heart Failure and VAD Therapy
Presented by: Jeffrey Teuteberg

 

Sunday, March 19

Session 732: Nuclear Cardiology: Current Applications and Best Practices: Joint Symposium of the American Society of Nuclear Cardiology and the American College of Cardiology

Nuclear Cardiology: Risk Stratification
Presented by: Prem Soman

 

Session 738: Controversies in Mitral Valve Surgery: Joint Symposium of the Society of Thoracic Surgeons and the American College of Cardiology

What to do if the left ventricle fails after mitral valve surgery
Presented by: Robert Kormos

 

Session 770: Great Debates in Cardiac MRI

Debate Con: Stress MRI is the Test of Choice for Ischemia Assessment
Presented by: Prem Soman

 

Session 4105: Advanced Heart Failure and VAD Therapy
Presented by: Jeffrey Teuteberg

 

Session 1274: The Challenges of Outcome Prediction in Valvular Heart Disease

Poor Agreement Between Transthoracic Echocardiography and Right Heart Catheterization for Assessment of Pulmonary Hypertension Severity: Clinical Applications in the TAVR Era

Presented by: Islam Abdelkarim, Jeffrey Xu, Michael Sharbaugh, Andrew Althouse, William Katz, Frederick Crock, Matthew Harinstein, Dustin Kliner, Forozan Navid, Joon Lee, John Schindler, Thomas Gleason, João Cavalcante

 

Session 1282: Advances in Chronic Total Occlusion Intervention

The Impact of Epicardial Collateral Use on the Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Contemporary Multicenter Registry

Presented by: Judit Karacsonyi, Khaldoon Alaswad, Farouc Jaffer, Robert Yeh, Dimitrios Karmpaliotis, Jeffrey Moses, Ajay Kirtane, Manish Parikh, Ziad Ali, David Kandzari, Nicholas Lembo, William Lombardi, R. Michael Wyman, Anthony Doing, Catalin Toma, James Choi, Mitul Patel, Ehtisham Mahmud, Barry Uretsky, Aris Karatasakis, Bavana Rangan, Imre Ungi, Craig Thompson, Subhash Banerjee, Emmanouil Brilakis

 

Session 1307M: Emerging Applications for Imaging Cardiac Amyloidosis: Nuclear Cardiology

Predictors of a Positive Technetium Pyrophosphate Scan in Patients With Suspected Cardiac Amyloidosis

Presented by: Ahmad Masri, Ricardo Nieves, Michael S. Sharbaugh, Andrew Althouse, William Follansbee, João Cavalcante, Prem Soman

 

Session 1221M: TAVR outcomes Prognostication

Prognostic Value of Right Ventricle-Pulmonary Artery Coupling in TAVR Patients: Time to Integrate the Right Side Unit

Presented by: João Cavalcante, Islam Abdelkarim, Michael Sharbaugh, Andrew Althouse, Jeffrey Xu, Wei Han, William Katz, Frederick Crock, Matthew Harinstein, Dustin Kliner, Forozan Navid, Joon Lee, John Schindler, Thomas Gleason

 

Session 769: Life After LVAD: The Good, The Bad and The Ugly

Right Ventricular Failure After LVAD
Presented by: Robert Kormos

 

Session 785: Radiation from Diagnostic Imaging: Risk-benefit Analysis
Panelist: Prem Soman

Genetic Test Helps Improve Outcomes in Heart Stent Patients

A genetic test recently implemented at UPMC Presbyterian can significantly reduce the risk of cardiovascular events by helping to identify more effective medication for some heart patients, according to the results of a large study conducted in part at the University of Pittsburgh and UPMC. The findings are being presented today at the American Heart Association’s Scientific Sessions in New Orleans.

The test identifies a genetic deficiency that affects the body’s ability to activate clopidogrel, a common anti-clotting drug given after a coronary artery stent is inserted. About 30 percent of all patients have the genetic deficiency, which can lead to decreased clopidogrel effectiveness and increased risk for adverse cardiovascular events, such as strokes, heart attacks and death.

In the current study from the National Institutes of Health’s Implementing Genomics in Practice (IGNITE) Network, researchers at the University of Pittsburgh School of Pharmacy and other sites throughout the country analyzed medical outcomes in 1,815 patients who had genetic testing at the time of their cardiac procedure. The testing allows physicians to pinpoint the best anti-clotting medication for each patient.

The study reported significant results: About 60 percent of patients with the genetic deficiency were given a different, more effective medication. Using the genetic data to guide changes in therapy reduced the percentage of deaths, heart attacks or strokes by nearly half compared with those who continued taking clopidogrel, the researchers found. Among those who had the genetic deficiency and continued taking clopidogrel, 8 percent experienced one of those complications.

“We saw significantly fewer adverse events among patients who were switched to an alternative drug,” said Larisa Cavallari, PharmD, director of the Center for Pharmacogenomics at the University of Florida College of Pharmacy who led the multi-institutional study.

Earlier this year, UPMC Presbyterian became one of the first medical centers in the country to make this test available for patients as part of the PreCISE-Rx (Pharmacogenomics-guided Care to Improve the Safety and Effectiveness of Medications) initiative. Approximately 10 percent of the study population was analyzed by the team at Pitt and UPMC, one of the affiliates in the IGNITE Network.

“This study is a major step forward as it shows applying pharmacogenomics to achieve a precision medicine approach in cardiac stent patients can provide significant benefits,” said Philip Empey, PharmD, PhD, assistant professor of pharmacy and therapeutics at the Pitt School of Pharmacy and leader of the Pitt team.

PreCISE-Rx is a leading initiative of the Institute for Precision Medicine (IPM), a joint effort by UPMC and Pitt to move biomedical research into personalized well-being and clinical care.

