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Weill Cornell Physician-Scientists Present At ACC Meeting

April 4, 2011

Dr. Antonio M. Gotto, a Leading Authority on Lipid Therapy and Cardiovascular Disease, and Other Physician-Scientists Are Available for Expert Commentary

Available for expert commentary on the latest research findings presented at the 2011 American College of Cardiology Annual Meeting in New Orleans, April 2 to 5, is Dr. Antonio M. Gotto Jr., the Stephen and Suzanne Weiss Dean of Weill Cornell Medical College and a recognized authority on lipid therapy and cardiovascular disease.

Among those presenting at this year’s ACC conference are physician-scientists from the Ronald O. Perelman Heart Institute at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and Weill Cornell Medical College. The following are some of their notable research studies:

* Increased Body Mass Index Associated With Greater Prevalence, Extent and Severity of Coronary Artery Disease

Dr. Troy LaBounty
A cardiologist at the Ronald O. Perelman Heart Institute of NewYork-Presbyterian Hospital/Weill Cornell Medical Center and assistant professor of medicine at Weill Cornell Medical College

According to Dr. Troy LaBounty and his co-investigators, higher body mass index (BMI) is associated with increased cardiac risk factors and events, but the relationship between BMI and the prevalence, extent and severity of coronary artery disease (CAD) and mortality is not established. The investigators looked at 24,775 consecutive patients without known CAD undergoing clinically indicated coronary CT angiography at 12 international centers. They found that overweight and obese patients have increased prevalence of CAD risk factors; patients also had greater prevalence, extent and severity of CAD that may not be explained by the Framingham Risk Score alone. However, BMI is not associated with a difference in mortality.

#1061-205. Sunday, April 3, 3:30-4:45 p.m.

* Coronary CT Angiography Imaging Using 80 vs. 100 kVp Associated With 47-Percent Reduction in Radiation Dose

Dr. Troy LaBounty A cardiologist at the Ronald O. Perelman Heart Institute of NewYork-Presbyterian Hospital/Weill Cornell Medical Center and assistant professor of medicine at Weill Cornell Medical College

According to Dr. Troy LaBounty and his co-investigators, current methods to lower the radiation dose of coronary CT angiography (CCTA) include reduced 100 kVp imaging. The effect of further reduced 80 kVp voltage on radiation dose and image quality across CCTA platforms is not known. The investigators performed a prospective, multicenter, randomized trial of 208 consecutive patients without prior coronary revascularization and normal body mass index referred for CCTA. Patients were randomized to 80 or 100 kVp imaging. The study found CCTA imaging using 80 vs. 100 kVp was associated with a 47-percent reduction in radiation dose. Despite a similar or decreased signal/noise ratio and graded image quality, per-artery interpretability was comparable or improved across multiple platforms.

#1025-213. Sunday, April 3, 10:00-11:15 a.m.

* Relationship of Non-Obstructive Coronary Artery Disease to Mortality

Dr. James K. Min
A cardiologist at the Ronald O. Perelman Heart Institute of NewYork-Presbyterian Hospital/Weill Cornell Medical Center and assistant professor of medicine at Weill Cornell Medical College

Dr. James K. Min and his co-investigators examined mortality risk in relation to presence and extent of non-obstructive coronary artery disease (CAD). The investigators evaluated 18,037 consecutive adults from 12 centers in six countries undergoing clinically indicated 64-detector row cardiac computed tomography angiography (CCTA) without obstructive CAD by CCTA. They found presence and extent of non-obstructive CAD augments prediction of individuals at risk of death.

#912-6. Monday, April 4, 11:30-11:45 a.m.

* Persistence of Left Ventricular Hypertrophy Associated With Markedly Worse Outcomes in Patients With Lower Achieved Systolic Pressure During Antihypertensive Treatment: The LIFE Study

Dr. Peter M. Okin
A cardiologist at the Ronald O. Perelman Heart Institute of NewYork-Presbyterian Hospital/Weill Cornell Medical Center and professor of medicine at Weill Cornell Medical College

According to Dr. Peter M. Okin and his co-investigators, it is well-established that reducing systolic pressure (SBP) to a target goal of less than 140 mm Hg in hypertensive patients improves outcomes. However, data on whether more aggressive reduction of systolic blood pressure to lower treatment goals further improves outcomes have been conflicting. The investigators reviewed data from the LIFE study, focusing on a subset of 463 hypertensive patients with mean SBP ⓰¤130 mm Hg were randomly assigned losartan- or atenolol-based treatment. They found that failure to regress Cornell product LVH among patients with greater lowering of SBP during treatment (mean achieved SBP ⓰¤130 mm Hg) is associated with significantly higher risk of heart attack, stroke, cardiovascular and all-cause mortality. They say these findings suggest that persistence of LVH in a subset of these patients may in part explain the lack of benefit seen in hypertensive patients despite treatment to lower SBP. Furthermore, they say, the results suggest that it may be necessary to track end-organ damage, in this case as manifested by ECG LVH, in addition to BP to fully assess response to treatment in hypertensive patients.

#1114-300. Monday, April 4, 4:45-6:00 p.m.

* T-Wave Alternans Testing and ST Depression Assessment Identifies Low-Risk Individuals With Ischemic Cardiomyopathy in the Absence of Left Ventricular Hypertrophy

Dr. Peter M. Okin
A cardiologist at the Ronald O. Perelman Heart Institute of NewYork-Presbyterian Hospital/Weill Cornell Medical Center and professor of medicine at Weill Cornell Medical College

According to Dr. Peter M. Okin and his co-investigators, although ECG left ventricular hypertrophy (LVH) by Cornell product (CP) predicts increased mortality in patients with ischemic cardiomyopathy (ICM), those without CP LVH (CP-) remain at relatively high risk. The investigators examined whether T-wave alternans (TWA) testing and ST depression (STd) can improve risk stratification in these patients. Resting ECG, TWA and electrophysiologic testing were performed in 317 patients with ICM and prior non-sustained ventricular tachycardia in sinus rhythm. The found that CP LVH, STd, and TWA testing stratify three-year mortality risk in ICM patients. The presence of CP LVH or STd and/or abnormal TWA testing in CP- patients signifies high risk while the absence of all three indicators identifies a large subset of low-risk individuals.

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