ORLANDO, Fla.  — A research network led by a Mayo Clinic physician found that stem cells obtained from bone marrow delivered two to three weeks after a person has a heart attack did not improve heart function. This is the first study to systematically examine the timing and method of stem cell delivery and provides vital information for the field of cell therapy.

The results were presented this morning at the 2011 Scientific Sessions of the American Heart Association Meeting in Orlando, Fla. They also will be published online in The Journal of the American Medical Association to coincide with the presentation.

“Some data suggests that stem cell therapy is helpful within the first week after a heart attack,” says Robert Simari, M.D., cardiologist at Mayo Clinic and chair of the Cardiovascular Cell Therapy Research Network (CCTRN). The network includes five clinics and other sites supported by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health. “Our study helps identify the limits of when stem cell therapy might be beneficial. We now know that this therapy should not be extended two to three weeks after a heart attack. While it is safe to do so, we did not find any benefit to heart function after six months.”

Journalists: The following web-video and audio clips with Dr. Simari are available for download and use in your stories.

Overview:    MOV    MP3

Findings:   MOV   MP3

Takeaway:    MOV    MP3

Below is a link to an edited youtube video with Dr. Simari that you can embed with your stories.

The “Know Your Numbers” music video is a parody of the 1982 hit song “867-5309/Jenny” and will be launched at the third annual Social Media Summit. Viewers will learn the importance of knowing their numbers for blood pressure, lipids and body mass index. As part of the campaign, viewers can use a free application on Mayo Clinic’s Facebook page that will help them calculate their risk of a heart attack and learn how to prevent one.

Dr. Sharonne Hayes, a Mayo Clinic cardiologist, describes the video:

Hear what Lisa M. Tate, Chief Executive Officer, WomenHeart, says the WomenHeart Champions have accomplished and why this year’s focus is so important:

Mayo Clinic today announced a partnership with other organizations to develop a Global Smoke-free Worksite Challenge. The partners are committed to making their worksites 100 percent smoke-free and to help others do likewise. The announcement was made at the Clinton Global Initiative annual meeting Sept. 21, 2011.

This effort is a global multi-sector partnership comprised of private sector companies, nongovernmental organizations and governments. The challenge aims to expand the number of employees of all sectors able to work in a smoke-free environment. And it fits right in with the commitment that Mayo brought last year to CGI, called Global Bridges. That initiative has already begun to build and energize a worldwide network of healthcare providers in the development of tobacco control and treatment programs in their countries and regions.  In less than one year, Global Bridges has trained more than 5,800 health care providers from 31 counties in sessions ranging from short webinars to intensive workshops.

Below Dr. Richard Hurt, chairman of Global Bridges and founding director of Mayo’s Nicotine Dependence Center, discusses the impact of this challenge.

Mayo Clinic is committed to the health of its patients and employees and has been at the forefront of tobacco dependence treatment, offering expert care to smokers who want to quit, for more than three decades. As a leading medical center, we were also among the first to make our worksite smoke-free over 25 years ago. Our example spread: first our county, then our state adopted smoke-free worksite legislation 2007.

Dr. John Noseworthy, Mayo Clinic president and CEO, shares his thoughts about Mayo’s commitment to a tobacco-free workplace and how this challenge will benefit people in other workplaces globally.

Global Smoke-free Worksite Challenge is collaboration among the American Cancer Society, the Global Business Coalition on Health, Johnson & Johnson, Mayo Clinic, the Campaign for Tobacco-Free Kids, and the United States Department of Health & Human Services.

To view the entire Clinton Global Initiative press conference, click here.

For more information on the Global Bridges website, click here

Journalists: The following video and audio clips are available for download and use in your post-embargo stories.

Click here to view the press release.

