Interventional Cardiology
Interventional Cardiology research includes both investigator-initiated and multicenter research projects that offer cutting edge therapies and participation in ongoing clinical trials.
Our faculty holds investigator initiated and multicenter trial related grants across a broad spectrum of interventional cardiology practices. We are helping to lead national research efforts in the prevention of acute kidney injury after cardiac catheterization, steering the Heart Team approach to left main stenting, and leading national investigations into patient compliance with dual antiplatelet therapy after drug eluting stenting. Our site is actively involved in research in all 3 key ares of current practice: coronary diagnosis (optical coherence tomography) and intervention (next generation drug eluting stents); endovascular therapies (next generation stents, renal artery interventions and inflammation); and structural heart interventions (Heart Team approaches to aortic valve disease). Through these ongoing projects, our faculty will continue to maintain national prominence and leadership in research, publication and device development.
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.
The invasive cardiology faculty and fellows have presented original contributions at national conferences and in prestigious journals. The potential role of changes in inflammation after coronary intervention is an ongoing focus and has received extramural funding.
Multicenter Research
Our 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 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 myocardial infarction, and the role of atherectomy in the treatment of bifurcation lesions. In addition, our faculty play a leading role in multicenter trials of innovative interventional cardiologic technologies. For example:
- Therapeutic angiogenesis for coronary artery disease with the use of gene therapy and growth factors
- Two drug eluting stent trials (paclitaxel eluting stents)
- Novel technology for treatment of occluded saphenous vein grafts (distal embolic protection and coated stents)
- Expertise in diabetes and thrombosis has led to ongoing catheterization laboratory participation in multiple multicenter trials designed to determine optimal treatment of patients with diabetes (BARI 2D) and optimal adjunctive antithrombotic therapy for PCI
- Novel regimens for treatment of ST elevation myocardial infarction with both primary and facilitated PCI strategies
Device Development
Dr. Harold Dauerman has utilized both single center and multi-center registry studies to elucidate the interventional cardiology treatment options for high risk patient subsets those with in stent restenosis, bifurcation lesions, ST elevation AMI and cardiogenic shock. Currently, our research focus has been on the identification of high risk patients undergoing PCI characterized with analysis of systemic markers of inflammation, and the impact of anti-inflammatory treatment options on outcomes in risk patients.
An additional focus has been improving outcomes during and after PCI by taking advantage of information gained by evaluating biochemical effects of administration of antiplatelet agents. We have recently delineated platelet reactivity as a predictor of outcome during and following PCI. Further work is currently underway to characterize responses of patients to long-term administration of antiplatelet agents.