“The success of PreCISE-Rx demonstrates that the IPM is well-positioned to dramatically improve the standard of care through precision medicine by taking advantage of the world-class clinical and research expertise in Pittsburgh,” said Adrian Lee, PhD, professor of pharmacology and chemical biology at Pitt, and director of the Women’s Cancer Research Center, University of Pittsburgh Cancer Institute.

Other institutions that participated in the clopidogrel research were the University of North Carolina, the University of Maryland-Baltimore, the University of Alabama-Birmingham, Vanderbilt University Medical Center, the University of Illinois-Chicago, Indiana University-Indianapolis, Sanford Health, Duke University and the University of Pennsylvania.

Heart Failure Care Improving, but Hospitalizations on the Rise

Although hospitalizations have increased in recent years for patients with congestive heart failure, survival rates and length of stay have improved, according to new research from experts at the University of Pittsburgh School of Medicine and UPMC Heart and Vascular Institute. The results, published in the journal Clinical Cardiology and presented Sunday at the American Heart Association Scientific Sessions, were based on more than 15 million US hospital admissions between 1996 and 2009 due to congestive heart failure.

The prevalence of heart failure is increasing in the US due to its aging population and significant advancements in management of associated co-morbidities, such as ischemic heart disease, diabetes, stroke, peripheral vascular disease and hypertension. More than 5 million Americans are living with heart failure, and close to 500,000 patients are newly diagnosed each year.

Heart failure also is a common cause of hospital admissions, leading to significant costs for the nation’s health care system. A recent report from the American Heart Association estimated the annual direct and indirect costs associated with heart failure in the US at more than $30.7 billion. However, until this study, little was known about recent trends involving those admissions, including length of stay and in-hospital mortality.

“There has been significant progress in heart failure management over the past two decades, but more has to be done,” said Muhammad Bilal Munir, MD, clinical instructor of medicine in Pitt’s Division of General Internal Medicine and corresponding author of the study. “The number of hospitalizations has increased, identifying a need to implement heart failure quality measures stringently to reduce these admissions, therefore reducing heart failure-associated health care costs.”

The number of heart failure hospitalizations increased from 1,000,766 in 1996 to about 1,173,832 in 2009, according to study results. The mean length of stay fell from 6.07 days in 1996 to about 5.26 days in 2009, and inpatient mortality rates declined from 4.92 percent in 1996 to 3.41 percent in 2009.

Researchers say the findings likely reflect the changes in the management of heart failure across the country, which include numerous advances in care such as new drug therapies and sophisticated devices. Further efforts are needed to curb the cost of heart failure management, experts agreed, with a focus on reducing heart failure hospital admissions and readmissions, especially for patients with less severe symptoms who could be treated with aggressive outpatient management.

Additional study authors are Michael S. Sharbaugh, MPH; Floyd W. Thoma; Muhammad Umer Nisar, MD; Amir S. Kamran, MD; Andrew D. Althouse, PhD; and Samir Saba, MD, all from the UPMC Heart and Vascular Institute.

UPMC Heart and Vascular Experts to Present at the American Heart Association’s Annual Scientific Sessions

The UPMC Heart and Vascular Institute will be well-represented at the American Heart Association’s Scientific Sessions in New Orleans on Saturday, Nov. 12 – Wednesday, Nov. 16. Faculty research will be presented in both oral and abstract presentations.

November 13, 2016

511 – The Role Of Exposure To Environmental Pollutants In Racial Disparity In Cardiovascular Risk Factors And Novel Markers

Presented by: Sebhat Erqou, Jane Clougherty, Steven Reis

553 – Population Based Characterization of the Definition, Prevalence and Associated Mortality of Pulmonary Hypertension in the Setting of Left Heart Disease

Presented by: Rebecca R. Vanderpool, Melissa I. Saul, Seyed Mehdi Nouraie, Mark T. Gladwin, Marc A. Simon

 S4127 / 4127 – Trends in Heart Failure Hospitalizations Using Data From National Hospital Discharge Survey

Presented by: Muhammad Bilal Munir, Michael S. Sharbaugh, Floyd W. Thoma, Muhammad Umer Nisar, Amir S. Kamran, Andrew D. Althouse, Samir Saba

Advances in Contrast Echocardiography, Molecular and Myocardial Imaging

S4217 / 4217 – Targeted Delivery of AntimiR-23a Using Ultrasound and Microbubbles Suppresses Cardiac Hypertrophy and Improves Cardiac Function in vivo

Presented by: Jonathan A Kopechek, Charles F. McTiernan, Xucai Chen, Rafey Feroze, Bin Qin, Jissy Cyriac, Linda Lavery, Daniel Whitehurst, Flordeliza S. Villanueva

Clinical Applications of Nuclear Cardiology

S4251 / 4251 – Assessment of Dyssynchrony as an Indicator of Right Ventricular Free Wall Function by Gated Blood Pool SPECT (GBPS) in Patients undergoing LVAD Implantation

Presented by: Aditi Nayak, Christopher B. Link, Andrew D. Althouse, Robert L. Kormos, Marc A. Simon, Jeffrey J. Teuteberg, Luigi G. Lagazzi, Prem Soman

November 14, 2016

Metabolic Disease and Pulmonary Hypertension

670 – Development of a Mouse Model of Metabolic Syndrome, Pulmonary Hypertension, and Heart Failure With Preserved Ejection Fraction (PH-HFpEF)

Presented by: Yen-Chun Lai, Qingqing Meng, Neil Kelly, Marta Bueno, Jeffery Baust, Timothy Bachman, Rebecca Vanderpool, Josiah Radder, Jian Hu, Alison Morris, Ana Mora, Mark T. Gladwin

Imaging the Mitral Valve and Strain Imaging

M5020 / 5020 – Vector Flow Mapping Quantification of Left Ventricular Energy Loss Occurring in Normal Subjects

