Visit: heart.beaumont.edu for other Beaumont Health System Heart & Vascular Information.

RES E ARCH

Beaumont’s Heart and Vascular Research department is one of the largest in the country. The department is involved in more than 120 cardiovascular research studies a year and has historically published extensive research in the most prominent peer-reviewed scientific journals.

Selected Current Trials

EVEREST II trial: Percutaneous MitraClip repair versus surgery for mitral valve repair This study is designed to compare percutaneous mitral valve repair with the MitraClip versus surgical mitral valve repair for patients with significant mitral regurgitation. The primary efficacy endpoint is freedom from surgery for valve dysfunction,

death and mitral regurgitation > 2+. Principal Investigator: GEORGE HANZEL, M.D. Study Coordinator: JIM WEGNER, B.S. 248-898-3123 or jwegner@beaumont.eduBeaumont website: heart.beaumont.edu/heart-valve-structural-disease-research

PARTNER II trial: TAVR for aortic stenosis The purpose of this trial is to determine the safety and effectiveness of the Edwards SAPIEN XT™ device and NovaFlex delivery systems in inoperable patients with symptomatic critical aortic stenosis. Study patients will be randomized to the SAPIEN valve tested in the earlier trial, or a new, lower profile SAPIEN XT valve. The FDA approved, multi-center trial will involve 600 patients in about 35 centers in the U.S. “In the PARTNER II trial, we are evaluating a new valve that we think will be more durable and a smaller delivery system that will allow us to treat more patients with fewer vascular complications,” said George Hanzel, M.D., director, Cardiac Catheterization Laboratory, Beaumont Hospital, Royal Oak.

Primary investigator: GEORGE HANZEL, M.D. Coordinator: WARREN REAVES 248-898-4541 or wreaves@beaumont.eduBeaumont website: heart.beaumont.edu/heart-valve-structural-disease-research

PREVAIL WATCHMAN® Trial: Watchman device for left atrial appendage in atrial fibrillation This trial is designed to study the Watchman® device that is currently under FDA review for treatment of atrial fibrillation instead of anticoagulation with warfarin. The device forms a mechanical barrier that seals off the left atrial appendage to prevent clot formation. Approximately 97 percent of all patients that have had the device placed are no longer taking warfarin.

Primary investigator: STEVEN ALMANY, M.D.Coordinator: ANN MCHUGH, R.N. 248-898-6549 or amchugh@beaumont.edu Beaumont website: heart.beaumont.edu/heart-valve-structural-disease-research

Research suggests calcium supplements may increase heart attack risk (Original Article) Associations of dietary calcium intake and calcium supplementation with myocardial infarction, stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg), Published: BMJ Group, May 21, 2012

The study focused on examining the associations of dietary calcium intake, in total or separated from dairy sources and from non-dairy sources and calcium supplementation with myocardial infarction, stroke risk and overall cardiovascular disease mortality. They found that those who took calcium supplements were 86 percent more likely to have a heart attack than those who did not take supplements. The study concluded that increasing calcium

intake from diet might not present significant cardiovascular benefits, whereas calcium supplements may raise myocardial infarction risk and should be taken with caution.

Beaumont perspective: There is no data to suggest that supplemental calcium is beneficial to cardiac patients. However, Vitamin D supplements may be beneficial as this is currently being researched. Current recommendations for Vitamin D is 2000 mg daily.

Dark chocolate: Sweet prevention for CV events(Original Article) The effectiveness and cost effectiveness of dark chocolate consumption as prevention therapy in people at high risk of cardiovascular disease: best case scenario analysis using a Markov model Published: BMJ Group, May 31, 2012

A Markov model designed study was performed to determine the long-term effectiveness and cost effectiveness of daily dark chocolate consumption in participants with metabolic syndrome at high risk of cardiovascular disease. Assuming 100 percent compliance (best case scenario), the researchers determined that daily consumption of dark chocolate can reduce 85 cardiovascular events per 10,000 population treated over 10 years. The outcome of the study was that blood pressure and cholesterol lowering effects of dark chocolate

consumption are beneficial in the prevention of cardiovascular events in a population with metabolic syndrome.

Beaumont perspective: : Finally something that tastes good may be good for you! Although no large-scale trial has been completed, smaller trials seem to show a benefit. Obviously, chocolate must be consumed in moderation.

Survey: Side effects top reason patients stop using statins (Original Article) Understanding Statin Use in America and Gaps in Patient Education Published: Journal of Clinical Lipidology March 16, 2012

The survey reported that experiencing side effects such as muscle-related pain or weakness was a top reason for patients to stop taking statins. The article covers some important insights into behavior and attitudes among current and former users. The study suggests that more effective dialogue between health care providers and patients might increase the use of statins, in particular, when the patient has concerns with side effects and drug costs.

