How to Engage with Content & Colleagues at a Virtual Meeting (And Like It!)

Now that AHA20 is going virtual, you might have some questions: Is it worth it? How can I connect with my council? Will the valuable networking still happen? Will I actually learn anything? So many of our regular touchstones have been canceled in 2020, but you don’t have to give up Scientific Sessions. It won’t be the same, but with a little planning, it will be great in different ways.

I polled the AHA early career bloggers for their best virtual meeting tips, and here’s their rundown on how to make virtual meetings work for you:

  • Use multiple channels. While the meeting may be streaming on a designated platform, you might also find engagement using outside tools or social media platforms.
    • Follow the official hashtag (#AHA20) on twitter. This is a great way to highlight key presentations, engage with other participants, and connect with experts and presenters. (If you haven’t used twitter professionally before, take the time to set up your bio, make sure your existing content is safe for work, and make your avatar a good picture of you. Or consider a dedicated profile for work. Do some legwork ahead of time to follow people and organizations you’re interested in connecting with during the conference).
    • You could create a Slack Channel with others in your institution or research area to share resources and have ongoing conversations.
    • You could make a Strava group to engage in a little healthy competition and give one another kudos— who got their workout in today?
  • Take breaks. At a face-to-face event, you spend time walking between sessions and break for meals. When everything is online, it’s easy to forget to get up, rest your eyes, and move around.  Hydrate. Take bio breaks. Bonus points if you go outside and don’t take your phone.
  • Consider using a standing desk, or even a makeshift setup, to help you be more mobile throughout the day. Changing position frequently is one of the keys to avoiding pain from being sedentary.
  • Take notes! Things start to run together and a good note-taking strategy will help you remember key information. Maybe you use a good, old-fashioned paper notebook, or maybe you prefer a tool like Evernote. Up to you.
  • Use the interactive tools to ask questions. Especially if you haven’t gotten up the gumption to stand up and ask questions at a live session, you might find the online format more accessible.
  • Connect with colleagues before the meeting starts, and schedule times to debrief and share key takeaways. This helps to keep momentum and excitement going.
  • Constant on-screen interaction can be very taxing. If available, try the on-demand option to give yourself more flexibility. Also consider taking a break from being on camera and just listen.
  • Let yourself be immersed. When you travel to a meeting or conference, you may arrange child care, get someone to cover your clinical or teaching duties, and put up your out-of-office message. While it might be tempting to squeeze conference sessions around your regular responsibilities, you’ll miss the value that the immersion experience provides.

And remember, the virtual conference is accessible to all– if you might ordinarily be limited by difficulty traveling or cost, this is could be your year.

Share other tips (@AHAmeetings and #AHAEarlyCareerBlogger on twitter), connect with the Early Career Community, and grow your network!

And register for sessions: https://professional.heart.org/en/meetings/scientific-sessions


A Framework for Going to Professional Conferences & Meetings

During my graduate education years, my understanding and focus on attending conferences was almost exclusively centered on two priorities:

  1. Learning about the science happening in my area of interest, and the surrounding research that can complement and elevate my present projects.
  2. Being able to participate (via poster or a short talk) and deliver a useful and potentially distinguished presentation at the conference.

This is pretty much the default priority list for any grad student – not just in biomedical science, but this accurately applies to all academic fields. In fact I’d argue these are basically all that’s needed and required by students being exposed to academic conferences. Professional meeting events come with relatively steep learning curves when students are first experiencing them. Major conferences are (mostly, but not always) held in cities/towns that attendees don’t reside in, so the difficulty of housing, scheduling food, sleep and even clothing choices all come into play.

Unfamiliar surroundings and temporary changes in daily rhythms can lead to elevated stress levels; an effect called allostatic1 load, with measurable biological changes previously reported2, like elevated cortisol and Interlukin-1β levels measured from human salivary samples. Packed conferences potentially strain mental and emotional health, with the cognitive (over)loading that comes from the equivalent of attending a dozen classes (sessions) back-to-back, then doing it all over again the next day and so on, depending on how long the conference is.