Presented by: Masataka Sugahara, Zhi Qi, Tijmen Koopsen, Marc A. Simon, John Gorcsan lll

Imaging the Right Heart and the Left Ventricle in Mitral Regurgitation

M5027 / 5027 – Three Dimensional Echocardiographic Wall Motion Tracking Assessment of Right Ventricular Remodeling and Effects on Left Ventricular Function as Prognostic Predictors in Patients With Pulmonary Hypertension

Presented by: Masataka Sugahara, Zhi Qi, Marc A. Simon, Michael A. Mathier, John Gorcsan lll

 Percutaneous Non-Coronary Cardiac Intervention (including Percutaneous Valves) III

M5078 / 5078 – Predictors of Mortality in Patients With Persistent Pulmonary Hypertension Following Transcatheter Aortic Valve Replacement

Presented by: Ahmad Masri, Michael S. Sharbaugh, Andrew D. Althouse, Islam Abdelkarim, Wei Han, William E. Katz, Frederick Crock, Mathew Harinstein, Dustin E. Kliner, Forozan Navid, Thomas G. Gleason, Joon S. Lee, John T. Schindler, João L. Cavalcante

Percutaneous Non-Coronary Cardiac Intervention (including Percutaneous Valves) III

M5081 / 5081 – Prognostic Value of Baseline Right Ventricular Dysfunction in Patients Undergoing Transcatheter Aortic Valve Replacement

Presented by: Islam Abdelkarim, Wei Han, Floyd Thoma, Andrew D Althouse, William E Katz, Frederick W Crock, Matthew E Harinstein, Dustin E Kliner, Forozan Navid, Thomas G Gleason, Joon S Lee, John T Schindler, João L Cavalcante

 Arrhythmia: Clinical Electrophysiology, Diagnosis and Risk Stratification V

M5186 / 5186 – Depression and 5-Year Stroke Risk in Patients With Atrial Fibrillation

Presented by: Bruno B. Lima, Andrew D. Althouse, Muhammad B. Munir, Michael S. Sharbaugh, Bruce L. Rollman, Samir Saba

 

Treatment of Arrhythmias: ICD/Pacemaker – excluding CRT II

M5276 / 5276 – Reversible Cause of Sudden Cardiac Arrest and Rates of Defibrillator Implantation

Presented by: Adetola Ladejobi, Deepak Kumar Pasupula, Shantanu Patil, Shasank Rijal, Bilal Munir, Asad Durrani, Awais Javed, Max Wayne, Oluremi Ajala, Natasha A. Kassim, Shubash Adhikari, Samir Saba

 

Ventricular Function/Hemodynamics and Biomarkers III

M4257 / 4257 – Myocardial Fibrosis is Associated With Pulmonary Artery Pressure and Adverse Outcomes in Patients With Preserved Left Ventricular Systolic Function

Presented by: George Cater, Erik Schelbert, Marc A. Simon, Peter Kellman, Timothy Wong

 

November 15, 2016

Echocardiography in Clinical Syndromes: CAD, Stress Echo, Vascular Disease

Echocardiographic Radial and Circumferential Strain Follow-up Analysis of Neurocardiac Injury in Patients With Subarachnoid Hemorrhage

Presented by: Zhi Qi, Masataka Sugahara, Elizabeth A. Crago, Yugang Chang, Theodore F. Lagattuta, Khalil Yousef, Robert M. Friedlander, Marilyn T. Hravnak, John Gorcsan III

 

Medical Aspects End Stage Heart Failure: Transplantation and Device Therapies IV

T4071 / 4071 – Critical Preoperative Factors and Specific Postoperative Adverse Events Drive Left Ventricular Assist Device Implant Hospitalization Costs

Presented by: Christine V. Nikas, Jennifer O. Larsen, Jeffrey J. Teuteberg, Luigi G. Lagazzi, Andrew D. Althouse, Michael S. Sharbaugh, Michael A. Shullo, Kathleen L. Lockard, Elizabeth M. Dunn, Nicole M. Kunz, Robert L. Kormos

 

770 – Heart Failure Admissions Under Observation versus Short Inpatient Stay: A Cohort Study

Presented by: Ahmad Masri, Andrew D. Althouse, Jeffrey McKibben, Floyd Thoma, Michael A. Mathier, Ravi Ramani, Jeffrey J. Teuteberg, Oscar C. Marroquin, Joon S. Lee, Suresh R. Mulukutla

 

VA.RFO.14 – Novel Insights into the Clinical Spectrum of PH and PAH

819 – Identification of a Pro-Hypertrophic Pathway With Chamber Specificity for the Right Ventricle; Implications for Right-Heart Dysfunction in Pulmonary Arterial Hypertension

Presented by: Imad Al Ghouleh, Daniel Meijles, John Sembrat, Mauricio Rojas, Rebecca R. Vanderpool, Jeffrey Baust, Asma Naqvi, Patrick J. Pagano,

 

Determinants of Clinical Outcome in Pulmonary Artery Hypertension

T4261 / 4261 – Nitric Oxide Synthase (NOS3) Asp298Glu Polymorphism and Survival in Pulmonary Arterial Hypertension

Presented by: Andrew Klein, David Ishizawar, Karen Hanley-Yanez, Dennis M. McNamara

 

For more information, visit the event website.

UPMC First in Region to Use New Fully Dissolving Heart Stent

UPMC is the first hospital in western Pennsylvania to use Abbott’s fully dissolving Absorb GT1 Biodegradable Vascular Scaffold System (BVS), a first-of-its-kind device recently approved by the Food and Drug Administration. It functions by opening a blocked artery in the heart, restoring blood flow and providing relief from symptoms of coronary artery disease (CAD). A 58-year-old woman with severe coronary artery disease was the first patient to receive the absorbable device Tuesday.

