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Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic plaque in the arteries of the heart. It is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, and myocardial infarction.
Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium). It is most commonly a symptom of coronary artery disease.
Hypercholesterolemia, also called high cholesterol, is the presence of high levels of cholesterol in the blood. It is a form of hyperlipidemia, hyperlipoproteinemia, and dyslipidemia.
The University of Ottawa Heart Institute (UOHI) (French: Institut de cardiologie de l'Université d'Ottawa ) is Canada's largest cardiovascular health centre. It is located in Ottawa, Ontario, Canada. It began as a department in The Ottawa Hospital, and since has evolved into Canada's only complete cardiac centre, encompassing prevention, diagnosis, treatment, rehabilitation, research, and education.
Paul M. Ridker is a cardiovascular epidemiologist and biomedical researcher. He is currently the Eugene Braunwald Professor of Medicine at Harvard University and Brigham and Women's Hospital, where he directs the Center for Cardiovascular Disease Prevention. Ridker also holds an appointment as Professor in the Department of Epidemiology at the Harvard T.H. Chan School of Public Health.
A CETP inhibitor is a member of a class of drugs that inhibit cholesterylester transfer protein (CETP). They are intended to reduce the risk of atherosclerosis by improving blood lipid levels. At least three medications within this class have failed to demonstrate a beneficial effect.
The lipid hypothesis is a medical theory postulating a link between blood cholesterol levels and the occurrence of cardiovascular disease. A summary from 1976 described it as: "measures used to lower the plasma lipids in patients with hyperlipidemia will lead to reductions in new events of coronary heart disease". It states, more concisely, that "decreasing blood cholesterol [...] significantly reduces coronary heart disease".
The Libin Cardiovascular Institute is an entity of Alberta Health Services and the University of Calgary. It connects all cardiovascular research, education and patient care in Southern Alberta, serving a population of about two million. Its more than 1,500 members include physicians, clinicians and other health professionals, researchers and trainees.
Valentín Fuster Carulla, 1st Marquess of Fuster is a Spanish cardiologist and aristocrat.
Dalcetrapib is a CETP inhibitor which was being developed by Hoffmann–La Roche until May 2012. The drug was aimed at raising the blood levels of HDL cholesterol. Prevailing observations indicate that high HDL levels correlate with better overall cardiovascular health, though it remains unclear whether raising HDL levels consequently leads to an increase in cardiovascular health.
Jonathan L. Halperin is an American cardiologist and the author of Bypass (ISBN 0-89586-509-2), among the most comprehensive works on the subject of coronary artery bypass surgery. In addition, he is the Robert and Harriet Heilbrunn Professor of Medicine at The Mount Sinai School of Medicine as well as Director of Clinical Cardiology in the Zena and Michael A. Wierner Cardiovascular Institute at The Mount Sinai Medical Center, both in New York City. Halperin was the principal cardiologist responsible for both the design and execution of the multi-center Stroke Prevention in Atrial Fibrillation (SPAF) clinical trials, funded by the National Institutes of Health, which helped develop antithrombotic strategies to prevent stroke, and he subsequently directed the SPORTIF clinical trials, which evaluated the first oral direct thrombin inhibitor for prevention of stroke in patients with atrial fibrillation.
Steven E. Nissen is an American cardiologist, researcher and patient advocate. He was chairman of cardiovascular medicine at the Cleveland Clinic, in Cleveland, Ohio.
Stephen William MacMahon AO DSc FAA FMediSci FAHMS FACC is a British-Australian academic medical researcher, healthcare entrepreneur and founder of The George Institute for Global Health. He holds professorial academic appointments in medicine at UNSW Sydney and Imperial College London.
Ulf Landmesser is a German specialist for cardiology and internal medicine. He is professor at the Institute for Health Research in Berlin and Head of the Medical Clinic of Cardiology at the Charité in Berlin. Landmesser is known for his work on coronary interventions and modern methods of catheter-based heart valve therapy.
