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BWH was represented in full force at this year’s American Heart Association (AHA) Scientific Sessions Nov. 12-16 in Orlando, Fla. The event drew 20,000 attendees from more than 100 countries. BWH faculty received awards, delivered named lectures and presented late-breaking research. Many of the research findings presented made national headlines in major publications, such as The Wall Street Journal and USA Today.
“These presentations and lectures were very well-received,” said Elliott Antman, MD, senior investigator in the Thrombolysis in Myocardial Infarction (TIMI) Study Group and AHA Scientific Sessions chairman. “It is wonderful to see one’s colleagues have the opportunity to present their work and have it discussed by their peers in the best forum in the world for this kind of activity.”
BWH representation was notably larger than usual in the Late-Breaking Clinical Trial sessions, where researchers, including Samuel Z. Goldhaber, MD, director of the BWH Venous Thromboembolism Research Group, and Niteesh K. Choudhry, MD, PhD, Division of Pharmacoepidemiology and Pharmacoeconomics, presented findings on the investigational drug apixaban and the effect of co-payments on medication adherence, respectively. Others, such as Jessica L. Mega, MD, MPH, Cardiovascular Division, presented breakthrough findings on the drugs rivaroxaban and clopidogrel. The following are highlights from several major studies.
Rivaroxaban Aids in Treating ACS
Patients with acute coronary syndrome (ACS) are at risk of having another heart attack or stroke, despite medical and surgical therapies. But BWH researchers found that giving these patients a very low dose of rivaroxaban, an anti-blood clotting drug, may prove helpful in reducing that risk.
Mega, Eugene Braunwald, MD, Cardiovascular Division, and C. Michael Gibson, MS, MD, of Beth Israel Deaconess Medical Center, shared these findings from the ATLAS ACS 2-TIMI 51 study.
15,526 participants with ACS participated in the study and were given either 2.5 milligrams of rivaroxaban twice daily, 5 milligrams of rivaroxaban twice daily, or placebo for an average of 13 months. Researchers found that the very low dose reduced cardiovascular death by 34 percent.
Personalized Medicine, Personalized Dosage
Mega also presented the ELEVATE-TIMI 56 study, in which she and Marc S. Sabatine, MD, MPH, chairman of the TIMI Study Group, showed that the standard dose of the anti-platelet drug clopidogrel (Plavix) may not be optimal for people with a certain gene mutation.
The study included 333 participants with stable heart disease already taking the standard clopidogrel dose. Some participants had a mutation in a gene called CYP2C19*2, while others did not harbor the mutation.
Both groups underwent four treatment periods, wherein they were given different doses of clopidogrel in each period. Researchers found that those with the mutation required a dosage at least three to four times more than the standard dose to achieve similar effects seen in those without the gene mutation.
“Currently most doctors provide patients with a standard dose of clopidogrel. But studies such as this one suggest that this one-size-fits-all approach may not be optimal.” said Mega.
Stem Cell Breakthrough in Heart Failure Treatment
Patients’ own heart stem cells can improve their heart’s function after a heart attack, researchers found. The groundbreaking results of the SCIPIO study were presented by Piero Anversa, MD, Departments of Anesthesiology and Medicine, Division of Cardiovascular Medicine, and Roberto Bolli, MD, University of Louisville.
The study explored whether reinfusing a patient’s own heart cells could improve function after a heart attack. Researchers harvested heart stem cells from patients during coronary artery bypass surgery. The cells were then purified in the lab and allowed to grow before they were reintroduced into the patient’s heart.
Researchers saw an 8.5 percent improvement within just four months, and 12 percent after one year. Moreover, the size of the scarred regions in the patients’ hearts had decreased. The study is the first to report on reinfusing a patient’s own heart stem cells.
“Seeing these cells given successfully to very sick patients is the most rewarding experience that a physician-scientist can have in his or her lifetime,” said Anversa.
In addition to presenting exciting research, several of BWH’s faculty members were recognized by AHA:
Peter Libby, MD, chief of the BWH Cardiovascular Division, was the recipient of the 2011 Basic Research Prize.
Joseph Loscalzo, MD, PhD, Department of Medicine chairman, gave the prestigious Lewis A. Conner Memorial lecture.
JoAnn E. Manson, MD, MPH, DrPH, chief of the BWH Division of Preventive Medicine and the Michael and Lee Bell Professor of Women’s Health, received the Distinguished Scientist Award.
Patrick O’Gara, MD, executive medical director of the Shapiro Cardiovascular Center and clinical director of the Cardiovascular Division received the Laennec Master Clinician Award from the Council on Clinical Cardiology of the AHA.
Frank M. Sacks, MD, BWH senior physician, professor of Cardiovascular Disease Prevention at Harvard School of Public Health, professor of medicine at the Channing Laboratory, Department of Medicine, HMS and BWH, received the 2011 Research Achievement Award.