“We’re only at the beginning of understanding the potential benefits of this technology that could have long-lasting impacts for our patients,” said Catalin Toma, MD, assistant professor, Division of Cardiology, University of Pittsburgh School of Medicine, and director for interventional cardiology research at the UPMC Heart and Vascular Institute and one of the initial medical experts with access to the technology. “By resorbing in time, these implants allow for restoration of the vessel’s natural function without the restriction of the traditional metallic cage of the stent. This may have a positive effect on vessel healing for months and years to come.”

The most common type of heart disease, CAD occurs when arteries that supply blood to the heart become narrowed or blocked due to plaque buildup, leading to chest pain and shortness of breath, as well as an increased risk of heart attack. When patients present with heart attacks or chest discomfort due to plaque buildup, the obstruction is treated with metallic stents. Although this technology has been greatly improved in the past years, potential issues related to the permanent coronary implant may require additional procedures even many years after the initial operation.

Absorb GT1 BVS is made of naturally resorbable material that slowly disappears in about three years, leaving behind a restored vessel, free of a permanent implant. Metallic stents permanently restrict vessel movement, limiting future treatment options. Unrestricted vessels with restored function have the potential to flex, pulse and dilate in response to various demands on the heart, based on people’s lifestyle and activities, and allow for potential treatment options down the road. Similar to current generation drug-eluting stents, the BVS is coated with a drug that prevents the re-narrowing of the vessel over time.

The procedure is similar to regular coronary stenting intervention, which is performed by accessing the artery in the groin or wrist, and threading catheters to the coronary arteries. The blockage is first opened with an angioplasty balloon, followed by balloon-expandable scaffold implantation. While complex and hardened blockages are better served by regular metallic stents at this stage of the technology, the BVS could be beneficial for younger patients with their first CAD presentation, Dr. Toma noted.

UPMC Presbyterian Shadyside is one of the few centers in the US with experience in implanting the scaffolds. The hospital participated in the ABSORB III trial, which led to the recent FDA approval of the device, as well as the ABSORB IV trial, which compares the BVS to the top-performing current metallic stent technology.

The UPMC Heart and Vascular Institute is one of the world’s premier centers for comprehensive care, developing revolutionary devices and new models of treatment that improve the lives of those facing the most complex heart and vascular conditions.

Washington Health System and UPMC Announce Cardiac Surgery Partnership

A new partnership between Washington Health System (WHS) and the UPMC Heart and Vascular Institute will expand cardiac services in the Washington, Pennsylvania, area. Cardiac surgery services at Washington Hospital will now be performed by surgeons from UPMC, who will collaborate alongside WHS-Cardiovascular Care physicians and nurse practitioners, as well as all of the cardiologists and medical staff who practice at WHS.

Effective this month, a team of cardiothoracic surgeons from the UPMC Heart and Vascular Institute see patients in an office located at 125 N. Franklin Road, Suite 1-A, Washington, Pa., 15301. The office is in the same building as WHS-Cardiovascular Services.

“Washington Health System is committed to enhancing the quality of health care for patients in our service area,” said Paul Cullen, MD, vice president of medical affairs for WHS. “Having UPMC’s world class cardiac surgeons, right here in our community, will be beneficial to patients as well as WHS-affiliated medical providers. This partnership helps as we continue to strengthen our medical staff of over 200 primary care physicians and specialists and complements our ongoing efforts of collaborative care.”

Through the partnership, WHS is able to expand its cardiac service offerings to include the development of a transcatheter aortic valve replacement (TAVR) program, other minimally invasive procedures, and the expansion of heart failure and valve disease detection and management programs.

“This partnership between WHS and UPMC for cardiovascular care markedly expands the capabilities at WHS to facilitate the delivery of state-of-the-art cardiac surgery and therapeutics to residents of Washington and Greene counties,” said Thomas Gleason, MD, chief of the UPMC Division of Cardiac Surgery and Ronald V. Pellegrini professor at the University of Pittsburgh School of Medicine. “We look forward to jointly serving the patients in this region of western Pennsylvania.”

The cardiac surgery team at WHS includes Dr. Gleason; Chris Cook, MD, cardiac surgeon at the UPMC Heart and Vascular Institute; Claudio Lima, MD, director of cardiovascular surgery at UPMC Mercy and assistant professor of surgery at Pitt; and Forozan Navid, MD, cardiac surgeon and clinical assistant professor of surgery at Pitt.

For more information, call 724-250-4310 or visit www.whs.org.

UPMC Receives Nation’s Top Ratings for Heart Surgery

UPMC has been awarded top quality ratings by the Society of Thoracic Surgeons (STS). The health system recently received the maximum “three star” rating for coronary artery bypass grafting (CABG) procedures.

Based on a review of data that was compiled and publicly reported for the 2015 fiscal year, the score designates that UPMC is statistically better than the national average for this common cardiac procedure.

“We are very proud of the dedication displayed by our physicians and staff that led to consistently high quality across the board for CABG procedures as proven by these tremendous results,” said Thomas Gleason, MD, chief of the UPMC Division of Cardiac Surgery. “The UPMC Heart and Vascular Institute works hard to provide innovative cardiac care of the highest quality to patients throughout our system.”

The STS National Database was established to drive quality and safety improvements among cardiothoracic surgeons. It covers adult cardiac, general thoracic and congenital heart surgery.

The UPMC Heart and Vascular Institute is one of the world’s premier centers for comprehensive care, developing revolutionary devices and new models of treatment that improve the lives of those facing the most complex heart and vascular conditions.

Cholesterol Control and other Highlights from ACC 2016

The 2016 American College of Cardiology Conference was recently held in Chicago. One of the topics at this year’s conference was cholesterol control.

