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

Members of the Winthrop Research Team who are participating in the NIH-funded CIRT Trial gather outside Winthrop's new 95,000-square-foot Research and Academic Center, which is nearing completion and will house much of the Hospital's cutting-edge research initiatives.

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 (RA), reduces cardiovascular events in individuals with type 2 diabetes or metabolic syndrome who have had a heart attack or multiple coronary blockages.

"Winthrop was selected to participate in this trial because of the renowned ground-breaking research on autoimmune diseases such as 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, Inflammation Section, Winthrop Research Institute, and a team that includes 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 the 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," 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."

The CIRT research team consists of (pictured above, l.-r.) Dr. Jacobson; Dr. Voloshyna; Dr. Reiss; Wendy Drewes, BSN, RN, CCRC; Josh De Leon, MD, Director of the Cardiovascular Training Program, Director of Nuclear Cardiology and Director of Cardiovascular Research.

Dr. Reiss was sought out specifically by the head of the CIRT study, Paul Ridker, MD, who holds Winthrop's research accomplishments in this area in high regard.

In research studies, inflammation (the body's complex response to injury in its attempts to control and heal injury) has been linked to atherothrombosis (the hardening and narrowing of the body's arteries), a primary cause of cardiovascular disease, which has led the investigators of this trial to ask whether or not reducing inflammation can educe cardiovascular events.

"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, and potentially prevent recurrent cardiac events."

Winthrop's research will take this a step further, since the Hospital has already 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. "We will be examining 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.

Winthrop is currently seeking participants for this study.

For more information on how to enroll in this trial, call 1-866-WINTHROP.