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Joint effort tackling heart disease in WNY
A collaboration involving physicians, researchers, graduate students and undergraduate students from three prominent regional institutions is intent on improving heart health in Western New York, an area with a heart disease death rate that is twice the national average.
The collaboration, which took shape in 2005, involves UB, Niagara Falls Memorial Medical Center and Niagara University (NU), and converges at The Heart Center of Niagara (HCON), part of Niagara Falls Memorial Medical Center in Niagara County, where rates of cardiovascular disease and mortality from the disease are the greatest in the five-county region.
As their first goal, the parties in this venture established a joint research program to evaluate noninvasive cardiac imaging methods for identifying, tracking and stratifying risk of coronary artery disease (CAD) in the population.
Since the collaboration began, information from more than 4,000 patients has been gathered at the HCON to evaluate the effect of innovative positron emission tomography (PET), which offers a potentially more cost-effective and safer approach to managing CAD than traditional invasive coronary angiography. It is the largest database in the country containing this type of vital information, which will allow some of the most robust research possible to understand how PET can best be used to improve patient care
The partners also are evaluating novel risk factors for CAD, particularly genetic, psychological and environmental risk factors.
The collaboration has built upon initial investments by Niagara Falls Memorial Medical Center, UB and NU to yield new funding. New grants include $160,000 in support from the Merck Institute for Science Education-American Association for the Advancement of Science to NU for undergraduate research, and from the James H. Cummings Foundation of Buffalo toward construction of a new science facility at the university. This also leverages New York State’s investment in leading edge genetic analysis equipment at NU, which was funded through the GeNYsis program in 2001.
In addition, $43,500 was awarded to Brent Williams, an epidemiology doctoral student in the Department of Social and Preventive Medicine, UB School of Public Health and Health Professions, to develop the powerful PET patient database that will facilitate much of the research collaboration’s endeavors. The grants to Williams were awarded by the American Heart Association’s Founders’ Affiliate Predoctoral Fellowship program and the Department of Social and Preventive Medicine’s Saxon Graham Research Award program.
The partners in this collaboration have been organized to make the most of their natural strengths through the graduate programs at UB, including those at the public health school and the New York State Center of Excellence in Bioinformatics and Life Sciences. These partners will collaborate with the undergraduate Academic Center for Integrated Science in NU’s biology and chemistry departments, where students located close to Niagara Falls Memorial Medical Center can participate on site in research efforts at the HCON. Furthermore, NU students are able to utilize NU’s expanding laboratory facilities.
Beyond leading to new funding, the collaboration has produced new data on the use of myocardial perfusion imaging with PET on CAD management, published in the Journal of Nuclear Medicine in July 2007. Michael E. Merhige, medical director of the HCON and clinical associate professor of nuclear medicine in the UB School of Medicine and Biomedical Sciences, was first author.
Two manuscripts currently are being prepared for journal submission: the correlation of arterial inflammation with severity and progression of CAD, as measured by PET, which may provide a useful marker of disease progression in men, and the effect of genetic variation on the progression of CAD, which may identify patients who require more aggressive medical therapy for the disease.
Several clinical and basic research protocols currently are under way. A study involving 4,000-plus patients who have undergone cardiac PET imaging at the HCON since 2000 aims to determine if myocardial perfusion imaging with rubidium-82 PET can predict cardiac mortality. Another major study has the goal of identifying genetic and metabolic markers associated with CAD.
Other studies being planned by the HCON research collaboration include the utility of PET for longitudinal tracking of CAD, evaluating the therapeutic effectiveness of validation studies of novel PET software for quantification of CAD, the effects of environmental pollutants on the development and progression of CAD, and psychosocial predictors of CAD development and progression.
Most recently, in response to President Obama’s Research Challenge Grant initiative—part of the national economic stimulus effort— HCON has applied for funding from the National Institutes of Health. The two-year, $1 million grant would fund 15 additional research positions at HCON and provide data and analysis regarding the impact of urgent cardiac PET imaging in the emergency department and in patients being evaluated for chest pain. Preliminary data demonstrate a dramatic decrease in death rate with the use of PET imagery 24/7 in the emergency room.
This research collaboration highlights the power of combining public and private resources, including health care and academic institutions with other supporting organizations, to tackle critical needs of a community. The future goal is to expand funding and partnerships to expedite the ability to improve the patient care and health outcomes in the Niagara Falls community and beyond.
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