These conference days are as demanding as can be, especially for the lesser experienced graduate students. Thankfully, none of what is mentioned here is presently unknown, denied, or ignored. These days enough writing3 exists, reporting all of these observations, sometimes in scientifically quantifiable4 and systematically assessed5 studies. Efforts towards counteracting these difficulties are now discussed, advised, and hopefully even the most ambitious and keen grad students are finding ways to mitigate and avoid negative experiences. Being a scientist in the cardiovascular field, I’ll emphasize two quick notes, extremely obvious, but worth highlighting whenever possible:

  1. Physical endurance is an undervalued factor in conference attendance, a lot of calories are getting burned moving from session to session, participating in posters/presentations, meeting people and asking questions – so it’s vital to learn, mind and strategize your conference attendance to best fit your physical endurance status
  2. What you eat matters (always!) and will affect every aspect of your time at the conference (too much/not enough coffee, too much/too little food intake during the conference, healthy vs. unhealthy available options), so again mind and strategize the food/drink variables as part of the overall conference equation.

With repetition and understanding of the general framework of conference proceedings, many of the initial difficulties and trip-ups become learned experiences, allowing attendees to become more comfortable and capable navigators of these unusual few days. This could and does happen sometimes in later grad-school years (senior PhD students, for example), but I’ll focus on the category of attendees that I myself now have become part of the early career professionals and AHA Early Career Blogger. Being in my third year of a postdoctoral fellowship in biomedical research, I’ve been to enough conferences to have a sense of the invisible “skeleton” of conferences. I can identify where the differences between various conferences exist, and where the similarities lie. I’ve learned to gauge how to pack for conferences (if at all possible, avoid checking in luggage! Pack clothing that best represents your professional ambitions. Comfortable shoes are a life saver!), how to navigate the sessions, what to eat and what to avoid. Of course there is no set formula to any of this, trial and error is the most used approach, and sharing experiences can be beneficial (at least that’s my hope in writing this piece!).

I’ll also highlight that for early career professionals, additional priorities/requirements emerge to be added to the original grad-school stage list of goals (namely: learning new information in the field, and fulfilling the level of participation duties offered when registering for the event, like poster or slide presentations). These new aspects are:

  • Networking, which I’ll define here as establishing professional lines of communication that can be of benefit in building, and maintaining relationships with others to advance professional goals. This is a valuable advanced priority in conference attendance, but I do want to emphasize that it shouldn’t be a requirement within the early stages of conference participation, since at the beginning, conferences can be overwhelming without the additional stress of having to do expert-level professional socializing!
  • The newest emerging priority I’ve added to my conference attendance efforts is discovering new elements, sufficiently outside the main field you’re involved in, that can enhance and elevate work/career forward. What I mean by that, being a biomedical research scientist, is seeking sessions in the program that address topics not directly related to: Heart Failure, genomic stability, inflammation, and similar keywords that relate to research my group and I work on. The new elements for me include things like: science communication, social media engagement, scientific advocacy, linking scientists to policy makers; and many other examples of topics that exist around health and scientific research but are not necessarily done in a lab or hospital setting.

Conferences, professional meetings, symposiums, and all types of organized events that occur within professional settings are designed to deliver a large impact to the attendees in a short period of time. Maximizing an individual’s professional development from these settings is key, understanding how to do so requires planning, optimization and gained experience from multiple trials. As with everything else in life, it takes one step at a time.



  1. McEwen, Bruce S., and Ilia N. Karatsoreos. “Sleep deprivation and circadian disruption: stress, allostasis, and allostatic load.” Sleep medicine clinics1 (2015): 1-10.
  2. Auer, Brandon J., et al. “Communication and social interaction anxiety enhance interleukin-1 beta and cortisol reactivity during high-stakes public speaking.” Psychoneuroendocrinology94 (2018): 83-90.
  3. Elfering, Achim, and Simone Grebner. “Getting used to academic public speaking: Global self-esteem predicts habituation in blood pressure response to repeated thesis presentations.” Applied psychophysiology and biofeedback2 (2012): 109-120.
  4. Lü, Wei, et al. “Extraversion and cardiovascular responses to recurrent social stress: effect of stress intensity.” International Journal of Psychophysiology131 (2018): 144-151.
  5. Ebrahimi, Omid Vakili, et al. “Psychological interventions for the Fear of Public Speaking: a Meta-analysis.” Frontiers in Psychology10 (2019): 488.



Extended gratitude goes to the University of Ottawa Heart Institute Librarian: Sarah Visintini, MLIS for assistance in compiling primary material sources in this article. Twitter @SVisin


The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.