For many years, high cholesterol has been viewed as a potentially fatal condition. Now it may be slowly becoming a condition that is easier for doctors to manage thanks to new advances in medication and surgical options.

UPMC Heart and Vascular Institute’s Joon Sup Lee, MD sat down with MD Magazine and discussed highlights from the 2016 American College of Cardiology Conference.

Watch the video:

Joon Lee from UPMC: Advancements in Cholesterol Help Move Cardiology Forward

International Society for Heart and Lung Transplantation (ISHLT) 36th Annual Scientific Sessions

The UPMC Heart and Vascular Institute and UPMC Cardiothoracic Transplant Department will be well-represented at the International Society for Heart and Lung Transplantation (ISHLT) 36th Annual Meeting and Scientific Sessions in Washington, DC. Faculty research will be featured in both oral and poster presentations throughout the conference, including:

Wednesday, April 27

Pre-Meeting Symposium 01: Anticoagulation and MCS: Can We Do Better?

Co-Chair: Michael A. Shullo

Pre-Meeting Symposium 06: Back to the Future: Cell Therapy for Thoracic Organ Failure and Transplant?

Myeloid Cells to Induce Transplant Tolerance

Presented by: Angus Thomson

Pre-Meeting Symposium 07: The Future is Here: Emerging Issues in Infectious Disease

Mycobacterium Abscessus and Friends

Presented by: Fernanda Silveira

Pre-Meeting Symposium 13: Child’s Play: Infectious Risk After Transplant During Everyday Life

Outbreak – Measles, Varicella and Mumps

Presented by: Marian G. Michaels

Pre-Meeting Symposium 16: When Right is Wrong! Management of the Dying Right Ventricle

Peering Through the Looking Glass: Imaging the Right Ventricle

Presented by: Marc A. Simon

Pre-Meeting Symposium 19: Between a Rock and a Hard Place: Debating Treatment Decisions for Marginal Psychosocial Candidates

DEBATE 3: Substance Use: It’s OK To Dabble (PRO)

Presented by: Mary Amanda Dew

Pre-Meeting Symposium 22: Great Debates in MCS

DEBATE 2: INTERMACS 4-7: The Time is Now (PRO)

Presented by: Jeffrey J. Teuteberg

Pre-Meeting Symposium 28: Lifecycle Journey of Hepatitis C Heart Failure Patient in 2016

Immunosuppression— A Tricky Balance?

Presented by: Michael Shullo

Poster Session 1: Basic Science

0474 – Refinement of Ex Vivo Lung Perfusion Techniques for Better Microvasculature Maintenance in Lung Grafts

Presented by: K. Noda, S. Haam, Y. Wu, J. D’Cunha, J. D. Luketich, N. Shigemura

0490 – Identification of Hypoxic Cells in Lung Grafts for Future Cell Targeted Therapy for Obliterans Bronchiolitis

Presented by: K. Noda, H. Hara, S. Haam, J. D’Cunha, J. D. Luketich, N. Shigemura

0500 – CD8+ IL-17 Responses and Obliterative Airway Disease Persist in T-bet-/- Mouse Recipients of Lung Transplant Treated with Low Dose Azithromycin Therapy

E. A. Lendermon, J. M. Dodd-o, L. Guo, T. A. Coon, C. R. Ensor, C. P. O’Donnell, J. F. McDyer

 0505 – Relationship between Grafts’ Quality, Glucose Consumption and IL-6 Production during Ex Vivo Lung Perfusion

Presented by: K. Noda, S. Haam, J. D’Cunha, J. D. Luketich, N. Shigemura

0551 – Poor Blood Pressure Control Is Independently Associated with Renal Dysfunction After Heart Transplant

Presented by: M. Osnard, A. D. Althouse, L. Krall, C. Newman, C. Grabowski, F. Speicher, R. Zomak, L. Lagazzi, R. L. Kormos, M. Shullo, J. J. Teuteberg

Poster Session 1: Lung Transplantation

0646 – Pre-Treatment High Titer DSA Is Associated with Non-Responsiveness to Carfilzomib-Based AMR Therapy in Lung Transplant Recipients

Presented by: A. Zeevi, M. Marrari, M. R. Morrell, S. A. Yousem, J. M. Pilewski, J. D’Cunha, J. F. McDyer, C. R. Ensor.

Poster Session 1: Mechanical Circulatory Support

0706 – Right Ventricular Failure in Patients with Left Ventricular Assist Devices Is Associated with Downregulated Chemokine Receptors and Altered Right Ventricular Pressure Waveforms

Presented by: T. N. Bachman, R. Vanderpool, M. Jacus, A. Nayak, O. Hunter, A. Inashvili, L. Lagazzi, J. J. Teuteberg, C. McTiernan, K. Hanley-Yanez, D. McNamara, R. L. Kormos, M. Simon

0717 – Worsening Renal Function after Ventricular Assist Device Placement Is Associated with Twice the Risk of Death over 3 Years

Presented by: J. E. Holtz, A. N. Potter, N. C. Macpherson, D. Nguyen, R. L. Kormos, J. J. Teuteberg, J. A. Kellum

Thursday, April 28

Concurrent Session 07: It’s Tough to Make Predictions, Especially about the Future: Outcomes in MCS

Abstract Session Chair: Jeffrey J. Teuteberg

0039 – Insights from INTERMACS into Patient Characteristics Leading to Futility in LVAD Therapy

Presented by: R. L. Kormos, F. D. Pagani, A. D. Althouse, L. Warner Stevenson, J. J. Teuteberg, J. B. Young, J. K. Kirklin

