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Investigation of Motivational Interviewing and Prevention Consults to Achieve Cardiovascular Targets (IMPACT) trial
Gianos, Eugenia; Schoenthaler, Antoinette; Guo, Yu; Zhong, Judy; Weintraub, Howard; Schwartzbard, Arthur; Underberg, James; Schloss, Michael; Newman, Jonathan D; Heffron, Sean; Fisher, Edward A; Berger, Jeffrey S
BACKGROUND:Patients undergoing cardiovascular (CV) procedures often have suboptimal CV risk factor control and may benefit from strategies targeting healthy lifestyle behaviors and education. Implementation of prevention strategies may be particularly effective at this point of heightened motivation. METHODS:A prospective, randomized, pilot study was conducted in 400 patients undergoing a nonurgent CV procedure (cardiac catheterization ± revascularization) to evaluate the impact of different prevention strategies. Patients were randomized in a 1:1:1 fashion to usual care (UC; group A, n = 134), in-hospital CV prevention consult (PC; group B, n = 130), or PC plus behavioral intervention program (telephone-based motivational interviewing and optional tailored text messages) (group C, n = 133). The primary end point was the Δ change in non-high-density lipoprotein cholesterol (non-HDL-C) from baseline to 6 month. RESULTS:The mean age was 64.6 ± 10.8 years, 23.7% were female, and 31.5% were nonwhite. After 6 months, the absolute difference in non-HDL-C for all participants was -19.8 mg/dL (95% CI -24.1 to -15.6, P < .001). There were no between-group differences in the primary end point for the combined PC groups (B and C) versus UC, with a Δ adjusted between group difference of -5.5 mg/dL (95% CI -13.1 to 2.1, P = .16). Patients in the PC groups were more likely to be on high-intensity statins at 6 months (52.9% vs 38.1%, P = .01). After excluding participants with baseline non-HDL-C <100 mg/dL (initial exclusion criterion), Δ non-HDL-C and Δ low-density lipoprotein cholesterol were improved in the PC groups compared to UC (non-HDL-C -8.13 mg/dL [-16.00 to -0.27], P = .04; low-density lipoprotein cholesterol -7.87mg/dL [-15.10 to -0.64], P = .03). CONCLUSIONS:Although non-HDL-C reduction at 6 months following a nonurgent CV procedure was not significant in the overall cohort, an increased uptake in high-potency statins may translate into improved long-term health outcomes and cost reductions.
PMID: 29754664
ISSN: 1097-6744
CID: 3114632
PERIPHERAL VASCULAR DISEASE RISK EQUIVALENCE IN DIABETES DEPENDS ON CONCOMITANT RISK FACTORS [Meeting Abstract]
Wilcox, Tanya; Newman, Jonathan; Berger, Jeffrey
ISI:000429659704089
ISSN: 0735-1097
CID: 3055222
ASSOCIATIONS BETWEEN CONVENTIONAL CARDIOVASCULAR RISK FACTORS AND RISK OF PERIOPERATIVE ACUTE MYOCARDIAL INFARCTION AFTER NON-CARDIAC SURGERY [Meeting Abstract]
Wilcox, Tanya; Smilowitz, Nathaniel; Newman, Jonathan; Berger, Jeffrey
ISI:000429659703516
ISSN: 0735-1097
CID: 3055252
MISSED OPPORTUNITIES FOR CARDIOVASCULAR DISEASE (CVD) PREVENTION DURING US AMBULATORY CARE VISITS FOR PATIENTS WITH DIABETES MELLITUS [Meeting Abstract]
Newman, Jonathan; Berger, Jeffrey; Ladapo, Joseph
ISI:000429659703495
ISSN: 0735-1097
CID: 3055272
PREDICTORS OF LDL-CHOLESTEROL AND SYSTOLIC BLOOD PRESSURE (SBP) GOAL ATTAINMENT AT ONE YEAR: INTERIM DATA FROM THE ISCHEMIA TRIAL [Meeting Abstract]
Newman, Jonathan D.; Alexander, Karen; O'Brien, Sean; Gu, Xiangqiong; Govindan, Sajeev; Senior, Roxy; Rezende, Paulo; Moorthy, Nagaraja; Demkow, Marcin; Lopez-Sendon, Jose; Bockeria, Olga; Gosselin, Gilbert; Pandit, Neeraj; Stone, Peter; Boden, William; Spertus, John; Stone, Gregg; Hochman, Judith; Maron, David
ISI:000429659700085
ISSN: 0735-1097
CID: 3055352
The 2017 high blood pressure clinical practice guideline: The old and the new [Editorial]
Schwartzbard, Arthur Z; Newman, Jonathan D; Weintraub, Howard S; Baum, Seth J
PMID: 29574983
ISSN: 1932-8737
CID: 3011172
Walking to a pathway for cardiovascular effects of air pollution
Thurston, George D; Newman, Jonathan D
PMID: 29221647
ISSN: 1474-547x
CID: 2835622
Chelation Therapy as a Cardiovascular Therapeutic Strategy: the Rationale and the Data in Review
Mathew, Roy O; Schulman-Marcus, Joshua; Nichols, Elizabeth L; Newman, Jonathan D; Bangalore, Sripal; Farkouh, Michael; Sidhu, Mandeep S