Interview with Dr. John Spertus – Distinguished Scientist of AHA18

The road to becoming an accomplished researcher is not easy. As early career researchers, we spend many hours generating ideas that never come to fruition, conducting research that fails, writing manuscripts to see countless revisions and rejections, and grants that never succeed. Sometimes, it seems that those who succeeded have a secret formula that they are not sharing. I had the privilege of interviewing Professor John Spertus, MD, MPH, the Distinguished Scientist of AHA18, who seems to have figured out this secret formula. Prof. Spertus is the Clinical Director of Outcomes Research at Saint Luke’s Mid America Heart Institute. His research focuses on the importance of measuring clinical outcomes, creating and implementing risk models that provide health care tailored to individual patients.

Here are some of the questions I asked Professor Spertus:

1. How did you become a national leader in defining patient outcome measures?

The goal was never to become a “leader,” but rather to commit myself to overcome what I perceived to be grievous “wrongs” in the way we were conducting trials, engaging patients in their care and driving our profession to improve practice. When I was a fellow, it became incredibly clear to me that our treatments (e.g. PCI) were being justified based upon surrogate outcomes, but not on how the treatments improved patients’ symptoms, function and quality of life. I wanted to begin measuring patients’ health status, but first needed to develop the tools to do so. In retrospect, focusing on developing the infrastructure and tools to better study and improve care was a brilliant strategy – I just didn’t know it at the time. To me, I was trying to help improve our understanding of how diseases and their treatment affects patients. It was not considered “real science” by many at my institution, but perseverance and commitment to the vision really paid off. Similarly, my current commitment to implementing risk models – the foundation of precision medicine – seems to be an obvious solution to improving the value of healthcare so that we can preferentially deliver care to those that most benefit, while avoiding the costs and risk in those who don’t. Like PROs 20 years ago, there seems to be very little interest by my professional colleagues to redesign their current practice patterns, but I only hope in another 10 to 20 years that we all embrace this strategy of delivering care. I believe that holding fast to your vision and working to engage others in your dream is how one becomes a success and, ultimately, a leader.


2. When did you consider yourself a success?

I am still learning to be proud of my accomplishments, although I still haven’t contributed all that I would like. I am incredibly happy with the colleagues I have gotten to know who have all joined this vision to improve care and outcomes. The field has grown tremendously (when I started, there were only a few cardiologists in this area, as most academics favoured basic science or clinical trials) and that is incredibly gratifying to see. In particular, I revel in the colleagues I have helped inspire and train. To see them go on to do bigger and better things than I ever could have accomplished makes me very gratified and to believe that I have been a “success.”


3. What was your biggest career challenge?

Throughout my career, I have always pursued a very atypical, independent path. Moving to UMKC, which was not a vigorous research institution at the time, was a big challenge. There were not colleagues to collaborate with or learn from and the field did not have much of an infrastructure or “proven path” to success. However, the others in outcomes research – Harlan Krumholz, John Rumsfeld, David Cohen, Eric Peterson and many others – were similarly isolated, to some extent, at their institutions. Being able to create friendships and to create inter-institutional collaborations was tremendously validating to me as I started. Moreover, the interest and support of the AHA and ACC in the evolving fields of quality of care and outcomes research was a huge help.


4. How do you push through your worst times?

I vent. I find it very frustrating to face rejections – even today. I have moments of getting angry, followed by an agitated urgency to address whatever obstacles have arisen. I think addressing these challenges and moving on is the best way to navigate difficult times. Family and friends are very helpful, but ultimately, it is the passion to make the world a better place that drives me to overcome the innumerable setbacks I face and to move on. As one gets older, you forget many of the frustrations and delight in the progress that has occurred. But to get to this place, you need the perseverance and passion to get through the obstacles.


5. What’s your advice for young researchers like me?

The number one recommendation is to find an area where you feel passionately that things could be better. Opportunities exist, if only taken, to improve patients’ care and outcomes. Once this is identified, build the tools and skills to take your insights of how things could be improved to actually contribute to changing the world for the better. Share and collaborate as much as you can. Not only can you learn much from others, but having colleagues to share the journey with you makes it so much easier to weather the setbacks and so much more fun to celebrate the successes.



Professor John Spertus, MD, MPH was recognised as American Heart Association’s Scientific Sessions 2018 Distinguished Scientist. The award recognizes prominent scientists and clinicians who have made significant and sustained contributions to advancing the understanding, management and treatment of cardiovascular disease and stroke.



