The Cardiometabolic Health Congress has announced Stanley Hazen, MD, PhD, Head of the Section for Preventive Cardiology and Rehabilitation of the Cleveland Clinic as its Keynote speaker for the 12th Annual CMHC, taking place October 4-7, 2017, at the Sheraton in Boston, MA. Specializing in preventive cardiovascular care, including the treatment of hyperlipidemia, diabetes, hypertension, and obesity, Dr. Hazen will discuss his groundbreaking work concerning gut microbes as a factor and therapeutic target in cardiometabolic diseases. Dr. Hazen has received numerous awards including election to membership in honorary societies in science and clinical arenas alike and also serves as reviewer and/or is on the editorial board for many scientific journals, including Circulation and the Journal of Lipid Research.
Dr. Braunwald, Professor at Harvard Medical School, is a world-renowned expert in the field of cardiovascular medicine and is believed to be the most frequently cited author in the field of cardiology, with more than 1000 publications in peer-reviewed journals. His landmark research includes the identification of hypertrophic cardiomyopathy as a clinical entity. As Founder and Chairman of the TIMI Study Group, one of their many achievements was the PROVE-IT TIMI 22 Trial, which demonstrated the benefit of intensive reduction of LDL cholesterol by statin therapy. Dr. Braunwald will be joining a panel at the 12th Annual CMHC that includes Drs. Christie Ballantyne, Paul Ridker, and Marc Sabatine to discuss the clinical trials FOURIER, REVEAL, and CANTOS.
The SPRINT trial created both excitement and controversy in the medical community when it was realized aggressive blood pressure lowering to a target of 120 mmHg resulted in significant reductions in cardiovascular events and all-cause mortality. These reductions were seen in all of SPRINT’s subgroups including those older than age 75, persons with previous CAD, and those with chronic kidney disease. In her Keynote presentation, “Update and Clinical Implications of the SPRINT Trial,” Suzanne Oparil, MD, one of the principal investigators of the trial, will discuss the benefits seen in SPRINT as well as its caveats while touching on some of the ongoing substudies, including a cost-effectiveness analysis and a mind outcomes study examining the question of whether aggressive blood pressure lowering preserves cognitive function and brain structure.
Although we may be entering an era of waning cardiovascular risk attributable to LDL cholesterol, the recurrent event rate even with the best of current therapies remains unacceptably high. In his Keynote presentation, “Triglycerides on the Rise: Should We Swap Seats on the Seesaw?” Dr. Peter Libby will discuss the increasing prevalence of other cardiovascular risk factors, including triglycerides and specifically, the apolipoprotein constituent of many triglyceride-rich lipoproteins, apoC3. According to Dr. Libby, “We have a growing need for novel therapies that address the global shift in the risk factor profile we currently confront. Treatments that target triglyceride-rich lipoproteins, inflammation, diabetes, obesity, and other contributors to residual risk in the statin era now urgently require rigorous assessment in clinical trials.”
It is known that diabetes, obesity, and metabolic syndrome are the result of gene/environment interactions but a newly recognized component of the gene/environment interaction is the gut microbiome. In the Keynote presentation, “The Gut Microbiome as a Modifier of Insulin Resistance and Metabolic Syndrome,” Dr. Ronald Kahn will discuss results of his research in mice which have shown that given different diets, different mice adapt with different microbiomes, some of which are more or less likely to produce insulin resistance and the metabolic syndrome. Thus, the microbiome interacts with the genetics of the mouse, and by shifting the microbiome, a mouse genetically at the borderline of becoming insulin resistant, for example, may become less insulin resistant. Dr. Kahn will explain how the gut microbiome is an important mediator of the gene/environment interaction, some of the mechanisms by which the gut microbiome works, and ultimately what the implications are in terms of how we treat patients.
The ever-increasing obesity epidemic has placed that risk factor at the front of cardiovascular disease risk assessment and management. But specifically, how does body fat distribution impact cardiovascular risk? In the Keynote presentation, “Obesity Fat Distribution and Cardiovascular Risk,” Dr. Subodh Verma will evaluate the epidemiology and clinical course of visceral fat as it relates to cardiovascular event rates and explain the mechanistic basis of how visceral adiposity leads to cardiovascular disease. Additionally, Dr. Verma will shed light on the role of epicardial fat tissue as a source of inflammatory cytokines in cardiometabolic risk, critique the literature linking weight reduction to cardiometabolic risk reduction, and discuss the current guidelines for the management of cardiovascular risk in obesity.
“The value of a technique, in part, is if it can show you what is likely to work and not likely to work,” according to Dr. Steven E. Nissen, Chairman, Department of Cardiovascular Medicine at the Cleveland Clinic. In his keynote presentation, Intravascular Ultrasound Insights into the Regression and Progression of Coronary Atherosclerosis, Dr. Nissen will discuss the role of IVUS as a screening tool and in determining new approaches to treatment and selecting those that are suitable for further development versus those that are not.
“What IVUS has taught us from the very beginning is that atherosclerosis is not a disease of the coronary lumen, it is a disease of the vessel wall,” he said. Dr. Nissen will describe the method behind IVUS and early findings associated with its use. About 10 randomized controlled trials have been done with IVUS to examine different approaches to either slow progression or induce regression of coronary atherosclerosis. Dr. Nissen will review some of these trials (eg, REVERSAL and ASTEROID) as well as discuss future directions (eg, the Apoa1 Milano project). Dr. Nissen will also touch on the ongoing GLAGOV trial, which is studying high-dose statin therapy alone compared with high-dose statin therapy plus a PCSK9 inhibitor, for which results are expected later this year.