AHA: American Heart Association Scientific Sessions

Ample evidence supports obesity as an independent risk factor for cardiovascular disease (CVD). Traditionally, obesity is defined by body mass index (BMI); however, recent data suggest metabolic syndrome and excess adipose tissue play more of a role than BMI in determining CVD risk. In this session, Jaime Armando, PhD, and colleagues from the University of Texas Southwestern Medical Center; and Amparo Figueroa, MD, MPH, from Massachusetts General Hospital, presented results from studies that examined the roles of metabolic syndrome and excess adipose tissue in determining CVD risk.

In a presentation titled Readmission for Stroke and Quality of Care Among Hospitalized Patients With Transient Ischemic Attack: Real World Delivery of Care, Emily C. O'Brian, PhD, from Duke University School of Medicine, presented results from the American Heart Association's Get With the Guidelines (GWTG)-Stroke program. GWTG is a hospital improvement program designed to improve adherence to evidence-based care.

In this session, data were presented from 3 separate trials that focused on potential ways to reduce the risk for bleeding in patients who require anticoagulation therapy, including the use of genetic tests to optimize warfarin dosing and the use of the factor Xa inhibitor edoxaban. Munir Pirmohamed, MD, PhD, from the University of Liverpool, discussed results from the EU-PACT trial; Stephen Kimmel, MD, from the University of Pennsylvania School of Medicine discussed results from the COAG trial; and Robert P. Giugliano, MD, SM, FAHA, FACC, from Brigham and Women's Hospital, discussed results from the ENGAGE TIMI-AF 48 trial.

In this session, Denise Bonds, MD, MPH, from the National Heart, Lung, and Blood Institute, discussed the limitations of outcomes research conducted using claims or registry data. According to Dr Bonds, the trend is to use new data, big data, and patient-powered data. In another presentation, Catarina Kiefe, PhD, MD, from the University of Massachusetts Medical School, provided preliminary findings from her research in patients with acute coronary syndrome as an example of how outcomes research is evolving.

Patients spend far more time in the home than with their healthcare providers, making the home an ideal and perhaps essential place to improve adherence and outcomes. In this session, Kathryn Donofrio, DNP, MBA, RN, from Swedish Covenant Hospital, and Debra Moser, DNSc, MN, RN, from the University of Kentucky, discussed home-based strategies for care improvements in patients with heart failure.

Accountable Care Organizations (ACOs) are designed to improve the quality and continuity of care, but it remains unclear how stakeholders can be successful in this new model and also how the shift in incentives will truly impact care. In this session, W. Douglas Weaver, MD, from the Henry Ford Heart and Vascular Institute and Henry Ford Hospital, and Karen E. Joynt, MD, MPH, from Brigham and Women's Hospital and Harvard Medical School, discussed the potential impact of ACOs on specialty care and the potential for ACOs to limit access to care.

Recently released guidelines from the American College of Cardiology and American Heart Association base treatment on a 10-year risk for atherosclerotic cardiovascular disease, a shift from the previous guidelines' overall emphasis on treat to target. In this session, C. Noel Bairey Mertz, MD, FACC, from the Cedars-Sinai Heart Institute; Jennifer G. Robinson, MD, MPH, from the University of Iowa; and Karol Watson, MD, PhD, FACC, from the University of Southern California, Los Angeles, discussed the evidence supporting cholesterol lowering in women, the elderly, and minorities.

The participants in this session noted that the medical record of the future will likely include a prognostic genetic component that will have short- and long-term implications. Panelists included Jennifer Hall, PhD, FACC, FAHA, from the University of Minnesota; Dan Roden, MD, from Vanderbilt University; Gary H. Gibbons, MD, from the National Heart, Lung, and Blood Institute; and Christopher Cannon, MD, from Brigham and Women's Hospital.

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