Research
The University Invasive Cardiology Faculty are active in both investigator initiated and multicenter research projects.
Investigator Initiated Research
Our group translates mechanistic research in thrombosis from the bench to the cardiac catherization suite. Single center, grant supported research studies are ongoing in defining the role of platelet reactivity in identifying cardiac risk and response to therapy.
Our invasive cardiology faculty and fellows have presented original contributions at national conferences and in prestigious journals (1-3). The potential role of changes in inflammation after coronary intervention is an ongoing focus and has received extramural funding.
Multicenter Research
University interventional cardiology faculty are leaders in both registry and clinical trials in percutaneous coronary interventions (PCI). Both Dr. Dauerman and Dr. Watkins are active in the Northern New England Cardiovascular Diseases Study Group, a regional registry. These investigators participate in multiple research projects with this study group registry organizations. Examples of recent publications emanating from registry participation include analyses of outcomes in patients with cardiogeric shock, outcomes in those with diabetes, relationships between procedural volumes and outcomes, the role of invasive treatment of acute mycocardial infarction, and the role of atherectomy in the treatment of bifurcation lesions (4-11). In addition, University faculty play a leading role in multicenter trials of innovative interventional cardiologic technologies.
Examples:
1. Therapeutic angiogenesis for coronary artery disease with the use of gene therapy and growth factors (12,13)
2. Two drug eluting stent trials (paclitaxel eluting stents)
3. Novel technology for treatment of occluded saphenous vein grafts (distal embolic protection and coated stents)
4. Expertise in diabetes and thrombosis has led to ongoing catheterization laboratory participation in multiple multicenter trials designed to determine optimal treatment of patients with diabeties (BARI 2D) and optimal adjunctive antithrombotic therapy for PCI
5. Novel regimens for treatment of ST elevation mycocardial infarction with both primary and facilitated PCI strategies
Representative Publications
Aggarwal, A., Schneider, D.J., Terrien, E.F., Terrien, C.M., Sobel, B.E., Dauerman, H.L.: Comparison of effects of Abciximab – vs – Eptifibatide on C-Reactive Protein, Interleukin-6, and Interleukin-1 Receptor antagonist after coronary arterial stenting. Am J Cardiol, in press
Kabbani SS, Watkins MW, Ashikaga T, Terrien EF, Holoch PA, Sobel BE, Schneider DJ. Platelet reactivity characterized prospectively: a determinant of outcome 90 days after percutaneous coronary intervention. Circulation 2001; 104(2):181-186.
Kabbani SS, Watkins MW, Holoch PA, Terrien EF, Sobel BE, Schneider DJ. Platelet reactivity in coronary ostial blood: a reflection of the thrombotic state accompanying plaque rupture and of the adequacy of anti-thrombotic therapy. J Thromb Thrombolysis 2001; 12(2):171-176.
Watkins MW, Luetmer PA, Schneider DJ, Witmer WT, Vaitkus PT, Sobel BE. Determinants of rebound thrombin activity after cessation of heparin in patients undergoing coronary interventions. Cathet Cardiovasc Diagn 1998; 44(3):257-264.
Niles NW, McGrath PD, Malenka D, Quinton H, Wennberg D, Shubrooks SJ, Tryzelaar JF, Clough R, Hearne MJ, Hernandez F, Jr., Watkins MW, O'Connor GT. Survival of patients with diabetes and multivessel coronary artery disease after surgical or percutaneous coronary revascularization: results of a large regional prospective study. Northern New England Cardiovascular Disease Study Group. J Am Coll Cardiol 2001; 37(4):1008-1015.
Shubrooks SJ, Jr., Malenka DJ, Piper WD, Bradley WA, Watkins MW, Ryan TJ, Hettleman BD, VerLee PN, O'Meara JR, Robb JF, Kellett MA, Hearne MA, McGrath PD, Wennberg DE, O'Rourke DJ, Silver TM. Safety and efficacy of percutaneous coronary interventions performed immediately after diagnostic catheterization in northern new england and comparison with similar procedures performed later. Am J Cardiol 2000; 86(1):41-45.
O'Connor GT, Malenka DJ, Quinton H, Robb JF, Kellett MA, Jr., Shubrooks S, Bradley WA, Hearne MJ, Watkins MW, Wennberg DE, Hettleman B, O'Rourke DJ, McGrath PD, Ryan T, Jr., VerLee P. Multivariate prediction of in-hospital mortality after percutaneous coronary interventions in 1994-1996. Northern New England Cardiovascular Disease Study Group. J Am Coll Cardiol 1999; 34(3):681-691.
Dauerman HL, Goldberg RJ, White K, Gore JM, Sadiq I, Gurfinkel E, Budaj A, Lopez dS, Lopez-Sendon J. Revascularization, stenting, and outcomes of patients with acute myocardial infarction complicated by cardiogenic shock. Am J Cardiol 2002; 90(8):838-842.
Dauerman HL, Yarzebski J, Gore JM, Lessard D, Goldberg RJ. Use of the invasive management strategy for patients with non-Q-wave myocardial infarction: an observational database report from the Worcester Heart Attack Study. Am Heart J 2002; 143(6):1033-1039.
Furman MI, Dauerman HL, Goldberg RJ, Yarzebski J, Lessard D, Gore JM. Twenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial Q-wave and non-Q-wave myocardial infarction: a multi-hospital, community-wide perspective. J Am Coll Cardiol 2001; 37(6):1571-1580.
Dauerman HL, Goldberg RJ, Malinski M, Yarzebski J, Lessard D, Gore JM. Outcomes and early revascularization for patients > or = 65 years of age with cardiogenic shock. Am J Cardiol 2001; 87(7):844-848.
Dauerman HL, Higgins PJ, Sparano AM, Gibson CM, Garber GR, Carrozza JP, Jr., Kuntz RE, Laham RJ, Shubrooks SJ, Jr., Baim DS, Cohen DJ. Mechanical debulking versus balloon angioplasty for the treatment of true bifurcation lesions. J Am Coll Cardiol 1998; 32(7):1845-1852.
Simons M, Annex BH, Laham RJ, Kleiman N, Henry T, Dauerman H, Udelson JE, Gervino EV, Pike M, Whitehouse MJ, Moon T, Chronos NA. Pharmacological treatment of coronary artery disease with recombinant fibroblast growth factor-2: double-blind, randomized, controlled clinical trial. Circulation 2002; 105(7):788-793.
Grines CL, Watkins MW, Helmer G, Penny W, Brinker J, Marmur JD, West A, Rade JJ, Marrott P, Hammond HK, Engler RL. Angiogenic Gene Therapy (AGENT) trial in patients with stable angina pectoris. Circulation 2002; 105(11):1291-1297.