Concurrent Session 08: Quality Over Quantity? Quality of Life in MCS

Abstract Session Chair: Mary Amanda Dew

 Concurrent Session 11: The Heartbreak of Rejection: All Against the Graft

0066 – Initial Analysis of the Donor-Derived Cell-Free DNA – Outcomes AlloMap Registry (D-OAR) Study in Heart Transplant Recipients Undergoing Surveillance for Rejection

Presented by: J. A. Kobashigawa, K. Khush, J. J. Teuteberg, M. Song, M. Grskovic, D. Hiller, R. Woodward, E. Deljkich, J. Yee, F. Latif, N. Sulemanjee, S. Murali

Concurrent Session 15: Let’s Be Specific: Donor Specific Antibodies – Challenges Ahead

The Timeline of DSA after Cardiac Transplantation

Presented by: A Vu, J. J. Teuteberg, A. Zeevi, M. A. Shullo

Mini Oral 04: Donor and Recipient Management in Lung Transplantation

0165 – On-Demand Immunoglobulin-G Replacement Is Not Associated with Benefits in Lung Transplant Recipients with Hypogammaglobulinemia

Presented by: A. B. Lichvar, C. R. Ensor, M. R. Morrell, J. M. Pilewski, J. Hayanga, J. D’Cunha, A. Zeevi, J. F. McDyer, A. A. Petrov

 0166 – Carfilzomib-Based Therapy Produces Favorable Outcomes for Antibody Mediated Rejection of the Lung Allograft

Presented by: C. R. Ensor, A. Zeevi, M. Marrari, M. R. Morrell, S. A. Yousem, J. M. Pilewski, J. D’Cunha, J. F. McDyer

0168 – Extracorporeal Membrane Oxygenation (ECMO) as a Bridge to Lung Transplantation: Identifying Predictors of Mortality

Presented by: J. A. Hayanga, N. Shigemura, E. Chan, T. Richards, M. Morrell, J. D. Luketich, J. D’Cunha

Mini Oral 06: Pharmacy & Pharmacology and Mechanical Circulatory Support

0184 – CYP3A5 Pharmacogenetic Testing Predicts High Tacrolimus Dose Requirements Early after Cardiac Transplantation

Presented by: K. M. Deininger, A. Vu, R. L. Page II, A. V. Ambardekar, J. Lindenfeld, C. L. Aquilante

Poster Session 2: Heart Transplantation

0783 – Simple Technique for Open Sternal Wound Closure after Cardiac Transplant or LVAD

Presented by: U. Bansal, A. Bansal, J. K. Bhama

Poster Session 2: Lung Transplantation

0846 – Donor Derived Disease Transmission Events in Thoracic Organ Transplantation: Data Reviewed by the OPTN Ad Hoc Disease Transmission Advisory Committee

Presented by: J. M. Schaenman, A. Wilk, S. Tlusty, M. A. Nalesnik, M. G. Michaels, C. Wolfe, D. Kaul

0866 – Soluble CD14 and LBP as Markers for Primary Graft Dysfunction

Presented by: K. Ramphal, E. Cantu, M. Porteous, M. Oyster, S. Kawut, D. J. Lederer, R. Shah, S. Arcasoy, L. Snyder, M. Hartwig, S. Palmer, K. M. Wille, L. Ware, P. Shah, M. Crespo, C. Hage, A. Weinacker, V. Lama, Y. Suzuki, J. Orens, J. D. Christie, J. Diamond

Poster Session 2: Nursing, Health Sciences, Allied Health

0960 – Tales of Roller Coaster Rides and Resilience: Lung Transplant Caregivers in Their Own Words

Presented by: A.J. Haines

Poster Session 2: Pediatrics

0982 – Cost Effectiveness of Ventricular Assist Device Destination Therapy for Advanced Heart Failure in Duchenne Muscular Dystrophy

Presented by: D. A. Magnetta, J. Kang, P. D. Wearden, K. J. Smith, B. Feingold

Poster Session 2: Pulmonary Hypertension

1004 – PVR Predicts Cardiac Hospitalizations in Pulmonary Hypertension Associated with HFpEF and HFrEF

Presented by: R. R. Vanderpool, M. Saul, S. Nouraie, M. T. Gladwin, M. A. Simon

Friday, April 29

Sunrise Symposium 03: Thoracic Organ Transplantation and Malignancy

Lung Transplantation for Patients with Chronic GVHD Following Allogeneic Stem Cell Transplant

Presented by: Samuel Goldfarb

 Concurrent Session 24: What’s New in Primary Graft Dysfunction Post Lung Transplantation

0214 – Plasma RIP3 Is Decreased in PGD after Lung Transplantation

Presented by: A. D’Errico, M. Hotz, E. Cantu, M. Porteous, M. Oyster, R. Shah, S. Arcasoy, L. Snyder, K. M. Wille, M. Hartwig, L. B. Ware, P. Shah, M. Crespo, C. Hage, A. Weinacker, V. Lama, Y. Suzuki, J. Orens, S. Kawut, S. Palmer, D. J. Lederer, J. D. Christie, N. Mangalmurti, J. M. Diamond

Concurrent Session 25: Beyond Adherence: What’s New Out There?