Robert Roberts, is a cardiologist, geneticist, academic, and medical researcher.
Erin Kathleen Donnelly Michos is an American cardiologist. She is an associate professor of Medicine and Director of Women's Cardiovascular Health at Johns Hopkins School of Medicine. Michos is also an Associate Faculty of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins, and has a joint faculty appointment in the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health.
Kathryn J. Moore is a Canadian-born American cell biologist who is the Jean and David Blechman Professor of Cardiology and the founding director of the Cardiovascular Research Center at the New York University Grossman School of Medicine. Moore's research considers the pathogenesis of atherosclerosis, with a focus on the identification of novel therapeutic targets. She was elected Fellow of the National Academy of Sciences in 2021.
Jason C. Kovacic is an Australian-born cardiologist and physician-scientist; the Robert Graham Chair and Professor of Medicine, University of New South Wales; Executive Director of the Victor Chang Cardiac Research Institute in Sydney, Australia; and Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai, New York.
Gemma Alexandra Figtree is an Interventional Cardiologist at Royal North Shore Hospital, Professor in Medicine at the University of Sydney, chair of the Federal Government's 10-year Mission for Cardiovascular Health, and co-leader of the Cardiovascular Theme for Sydney Health Partners.
Roberto Ferrari is an Italian cardiologist who holds the position of Emeritus Professor at the University of Ferrara, where besides he was the chair of the Cardiology in the School of Medicine until the 2019–2020 academic year.
References
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This pharmacogenomic study of approximately 6000 patients with coronary artery disease suggested that the effects of the CETP inhibitor dalcetrapib on both cardiovascular outcomes and atherosclerosis imaging are determined by polymorphisms in the ADCY9 gene. Patients with the AA genotype at polymorphism rs1967309 had a 39% reduction in cardiovascular outcomes when treated with dalcetrapib versus placebo.
2- Ridker PM, Revkin J, Amarenco P, Brunell R, Curto M, Civeira F, Flather M, Glynn RJ, Gregoire J, Jukema JW, Karpov Y, Kastelein JJP, Koenig W, Lorenzatti A, Manga P, Masiukiewicz U, Miller M, Mosterd A, Murin J, Nicolau JC, Nissen S, Ponikowski P, Santos RD, Schwartz PM, Soran H, White H, Wright RS, Vrablik M, Yunis C, Shear Cl, Tardif JC. Cardiovascular efficacy and safety of bococizumab in high risk patients. N Engl J Med 2017;376:1527-1539.
In these large phase 3 randomized clinical trials of 27,438 patients, the PCSK9 inhibitor bococizumab was shown to reduce the rate of cardiovascular events in higher-risk patients but not in those at lower risk.
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In this large phase 3 randomized clinical trial, the dual PPAR agonist aleglitazar did not provide cardiovascular benefits in 7226 patients with diabetes and a recent acute coronary syndrome.
4- Pfeffer MA, Claggett B, Diaz R, Dickstein K, Gerstein HC, Køber LV, Lawson FC, Ping L, Wei X, Lewis EF, Maggioni AP, McMurray JJ, Probstfield JL, Riddle MC, Solomon SD, Tardif JC. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N Engl J Med 2015;373:2247-2257.
In this large-scale randomized clinical trial, the effects of the GLP-1 receptor agonist lixisenatide on cardiovascular outcomes were evaluated in 7000 patients with diabetes and a recent acute coronary syndrome.
5- Tardif JC, Kouz S, Waters DD, et al. Efficacy and safety of low-dose colchicine after myocardial infarction. N Engl J Med 2019;38:2497-2505. This international randomized trial of 4745 patients showed that the anti-inflammatory medication colchicine reduces the risk of ischemic cardiovascular events (including strokes) after a myocardial infarction. These results contributed to the approval of colchicine by Health Canada for the prevention of atherothrombotic events in patients with coronary artery disease and its entry in the European guidelines and South American guidelines for cardiovascular prevention.
