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BWHers gathered in Chicago Nov. 13-17 for the 2010 American Heart Association Scientific Sessions. In a tremendous showing from the hospital, researchers presented groundbreaking findings, led discussions and participated in the AHA’s annual Fun Run, which was dedicated this year to the memory of Kenneth L. Baughman, MD. The following summary highlights three of the many BWH contributions at the meeting.
Christopher Cannon, MD, a cardiologist in the TIMI Study Group, presented findings from his study on anacetrapib, an experimental cholesterol drug that raises HDL, or “good” cholesterol, and lowers LDL, or “bad” cholesterol.
“There are very few drugs available to treat low levels of good cholesterol, so the fact that anacetrapib is four to ten times more effective in raising good cholesterol compared to current therapies is very exciting,” said Cannon, a cardiologist and lead author of the DEFINE trial (Determining the EFficacy and Tolerability of CETP INhibition with AnacEtrapib).
The study, which was also published in the Nov. 17 issue of the New England Journal of Medicine, looked at 1,623 patients who were already taking statins to control their cholesterol. Patients in the group taking anacetrapib produced a remarkable 138 percent increase in good cholesterol, and a 40 percent reduction in bad cholesterol beyond that seen in the placebo group.
Anacetrapib inhibits an enzyme called CETP, which is involved in moving cholesterol between HDL and LDL particles.
“Our research shows that anacetrapib is well-tolerated by patients and is not associated with the dangerous blood pressure changes that have been seen in similar types of medication,” Cannon added. “If these same findings are validated in larger scale trials, then we may have a new kind of drug to fight cardiovascular disease.”
The drug is not currently available, and more studies are needed. The TIMI Study Group, led by Eugene Braunwald, MD, will collaborate with Oxford University in a 30,000 patient study starting early next year.
Women who report high levels of stress on the job have an increased risk of cardiovascular disease, according to BWH cardiologist Michelle A. Albert, MD, MPH, who also presented research findings at the AHA 2010 Scientific Sessions.
“Our study indicates that there are possibly immediate and definite long-term clinically documented cardiovascular health effects of job strain in women,” said Albert, a lead author of the study. “Your job can positively and negatively affect health, so it’s important for women and their health care providers to pay attention to the stresses of their jobs as part of the total health package.”
Job strain, a form of psychological stress, is defined as having a demanding job that provides limited opportunity for decision making or to use one’s creative or individual skills. Women who reported having high and active levels of job strain have a 40 percent and 56 percent increased risk of cardiovascular disease, respectively, including heart attacks and the need for invasive heart procedures, when compared to women with low job strain.
Researchers also found that job insecurity or fear of losing one’s job and job strain were both associated with risk factors for cardiovascular disease such as high blood pressure, increased cholesterol and excess body weight. However, job insecurity was not directly related to the development of heart attacks, stroke, invasive heart procedures or cardiovascular death.
“From a public health perspective, it is crucial for employers, as well as government and hospital entities, to monitor perceived employee job strain,” said Albert. “Initiating strategies to help employees manage stress could positively impact prevention of heart disease, employee productivity and business competitiveness.”
Albert also presented in the highlighted AHA Special Clinical Sessions/Late Breaking Sessions, where she discussed original work on the “Impact of Massachusetts Health Care Reform on Racial, Ethnic, Socioeconomic and Gender Disparities in Cardiovascular Care.”
On Nov. 13, the American Heart Association’s Council on Clinical Cardiology presented its highest honor, the James B. Herrick Award, to BWH’s Elliott M. Antman, MD, “in recognition of his praiseworthy accomplishments on multiple levels that have profoundly elevated the practice of cardiovascular medicine.” Antman, a senior physician at BWH and senior investigator in the TIMI Study Group, has directed clinical trials that established new benchmarks for treatment. He also led the development of practice guidelines to include current clinical findings and the creation of risk scores for evaluating critically ill patients.