0221 – Medical Adherence in the Late-Term after Lung Transplant

Presented by: K. R. Fox, A. J. DeVito Dabbs, A. F. DiMartini, D. M. Posluszny, E. M. Rosenberger, J. M. Pilewski, M. A. Dew

Concurrent Session 27: Are Two Pumps Better Than One? RV Failure and MCS

0232 – Risk Factors Associated with Right Ventricular Assist Device Implantation: Insights from INTERMACS

Presented by: M. S. Kiernan, D. DeNofrio, D. T. Pham, N. K. Kapur, R. Ruthazer, E. W, J. E. Rame, P. Alturi, E. Y. Birati, S. L. Myers, G. H. Oliveira, J. K. Kirklin, R. L. Kormos, F. D. Pagani, J. J. Teuteberg

0234 – Chemokine Receptor Down Regulation in Mechanical Circulatory Support Patients with Right Ventricular Failure

Presented by: A. Nayak, T. N. Bachman, K. Hanley-Yanez, C. McTiernan, D. McNamara, R. L. Kormos, O. Hunter, A. Inashvili, L. Lagazzi, J. J. Teuteberg, M. A. Simon

Concurrent Session 34: How Much is Too Much? Assessing Risk Prior to MCS

0275 – Physician Prediction of Outcomes in Ambulatory Patients with Advanced Heart Failure

Presented by: M. M. Kittleson, C. B. Patel, R. S. Cantor, A. D. DeVore, A. V. Ambardekar, J. T. Thibodeau, L. M. Cadaret, S. V. Pamboukian, J. J. Teuteberg, R. C. Forde-McLean, M. M. Mountis, M. Palardy, G. C. Stewart, M. A. Hamilton

Concurrent Session 40: Too Much of a Good Thing: Balancing Benefit and Medication Complexity

0315 – Effect of Aerosolized Antipseudomonals on Pseudomonas Recurrence and Bronchiolitis Obliterans Syndrome after Lung Transplantation

Presented by: C. A. Moore, J. M. Pilewski, K. M. Robinson, M. R. Morrell, C. J. Gries, A. Zeevi, J. F. McDyer, C. R. Ensor

Mini Oral 07: Patient Management and Outcomes in MCS

0693 – When Antibiotics Are Not Enough: Frequency, Etiology and Durability of the Surgical Management of Driveline Infections

Presented by: M. Lander, L. Lagazzi, R. L. Kormos, G. O’Shea, S. Weaver T. Schweke, M. Shullo, J. J. Teuteberg

0326 – Log Files from the HVAD: What Can Daily and Long-Term Changes in Flow Tell Us about Patients?

Presented by: A. Potter, S. Anderson, J. J. Teuteberg, R. L. Kormos, J. Holtz

Mini Oral 09: Risk Factors and Lung Transplant Outcomes

0343 – Outcomes in Lung Transplant Recipients with Mycobacterium Abscessus Infection

Presented by: Y. Hamad, J. M. Pilewski, J. D’Cunha, E. J. Kwak

0351 – Interleukin 12-Dependent CMV-Specific CD4+ T Cell Proliferation, T-bet Induction and Effector Function During Primary Infection Are Key Determinants for Early Immune Control in Lung Transplant Recipients

Presented by: I. Popescu, M. R. Pipeling, H. Mannem, P. D. Shah, J. B. Orens, J. F. McDyer

Mini Oral 11: Models in Transplantation: From Mouse to Rat to Pig to Human

0369 – Cyclosporine A Can Mitigate Mitochondrial Dysfunction in Lung Grafts during Ex Vivo Lung Perfusion: A Potent Contributor for Better Preconditioning

Presented by: S. Haam, K. Noda, J. D’Cunha, J. D. Luketich, N. Shigemura

0477 – Circulating Cytokines vs. Leukocytes: A Therapeutic Target during Ex Vivo Lung Perfusion

Presented by: K. Noda, S. Haam, D. Zaldonis, J. D’Cunha, J. D. Luketich, N. Shigemura

Poster Session 3: Junior Faculty Case Reports

1237 – Pulmonary Kaposi’s Sarcoma after Lung Transplantation, with 2-Year Follow-Up

Presented by: J. Yoon, N. Shigemura, J. D’Cunha, M. Mehrad, M. Pipeling

Poster Session 3: Lung Transplantation

1026 – The Paradoxical Impact of Warm Ischemia on Lung Allograft Survival

Presented by: C. D. Odell, E. Chan, N. Shigemura, M. R. Morrell, M. M. Crespo, J. M. Pilewski, J. D. Luketich, J. D’Cunha

Poster Session 3: Mechanical Circulatory Support

1042 – A Novel Combined Endpoint Integrating Quality of Life Can Inform Decisions about VAD in Ambulatory Advanced Heart Failure

Presented by: G. C. Stewart, A. V. Ambardekar, M. M. Kittleson, M. Palardy, A. DeVore, J. T. Thibodeau, J. J. Teuteberg, L. M. Cadaret, R. C. Forde-McLean, M. M. Mountis, S. V. Pamboukian, R. Cantor, R. Xie, L. W. Stevenson

1056 – Characteristics of Non-Compliant (NC) LVAD Patients

Presented by: J. Larsen, E. M. Dunn, N. M. Kunz, K. L. Lockard, J. J. Teuteberg, L. Lagazzi, A. D. Althouse, R. L. Kormos

1083 – No Pulse, No Problem! Measuring Blood Pressure and Estimating Pulse Pressure in Centrifugal Flow Left Ventricular Assist Devices

Presented by: J. E. Holtz, A. N. Potter, B. C. Lampert, L. Lagazzi, R. L. Kormos, J. J. Teuteberg

Poster Session 3: Pediatrics

1126 – The Impact of Age on the Incidence and Prevalence of Moderate to Severe Cellular Rejection Detected by Routine Surveillance Biopsy in Pediatric Heart Transplantation

Presented by: M. D. Zinn, K. E. Simpson, M. J. Wallendorf, A. D. Osborne, J. K. Kirklin, C. E. Canter

1139 – Impact of Routine Surveillance Biopsy Intensity on the Diagnosis of Moderate to Severe Cellular Rejection and Survival After Pediatric Heart Transplantation

Presented by: M. D. Zinn, K. E. Simpson, M. J. Wallendorf, A. D. Osborne, J. K. Kirklin, C. E. Canter.

