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Title
Winthrop-University Hospital Raises the Bar for Cardiovascular Research - Archived
Date
September 9, 2014
Article

Hospital Participates in Major International Trial

Researchers at Winthrop-University Hospital are participating in a major National Institutes of Health (NIH)-funded study that could lead to an entirely new approach to preventing recurrent heart attacks in high risk people. The main goal of the study, Cardiovascular Inflammation Reduction Trial (CIRT), is to discover if reducing inflammation can lower one’s risk of having a second heart attack, stroke, or dying from heart disease.

CIRT is an international, multi-site trial supported by the National Heart, Lung and Blood Institute (NHLBI), a part of the NIH, that will investigate whether taking low-dose methotrexate, a widely used anti-inflammatory therapy for rheumatoid arthritis, reduces cardiovascular events in individuals with type 2 diabetes or metabolic syndrome that have had a heart attack or multiple coronary blockages.

“Winthrop was selected to participate in this trial because of the renowned groundbreaking research on autoimmune diseases such as rheumatoid arthritis (RA) and lupus already performed at the Hospital,” said Alan M. Jacobson, MD, Chief Research Officer at Winthrop. This research is conducted by Allison Reiss, MD, Head of Inflammation Laboratory at Winthrop, and the rest of her team: Steven Carsons, MD, Chief of the Division of Rheumatology, Allergy and Immunology, Iryna Voloshyna, PhD, Research Associate and Michael Littlefield, BA, Laboratory Technician. Dr. Reiss and her group identified in such patients the specific inflammatory components present in the circulatory systems that impair their cells’ ability to metabolize cholesterol and, therefore, allow lipid accumulation in the artery, where it can lead to obstruction and heart attack. This research contributed to understanding the mechanisms through which several commonly used pain medications (COX inhibitors) elevate the risk for stroke and myocardial infarction.

“Winthrop’s contribution to the CIRT trial will be to examine how methotrexate affects cholesterol, which is crucial,” said Dr. Reiss. “Methotrexate does not just correct inflammation, but impacts how the cells handle cholesterol, which could in turn reduce one’s risk of heart attack,” she added.

The research team consists of Dr. Reiss; Josh De Leon, MD, Director of the Cardiovascular Training Program, Director of Nuclear Cardiology and Director of Cardiovascular Research; and Wendy Drewes, BSN, RN, CCRC. Dr. Reiss was sought out specifically by the head of the CIRT study, Paul Ridker, MD, who holds the Hospital’s research accomplishments already in this area in high regard.

A primary cause of cardiovascular disease is atherothrombosis (the hardening and narrowing of the body’s arteries). In research studies, inflammation (the body’s complex response to injury in its attempts to control and heal injury) has been linked to atherothrombosis, which has led the investigators of this trial to ask the question as to whether or not reducing inflammation can reduce cardiovascular events. Winthrop’s research will take it a step further, since the Hospital already has laid the groundwork that shows the way in which methotrexate alters the metabolism of cholesterol in the cells that are in the walls of the arteries where atherothrombosis occurs. “This is the first systematic attempt to understand clinically the role of inflammation in the development of atherothrombosis,” said Dr. De Leon. “It will give us new opportunities to treat patients, testing to see whether we have a new way to treat coronary artery disease to prevent recurrent cardiac events.”

CIRT is a randomized clinical trial, meaning some patients will take methotrexate and some a placebo (sugar pill). Approximately 7,000 participants are expected to enroll in this trial from research sites across the United States and Canada. Eligible participants are those patients who have suffered a heart attack in the past five years and who have type 2 diabetes or metabolic syndrome – all conditions known to be pro-inflammatory. This trial is a long term prevention trial where study participants will be followed for up to six years. Winthrop is currently seeking additional participants in the study.

“We will be looking at the blood and white blood cells of patients and looking for changes in cholesterol in response to methotrexate in the hopes that we can understand how it is beneficial, and perhaps predict in which patients it will do the most good,” said Dr. Reiss.

For more information about research initiatives at Winthrop or how to enroll in this trial, please call 1-866-WINTHROP or visit www.winthrop.org.