Dr. Noseworthy:

Initiative Announcement:    MOV     MP3

Benefits to a Smoke Free Workplace:   MOV    MP3

Why Mayo is Involved:    MOV   MP3

Dr. Hurt

Initiative is a Natural Extension of Mayo:   MOV   MP3

International Effect:    MOV    MP3

Dangers of Secondhand Smoke:    MOV   MP3

In October 2009, Dr. Sharonne Hayes, a cardiologist at Mayo Clinic who focuses on treating women with heart disease, was approached by a woman who’d experienced a rare cardiac condition. This conversation between the two happened at the annual WomenHeart Science & Leadership Symposium at Mayo Clinic. The woman previously had been told that her condition – spontaneous coronary artery dissection, also known as SCAD – was poorly understood, but that she was lucky because she survived. She was desperate for answers for herself and for others who suffered from SCAD.   Dr. Hayes and the woman discussed the possibilities of a study. “I couldn’t not do this study, or at least try. The most powerful motivator was the patient need and my personal connection to this group of women through WomenHeart,” Dr. Hayes says. Today, almost two years later, the results of a pilot study – involving 12 SCAD survivors from four countries using social media – are published in Mayo Clinic Proceedings. An accompanying editorial calls the use of social media a “novel solution” to recruit research participants, particularly for rare conditions. A larger study is now open for recruitment.

Click here to view the article.

To view the news release click here.

Journalists: The following video and audio clips are available for download and use in your post-embargo stories.

Pkg (.mov)   /         Nats Pkg  (.mov)                        Intro/Script   (.doc)

Dr. Sharonne Hayes – 2 Soundbites:  MOV   MP3   /  MOV    MP3     cg:  Mayo Clinic Cardiologist

Dr.  Marysia Tweet – 2 Soundbites:  MOV   MP3   /  MOV    MP3      cg: Mayo Clinic Cardiologist

Lee Aase – 2 Soundbites:  MOV    MP3   /   MOV    MP3    cg: Director, Mayo Clinic Center for Social Media

Animation:   MOV

Mayo Clinic’s recommendations to patients are the same as the FDA’s:

If a patient has been taking 80 mg of simvastatin daily for more than 12 months and has no side effects (especially muscle side effects), he or she can continue at that dose, with periodic monitoring, or switch to another medication or combination of medications to achieve the same LDL (bad cholesterol) goal.

New patients being treated for lipid lowering, the maximum dose of simvastatin should be 40 mg daily. If addition lipid lowering is necessary, other lipid-lowering agents should be considered (for example, atorvastatin, Vytorin, rosuvastatin, statin and niacin).

Patients who are taking and tolerating simvastatin, medications that can increase the risk of muscle side effects should be avoided, if possible. If such medications cannot be avoided, alternative lipid-lowering drugs with a lower potential for drug interactions should be considered (such as pravastatin or rosuvastatin).

Patients should look at the FDA website to see if they are on another medication that should not be used with simvastatin, or are on a medication that necessitates a lower dose of simvastatin. It is also recommended that patients talk with their physician about the use of simvastatin.

Click here to read more from the FDA

Dr. Randal Thomas, chair of Mayo Clinic’s Cardiovascular Health Clinic, offers patients an explanation of Mayo’s recommendations.

The study was stopped early because investigators found that niacin did not help reduce cardiac events, such as a heart attack, at least when it is added to statin therapy. Niacin did not increase the risk of heart problems, but simply did not show additional benefit to the use of statin therapy alone.

Niacin is a B vitamin that has the effect, when used in large doses, to reduce levels of bad cholesterol (LDL cholesterol) and fats (triglycerides), while raising the levels of HDL (“good”) cholesterol.

As a result of the NIH’s announcement, the Mayo Clinic Cardiovascular Health Clinic is recommending the use of statin therapy as an initial line of therapy for nearly all patients with heart disease who have abnormal cholesterol levels, including those who have a low level of HDL (“good”) cholesterol. Niacin is considered as an alternative therapy for cholesterol-lowering, on a case-by-case basis, particularly for patients who cannot tolerate a statin medication.

Patients who are taking niacin (Niaspan, Slo-Niacin or other types of niacin) in combination with a statin medication should contact the physician who is helping them treat their cholesterol abnormalities, to ask if niacin therapy is recommended for their individual case.

Dr. Randal Thomas, chair of Mayo Clinic’s Cardiovascular Health Clinic, offers patients an explanation of Mayo’s recommendations.

In a study presented today at the American Heart Association’s Scientific Sessions in Chicago, the researchers say that using a genetic score like the one they tested may provide added information to help cardiologists better estimate risk of heart attack in their patients and treat them accordingly.

To read more, click here.

“This tells us that bariatric surgery may become part of the treatment of patients with heart failure and obesity if there are no major contraindications for the surgery — and that this might be especially important for patients with significant obesity,” says the study’s lead investigator, cardiologist Francisco Lopez-Jimenez, M.D.