1152 – Pediatric Myocarditis in a Contemporary Multi-Center Cohort

Presented by: R. J. Butts, G. J. Boyle, S. Deshpande, K. Gambetta, K. Knecht, C. Prada Ruiz, M. Richmond, S. West, A. Lal

1155 – Pediatric Myocarditis: Variations in Immunotherapy and Impact on Outcomes

Presented by: K. Gambetta, G. J. Boyle, R. J. Butts, K. R. Knecht, A. K. Lal, Y. Law, A. Prada-Ruiz, M. E. Richmond, S. C. West, S. R. Deshpande

Poster Session 3: Pharmacy & Pharmacology

1175 – Tacrolimus Immunosuppressive Regimens Are Associated with a Mortality Benefit in Lung Transplantation Recipients at a High-Volume Single Center

Presented by: A. B. Lichvar, M. R. Morrell, J. Hayanga, J. M. Pilewski, M. M. Crespo, J. D’Cunha, A. Zeevi, J. F. McDyer, C. R. Ensor

1181 – Mycophenolate-Based Immunosuppressive Regimens Are Associated with a Mortality Benefit in Lung Transplantation Recipients at a Single High-Volume Center

Presented by: A. B. Lichvar, M. R. Morrell, J. Hayanga, J. M. Pilewski, M. M. Crespo, J. D’Cunha, A. Zeevi, J. F. McDyer, C. R. Ensor

Saturday, April 30

Concurrent Session 45: Pediatric Heart Failure

0412 – Risk Factors at Presentation Predict Outcomes of Pediatric Myocarditis: A Contemporary Multi-Center Cohort

Presented by: S. C. West, G. J. Boyle, R. J. Butts, S. R. Deshpande, K. Gambetta, K. R. Knecht, A. K. Lal, Y. Law, A. C. Prada-Ruiz, M. Richmond

Plenary Session – Pushing New Scientific Frontiers: It’s In Our Heritage

April 30, 2016, 9:45 AM – 11:45 AM

Co-Chair: Jeffrey J. Teuteberg

Lifetime Achievement Award to Adrian and Jean Kantrowitz

Presented by: Robert L. Kormos

Concurrent Session 48: Not Just to Survive, But to Thrive: Comprehensive Care of the MCS Patient

0435 – Substantial Reduction in Driveline Infection Rates with the Modification of Driveline Dressing Protocols

Presented by: M. Lander, N. Kunz, E. Dunn, K. Lockard, G. O’Shea, S. Weaver, T. Schweke, M. A. Shullo, L. Lagazzi, R. L. Kormos, J. J. Teuteberg

ISHLT Academy: Master Class in Mechanical Circulatory Support

SECTION B: Case Scenario: Chronic infection management on durable support and thromboembolic complication

Presented by: Robert L. Kormos

 For more information, visit the event website.

Pitt Finding Suggests New Heart Disease Screening Target for Middle-Aged Black Women

Middle-aged black women have higher levels of a protein in their blood associated with a predictor of heart disease than their white counterparts, even after other factors, such as obesity, are taken into consideration, according to a study conducted by the University of Pittsburgh Graduate School of Public Health and School of Medicine.

The finding, reported today in the journal Menopause, suggests routine blood testing of black menopausal women may be warranted to determine their heart disease risk and potentially when to start therapies, such as aspirin and statins. The research was funded by the National Institutes of Health (NIH).

“Multiple previous studies have shown that black women are at higher risk for heart disease than white women; however, guidelines for assessing cardiovascular disease risk in asymptomatic adults do not recommend selective race- or ethnic-based risk-assessment,” said lead author Norman C. Wang, MD, MS, assistant professor in Pitt’s School of Medicine. “Our study revealed for the first time that in black, but not white, women going through menopause, higher levels of an easily measured risk factor for heart disease are associated with higher amounts of early atherosclerosis, even after accounting for other risk factors for heart disease. A clinical trial to determine whether routine screening in this population can save lives may be warranted.”

Dr. Wang and his colleagues examined medical records, blood samples and heart CT scans for 372 black and white women from Pittsburgh and Chicago enrolled in the Study of Women’s Health Across the Nation (SWAN). The women averaged just over 51 years old, were not on hormone replacement therapy and had no known heart disease when enrolled.

The researchers looked at blood levels of five biomarkers linked to inflammation. All of the biomarkers were associated with coronary artery calcification, a predictor of heart disease that is measured with a heart CT scan. When the researchers then took into account the participants’ body mass index (BMI), a measure of overall body fat, they found that obesity was a key factor linking most of the elevated inflammation biomarkers and coronary artery calcification.

Regardless of BMI, black women with higher levels of one particular biomarker, C-reactive protein, were more likely to have coronary artery calcification than whites. In fact, black women with coronary artery calcification had an average level of C-reactive protein in their blood that was almost double that of their white counterparts.

“We clearly demonstrated that obesity, inflammation biomarkers and coronary artery calcification are linked for both black and white midlife women, further emphasizing the need to promote lifestyle changes to combat obesity at midlife when women are subjected to many physiological and biological changes that could potentially increase their risk for heart disease,” said senior author Samar El Khoudary, PhD, MPH, assistant professor in Pitt Public Health’s Department of Epidemiology. “Future research should build on our findings regarding black women and C-reactive protein by testing similar associations over time, which could potentially yield interventions that can help these women avoid developing heart disease.”

The researchers noted that their study only looked at black and white women, so the results are not generalizable to other racial or ethnic groups.

Additional researchers on the study are Karen A. Matthews, PhD, Emma J.M. Barinas-Mitchell, PhD, and Chung-Chou H. Chang, PhD, all of Pitt.

This work was supported by the NIH through the National Institute on Aging, National Institute of Nursing Research, Office of Research on Women’s Health and National Heart, Lung, and Blood Institute grants U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, HL065581 and HL065591.

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