Heart Matters

First generation drug-eluting stents offer many advantages over bare metal stents, the most significant of which is their efficacy in reducing the rate of restenosis. Now second generation drug-eluting stents are proving to be even more beneficial. How are these second generation drug-eluting stents further reducing the risk of late stent thrombosis, myocardial infarction and repeat revascularization? Dr. Richard Lange, professor and executive vice chairman of medicine at the University of Texas Health Science Center, in San Antonio, Texas, discusses the structural and molecular differences between first and second generation drug-eluting stents. With all the advantages of the newer stents, however, there is also an increased cost. Are second generation drug-eluting stents enough of an improvement upon their first generation counterparts to warrant the higher cost? Dr. Janet Wright hosts.

Beta blockers, anticoagulants, stenting procedures and bypass surgeries: these are all crucial cornerstones of cardiology that have saved and improved the quality of lives for our patients, yet the underlying causes of coronary artery disease aren't addressed by interventions and medications. Can we prevent and maybe even reverse heart disease by prescribing a plant-based diet? Dr. Caldwell Esselstyn, director of the cardiovascular prevention and reversal program at the Cleveland Clinic Wellness Institute and author of the book, Prevent and Reverse Heart Disease, says heart disease is "an essentially benign, food-borne illness," that can be prevented by adhering to a diet based around plants. What evidence supports this idea? Join us for part 1 of our two-part interview with Dr. Esselstyn. Dr. Janet Wright hosts.

For Part 2 of this interview, click here >>

One of the characteristics of our older patients with heart failure is that they often have other conditions and therefore take multiple medications. How can we reduce the risk of adverse drug events among patients with heart failure and other comorbidities? Dr. Michael Steinman, associate professor of medicine at the University of California-San Francisco and the San Francisco VA Medical Center discusses the challenge of managing medications for older patients with heart failure and offers his ideas on how to reduce drug interactions and encourage adherence. How can we better coordinate care between physicians to optimize care for patients with heart failure? Dr. Janet Wright hosts.

First generation drug-eluting stents offer many advantages over bare metal stents, the most significant of which is their efficacy in reducing the rate of restenosis. Now second generation drug-eluting stents are proving to be even more beneficial. How are these second generation drug-eluting stents further reducing the risk of late stent thrombosis, myocardial infarction and repeat revascularization? Dr. Richard Lange, professor and executive vice chairman of medicine at the University of Texas Health Science Center, in San Antonio, Texas, discusses the structural and molecular differences between first and second generation drug-eluting stents. With all the advantages of the newer stents, however, there is also an increased cost. Are second generation drug-eluting stents enough of an improvement upon their first generation counterparts to warrant the higher cost? Dr. Janet Wright hosts.

Beta blockers, anticoagulants, stenting procedures and bypass surgeries: these are all crucial cornerstones of cardiology that have saved and improved the quality of lives for our patients, yet the underlying causes of coronary artery disease aren't addressed by interventions and medications. Can we prevent and maybe even reverse heart disease by prescribing a plant-based diet? Dr. Caldwell Esselstyn, director of the cardiovascular prevention and reversal program at the Cleveland Clinic Wellness Institute and author of the book, Prevent and Reverse Heart Disease, says heart disease is "an essentially benign, food-borne illness," that can be prevented by adhering to a diet based around plants. What evidence supports this idea? Join us for part 1 of our two-part interview with Dr. Esselstyn. Dr. Janet Wright hosts.

For Part 2 of this interview, click here >>

Door-to-balloon time for a patient with ST-segment elevation myocardial infarction (or STEMI) should be less than 90 minutes. Wireless electrocardiography (or EKG) programs around the country are helping to reduce door-to-balloon time by transmitting EKG data to hospitals via broadband internet, where a specialist at the hospital makes a diagnosis and prepares to treat the incoming patient. What are some of the challenges, and advantages, of such programs? Mr. Jim Scheulen, chief administrative officer for the Johns Hopkins Department of Emergency Medicine and president of Johns Hopkins Emergency Medical Services, and Dr. Jeffrey Trost, assistant professor in cardiology, director of the Cardiac Catheterization Laboratory and director of the Interventional Cardiology Program at Johns Hopkins Bayview Medical Center, helped create a Baltimore consortium of hospitals that donated wireless EKG technology to the city's paramedic units. How effective has the Baltimore program been at improving treatment for MI patients, and how is this program similar to others around the country? Dr. Janet Wright hosts.

One of the biggest risks of antiplatelet therapy is gastrointestinal bleeding. Because of this risk, patients on the antiplatelet clopidogrel are often prescribed proten pump inhibitors, or PPIs. However, there are also concerns about PPIs decreasing the efficacy of clopidogrel. What approach should physicians take for patients at moderate to high risk for upper GI bleeding? Host Dr. Janet Wright welcomes Dr. Deepak Bhatt, chief of cardiology at the VA Boston Healthcare System, director of the Integrated Interventional Cardiovascular Program at Brigham and Women's Hospital & VA Boston Healthcare System, and associate professor of medicine at Harvard Medical School, to discuss evidence about the potential interactions between PPIs and clopidogrel based on findings from the COGENT trial.

Targeted molecular therapy has been successful in cancer therapeutics. How might this approach be applied in cardiology to prevent the development of atherosclerosis? Dr. Ken Fujise, chief of cardiology at University of Texas Medical Branch, where he is also professor of medicine and biochemistry and molecular biology, talks about his preliminary research investigating the role of fortilin in the progression of atherosclerosis and subsequent coronary artery disease. What are the prospects for development of anti-fortilin medication to prevent or slow atherosclerosis? Dr. Janet Wright hosts.

One of the biggest risks of antiplatelet therapy is gastrointestinal bleeding. Because of this risk, patients on the antiplatelet clopidogrel are often prescribed proten pump inhibitors, or PPIs. However, there are also concerns about PPIs decreasing the efficacy of clopidogrel. What approach should physicians take for patients at moderate to high risk for upper GI bleeding? Host Dr. Janet Wright welcomes Dr. Deepak Bhatt, chief of cardiology at the VA Boston Healthcare System, director of the Integrated Interventional Cardiovascular Program at Brigham and Women's Hospital & VA Boston Healthcare System, and associate professor of medicine at Harvard Medical School, to discuss evidence about the potential interactions between PPIs and clopidogrel based on findings from the COGENT trial.

Targeted molecular therapy has been successful in cancer therapeutics. How might this approach be applied in cardiology to prevent the development of atherosclerosis? Dr. Ken Fujise, chief of cardiology at University of Texas Medical Branch, where he is also professor of medicine and biochemistry and molecular biology, talks about his preliminary research investigating the role of fortilin in the progression of atherosclerosis and subsequent coronary artery disease. What are the prospects for development of anti-fortilin medication to prevent or slow atherosclerosis? Dr. Janet Wright hosts.