To read more, click here.

Presented today at the annual meeting of the American College of Cardiology, the review of 14 months’ worth of radiation data from 1,827 adult patients is an important early step in understanding ways to improve PCI safety and quality while optimizing therapeutic benefits. The Mayo Clinic study identified 20 clinical traits and circumstances that help predict whether a patient likely received higher or lower doses of radiation.

Significance

Identifying optimal means of using radiation in PCI is important because a chief advantage of PCI is its minimally-invasive nature in successfully opening vessels and placing stents, which makes it an increasingly popular option for treating select cases of heart disease. PCI’s minimally-invasive advantages include reducing patient trauma, speeding recovery and lowering costs, compared to traditional heart surgeries.

            However, PCI owes its precision, safety and effectiveness to the X-ray fluoroscopy imaging used. X-ray fluoroscopy produces many images to make a movie that allows physicians to visualize the intricate vessel anatomy being treated and, therefore, holds the potential for increased radiation risk. The amount of radiation dose used during PCI procedures is generally much greater than that used for a typical X-ray image such as a chest X-ray.

But because a chest X-ray is usually a screening test and a PCI is a lifesaving procedure, from the clinical perspective, the risk of not performing the PCI is much greater than the predicted radiation risk associated with the procedure.

Mayo study results show:

• Indicators of higher radiation dose included male gender higher body mass index (BMI); more complex disease, such as multiple diseased vessels or complex anatomy and lesions in the vessels; and previous history of coronary artery bypass graft (CABG) surgery.
• The median patient Body Mass Index (BMI) was 29.7, with most patients having a BMI between 21 and 44.6. A BMI less than 30 can fall into normal (20–24.9) or overweight (25–29.9) categories.
• The median cumulative skin radiation dose was 1.5 Gray (Gy), a unit of absorbed radiation, with a range 0.34 Gy to 4.5 Gy. In general, the cancer risk for a typical PCI is likely about 0.05 percent, whereas the “natural cancer rate” from daily living is about 35 percent, the Mayo team noted.

Implications for Cure

“Radiation risk is a recognized hazard of our specialty that has not been systematically or aggressively addressed,” explained Chet Rihal, M.D., lead cardiovascular physician on the study. “But our commitment to patient safety and quality at Mayo Clinic, and to protecting operators who perform the therapy, makes this a priority issue for us. The next step for us is to follow up from this initial identification of the problem and lead efforts to formulate specific practice changes clinicians can use to improve safety while maintaining quality.”

Data also showed that radiation doses that comparable patients received differed depending on which of the 13 physicians treated them. Dr. Rihal said investigating possible causes of this finding is among the goals of the next phase of study.

Context

Nationwide, concern n is growing across medical fields about reducing risks of radiation from all sources, such as X-rays and computed tomography (CT) scans, because radiation is a risk factor for developing certain cancers. Recently the U.S. Food and Drug Association (FDA) has been addressing accidental cases of overexposure to radiation in certain specialties. The Mayo Clinic study cases differ from the FDA efforts. Mayo’s cases do not involve accidents or overexposure, but commonly accepted clinical best practices. “This work is a natural expression of Mayo’s historic commitment to improving patient safety, care and quality of treatment,” Dr. Rihal says. “We aren’t correcting errors, just improving the way things are done for all concerned.”

Mayo’s is the largest study to identify clinical conditions that correlate with radiation dose level, and is therefore an important first step leading to designing ways to reduce radiation levels through quality improvement training. Another of the Mayo study’s authors, Kenneth Fetterly, Ph.D., explains, “There is no standard model of the clinical determinants of radiation skin dose in PCI, so by using clinical data from a large sample of Mayo Clinic adult patients and commonly accepted statistical methods, we identified correlations between clinical variables and radiation dose that we hope will be useful in improving care.”

Collaboration and Support

In addition to Drs. Rihal and Fetterly, other Mayo Clinic physicians and scientists who worked on the study were Ryan J. Lennon, M.S., Malcom R. Bell, M.B.B.S., and David. R. Holmes, Jr., M.D. Their work was supported by the Mayo Foundation for Medical Education and Research.

Below is a video with Dr. Rihal.