Chelation therapy, typically used to remove heavy metal toxins, has also been controversially used as a treatment for coronary artery disease. The first Trial to Assess Chelation Therapy (TACT) aimed to provide evidence on chelation therapy's potential for benefit or harm. Although TACT had some significant results, the trial does not provide enough evidence to recommend routine chelation therapy and has limitations. The second TACT was recently funded reigniting a discussion about the value of chelation therapy, its efficacy, and allocation of research resources. Despite limited evidence, patients continue to pursue chelation therapy as a treatment for coronary artery disease. As the medical community has a responsibility to understand all treatments patients pursue, it is important to comprehensively appraise chelation therapy for cardiovascular disease. Understanding the background of heavy metal toxicity, the putative target of chelation therapy, on the cardiovascular system is important to contextualize the role of chelation therapy in cardiovascular disease prevention. We review the clinical evidence of heavy metal toxicity and cardiovascular disease, and available clinical trial data on use of chelation therapy to minimize the cardiovascular burden of heavy metal toxicity.
PMID: 29129003
ISSN: 1573-7241
CID: 2785412
The Effect of a Vegan versus AHA DiEt in Coronary Artery Disease (EVADE CAD) trial: study design and rationale
Shah, Binita; Ganguzza, Lisa; Slater, James; Newman, Jonathan D; Allen, Nicole; Fisher, Edward; Larigakis, John; Ujueta, Francisco; Gianos, Eugenia; Guo, Yu; Woolf, Kathleen
Background/UNASSIGNED:Multiple studies demonstrate the benefit of a vegan diet on cardiovascular risk factors when compared to no intervention or usual dietary patterns. The aim of this study is to evaluate the effect of a vegan diet versus the American Heart Association (AHA)-recommended diet on inflammatory and glucometabolic profiles in patients with angiographically defined coronary artery disease (CAD). Study Design/UNASSIGNED:This study is a randomized, open label, blinded end-point trial of 100 patients with CAD as defined by ≥50% diameter stenosis in a coronary artery ≥2 mm in diameter on invasive angiography. Participants are randomized to 8 weeks of either a vegan or AHA-recommended diet (March 2014 and February 2017). Participants are provided weekly groceries that adhere to the guidelines of their diet. The primary endpoint is high sensitivity C-reactive concentrations. Secondary endpoints include anthropometric data, other markers of inflammation, lipid parameters, glycemic markers, endothelial function, quality of life data, and assessment of physical activity. Endpoints are measured at each visit (baseline, 4 weeks, and 8 weeks). Dietary adherence is measured by two weekly 24-hour dietary recalls, a 4-day food record during the week prior to each visit, and both plasma and urine levels of trimethylamine-N-oxide at each visit. Conclusion/UNASSIGNED:This study is the first to comprehensively assess multiple indices of inflammation and glucometabolic profile in a rigorously conducted randomized trial of patients with CAD on a vegan versus AHA-recommended diet.
PMCID:5764176
PMID: 29333503
ISSN: 2451-8654
CID: 2908222
Primary Prevention of Cardiovascular Disease in Diabetes Mellitus
Newman, Jonathan D; Schwartzbard, Arthur Z; Weintraub, Howard S; Goldberg, Ira J; Berger, Jeffrey S
Type 2 diabetes mellitus (T2D) is a major risk factor for cardiovascular disease (CVD), the most common cause of death in T2D. Yet, <50% of U.S. adults with T2D meet recommended guidelines for CVD prevention. The burden of T2D is increasing: by 2050, approximately 1 in 3 U.S. individuals may have T2D, and patients with T2D will comprise an increasingly large proportion of the CVD population. The authors believe it is imperative that we expand the use of therapies proven to reduce CVD risk in patients with T2D. The authors summarize evidence and guidelines for lifestyle (exercise, nutrition, and weight management) and CVD risk factor (blood pressure, cholesterol and blood lipids, glycemic control, and the use of aspirin) management for the prevention of CVD among patients with T2D. The authors believe appropriate lifestyle and CVD risk factor management has the potential to significantly reduce the burden of CVD among patients with T2D.
PMCID:5656394
PMID: 28797359
ISSN: 1558-3597
CID: 2664152