Beaumont perspective: Complaints of myalgias are not uncommon in patients using statins. It is often difficult however, to determine if myalgias are related to statin use. Long-term myalagias (related to statin use), may persist even after the drug is stopped. We often vary dosing and/or type of statin when trying to determine if myalgias are related to the particular statin.

Atrial FibrillationSEPTEMBER 2012, ISSUE II | TRENDING NEWS IN HEART & VASCULAR DISEASE AND SERVICES

Beaumont Heart & Vascular Updatefor physicians

3601 West 13 Mile Rd. | Royal Oak, MI 48073-6769http://heart.beaumont.edu

MARK YO U R CALE N DAR

U P CO M I N G CO N FE RE N CES

Advances in Cardiovascular Non-Invasive Imaging and Interventions Focus: The Role of Multimodality Imaging in Interventional Planning

Sept. 13 – 15, 2012 TOWNSEND HOTEL • BIRMINGHAM, MI

Practical Update in Cardiology

Oct. 27, 2012 MARRIOTT CENTERPOINT HOTEL • AUBURN HILLS, MI

Structural Heart Disease Focusing on Aortic and Mitral Valve Disease

Dec. 1, 2012TOWNSEND HOTEL • BIRMINGHAM, MI

To register for any of the above conferences, visit: heart.beaumont.edu/classes-and-events.

For more information about Heart and Vascular Continuing Medical Education, contact Shannon Herrington, CMP, Heart and Vascular Education at 800-732-6368 or email heartandvascularconferences@beaumont.edu

To receive the Beaumont Heart & Vascular Update for Physicians e-newsletter, opt-in at heart.beaumont.edu or scan our code below.

Visit: heart.beaumont.edu for other Beaumont Health System Heart & Vascular Information.

EDITOR: Steven Almany, M.D.

D I D YO U K N OW ?

How to refer a patient for a consult or admit Beaumont cardiologists and heart and vascular surgeons offer the most advanced therapies for complex heart and vascular disease. To contact one of our physicians to arrange a patient transfer, or for more information about our Heart & Vascular services, please contact the Beaumont Access Center at 888-877-8766.

Seven tests for $70 Beaumont offers a series of seven non-invasive heart disease risk assessment tests, including state-of-the-art ultrasounds of the major arteries for only $70. The tests are designed to identify risk factors and detect heart and vascular disease early, so a recommended course of action or treatment can begin sooner. Your patients can request a test by calling the appointment center at 800-328-8542.

NON-PROFIT ORGU.S. POSTAGE

PAIDPERMIT NO. 404ROYAL OAK, MI

L ATEST AT B E AU M O NT

Implantable loop recorder (ILR)

ILRs are tiny devices implanted subcutaneously that can capture ECG recordings automatically or during symptoms, activated by a hand held remote device. The looping memory feature assures that the pertinent heart rhythm is captured even if the recording is activated after the symptom has passed. The ILR is ideal for diagnosing the cause of concerning symptoms like recurrent syncope or severe palpitations. The battery lasts for 2 1/2 years, so diagnostic ECG recordings can be captured even if symptomatic events are infrequent and sporadic.

Home monitoring for protimes

The Beaumont Anticoagulation Management Service (AMS) manages more than 2,500 patients who are on warfarin therapy. AMS now offers patients the ability to test their own INR using a home INR machine. For more information on this program or to see if your patient qualifies for this type of testing program, please call 248-423-4366 or 248-423-4319. Most insurance companies cover this program.

Treatment for Deep Venous Thrombosis (DVT)

Despite standard treatment with anticoagulation, some patients with above knee DVT develop a persistent clot that may result in long-term complications such as leg pain and swelling. Beaumont is one of the few hospital systems in the region that is performing acute interventional management for patients with a large clot burden. Patients are treated with a combination of local lytic therapy and various devices to mechanically remove the clot. This approach is believed to improve symptoms, reduce hospital length of stay and limit long-term complications of large proximal DVT.

Minimally invasive treatment for vascular disease

Physicians at Beaumont treat most vascular problems (aortic aneurysm disease, peripheral vascular disease, carotid artery disease and diseases of the venous system) in a minimally invasive manner as an outpatient or with an overnight stay. Beaumont is one of approximately 25 hospitals in the country to be participating in the Ventana Trial, which enables vascular surgeons to treat extensive aortic aneurysms in a minimally invasive manner. When treated with a conventional surgical approach, these aneurysms often require a hospital stay of seven to 10 days and are associated with a significant incidence of post-operative complications. With the use of a stent graft, the patient’s length of stay is decreased and the incidence of post-operative complications is reduced. Call 888-877-8766 for more information.

For more information visit: heart.beaumont.edu or to talk to a Beaumont heart and vascular specialist, call 888-877-8766.

TRENDING NEWS IN HEART & VASCULAR DISEASE AND SERVICES

BEAUMONT HEART & VASCULAR UPDATE FOR PHYSICIANS