Any Physical Activity is Enough

When I was a nutrition intern in 2014, I would excitedly tell patients that walking 30 minutes a day, 5 days a week doesn’t have to be a daunting goal. In fact, research showed that accumulating bouts of 10 minutes conferred cardiac benefits.

Under the often cited “150 minutes/week moderate activity or 75 minutes/week vigorous activity” was the implication that if you couldn’t meet that goal, then why bother?

Did the research specifically say that? Nope. And over the years research on the so-called “Weekend Warriors” has flourished. Is it regular physical activity, or the cumulative amount, that reduces risk?

And then in 2016, the catchy phrase “Sitting is the new smoking” highlighted the birth of a newly emphasized term – physical inactivity – and the distinction between physical activity and exercise.

Earlier this month in Chicago, navigating the bustling 2018 AHA Scientific Sessions, the new Physical Activity Guidelines were revealed. Lo and behold, the news is even better – even a little bit of physical activity is worth it.

It’s not all about aerobic activity, either. We know that resistance training improves insulin sensitivity and helps maintain muscle mass as the human body ages. The result? Less frailty. “Healthy aging”. Fewer injuries from falls, and fewer falls overall.

The new Physical Activity Guidelines didn’t leave that goody out. Upper body weight training even once a week is beneficial – for your heart! Just when you thought you had to huff and puff to beef up your heart health.

With the new Hypertension Guidelines released at Scientific Sessions last year in Anaheim, a renewed effort surfaced for clinicians to encourage lifestyle behavior changes. Not enough time with the patient isn’t an excuse. Research showing that physicians who exercise are more likely to prescribe exercise hit headlines, and the simple fact that clinicians can utilize their position of authority to impart importance upon a topic.

“As a health care provider, you know it’s important to help your patients get more physical activity. But it can be challenging to motivate patients in the short time you spend together.” – Move Your Way, Physical Activity Guidelines 2nd Ed., Health Care Provider Fact Sheet

While not everyone feels comfortable taking on a counseling role with patients, there are key phrases and questions you can use to start the conversation. Check out this short Motivational Interviewing primer, which includes example wording to build rapport with your patient, empower them to make change, and establish a collaborative relationship.

  1. Help them set goals. “Are there activities you’d like to be able to do?” We’ve all heard “I want to be able to pick up my grandkids”. Knowing your patients’ motivations means you can work together to set goals that are important to them.
  2. Meet your patient where they are. Find out what they know, what they perceive as important and as barriers, and suggest small changes. Being able to walk a long driveway to get the mail is a better place to start than jumping from the couch to a 5K.
  3. Let them know what to look for. Instead of “aim for moderate intensity activity”, translate it to perceived exertion. A lazy walk is “I’m comfortable and could maintain this pace all day.” Encourage them to reach a Level 3 to 5 – “Comfortable but breathing harder – sweating a little but feel good and can carry on a conversation – just above comfortable, sweating more, and can still talk easily”. Everyone should start slow and build up to longer durations and higher intensities – take a look at the exertion table below to see what exertion level your patient should start in.



The new guidelines come with Move Your Way tools and resources to get the message out to your friends and family, your patients, and your community. Interactive tools and widgets, fact sheets and poster, and even videos, can help teach all Americans how they can move their way to move more.

Forming new habits is hard, and lifestyle change is no exception. We know the research, and we have the responsibility to translate that data into actionable information for our patients.

I had the opportunity to recap Scientific Sessions over dinner with my parents. What did I share? Just because you can’t run a marathon doesn’t mean you can’t reap the benefits of physical activity. A little bit goes a long way.



3 Key Reasons to Attend Scientific Sessions Early in Your Career

What is the value of traveling to a large cardiovascular meeting, when the information communicated in the sessions will be available via Live Streaming and the major news will be published immediately? Why go through the expense and the hassle of time away from work? Attending an event like Scientific Sessions is not easy for most of us — especially Early Career professionals who experience high demands on our time and limitations on our resources. So what makes it worthwhile? Of course this depends on your career type and your goals, but I believe the following three reasons are important for everyone in academia:

  1. Hearing and learning things you would not have sought out. When you’re at a professional conference, you have set aside time for learning. You are less likely to be squeezing learning in between other tightly scheduled commitments at home. This time allows for serendipitous exposure to new areas. For example, even though my research focuses on symptoms, risk, and communication, I heard some very interesting sessions about the microbiome. Similarly, this kind of broad exposure enables cross-pollination among disciplines that share common goals but diverse methods. What can basic scientists learn from nurses? What can interventional cardiologists learn from computer programmers?
  2. Personal connections. The power of small interactions— a chat in the coffee line, a well-put question during a session— is undeniable. The opportunity to make such connections with people at all levels in your field and related fields is one of the major benefits of attending a conference. Certainly this includes people who are “big names,” but also people whose work you might now take an interest in since you’ve met them (and vice versa). When I attended a 10-day seminar in Tahoe last year, I sat around the campfire with Dr. David Goff, director of an NIH division, and I was also the roommate of Dr. Sherry-Ann Brown, a junior scientist whose work I’ve since cited. I was able to reconnect with them and other old connections from the seminar at Scientific Sessions this year, and was genuinely interested in their work on a new level because I knew them.
  3. Momentum and enthusiasm. I always come home from events like this brimming with ideas. Science is a highly creative endeavor, and anything that sparks creativity is good for science. To make the most of this aspect, I keep good notes and make a priority list, including names, references, and contact information if applicable. I review my list on the plane ride home and identify “action items” for follow up. An event like Scientific Sessions also gives you a great feel for the overall state of cardiovascular research, and for the current priorities of different stakeholders. Using this information in long-range planning is smart and increases changes of successful projects going forward.

While it’s not feasible to attend every event that interests you, I highly recommend making an event like Scientific Sessions a priority, especially early in your career.

Why do you go to Scientific Sessions?

AHA Early Career Bloggers had the opportunity to get to know one another during Scientific Sessions 2018



Nursing And Allied Professional Sessions At The American Heart Association

During the American Heart Association Scientific Sessions, there were great sessions. It was really a struggle to make an overview of all the nurses and allied professional sessions in a short blog; they were just all very interesting and informative. But I summarized the topics that were for me the most interesting during the Sessions.
Adherence to medication use
Dr. Todd Ruppar (@ToddRuppar) presented the importance of the use of behavior prompt for cardiac patients to remember medication intake. Dr. Ellis presented one of the new examples of these behavioral prompt: the printable pillboxes with the possibility to connect to a mobile app (InterACT Pillbox).

Slide showing example of printable pill box with app capabilities

Dr. Rhonda Copper-deHoff suggested that pharmacogenetic testing could be a piece of the adherence puzzle in cardiac patients and Dr. Anton Vehovec (@antonvehovec) points out that medication adherence mediate the relationship between memory and emergency room visits and hospitalization. He stated that we should test interventions that aim to improve memory and look at the effect this has on medication adherence.


2. Technology use
Dr. Maria Liljeroos’ (@MartorMaria) research showed that telemonitoring is feasible to implement, but that we have to remember that it is still a challenge to include older cardiac patients.

Dr. Megan Reading gave a talk on technology use in patients with atrial fibrillation. In her research, they found that being asymptomatic was the main reason for not using technology. Also traveling and simply forgetting to use the technology were important reasons for not using it.

Dr. Mary Dolansky found in her research that the current evaluation of technology used to measure self-care behaviors, such as activity monitors, is insufficient. Future research should be focused on evaluating technologies for measuring and use in self-care in cardiac patients.

examples of self care measures slide

3. Palliative care/end of life in cardiac patients
A quote of Isaac Asimov, which Dr. Lisa Kitko used in her presentation, presents the importance of palliative care in cardiac patients:

Life is pleasant death is peaceful it's the transition that troublesome - Isaac Asimov

She further stated that we should remember that 67% of all patients with an LVAD have 5 or more comorbidities.

Dr. Lorraine Evangelista brings up in her presentation the importance of optimal palliative care in the beginning of the heart failure trajectory. She also presented a poster of Lisa Hjelmfors on the importance of communication about the heart failure prognosis in the US and Europe. And although most nurses think they have knowledge on prognosis and the communication with the patients, around 70% would like further education about this topic.

Dr. Dougherty gave a talk about technology advances create complex decision making for patients, family and providers. Health care professionals need to have conversations and discussions about device management at end of life.

Dr. Loreena Hill (@HillLoreena) and Dr. Donna Fitzsimons (@FitzsimonsDonna) stated that there is a paradigm shift regarding when deactivation should be discussed and who is responsible in long overdue if end of life care for patients with an ICD is to improve.

Study Characteristics

4. The importance of involving caregivers
Dr. Anna Strömberg (@Anna_Submitting) talked about the importance of involving caregivers and the support and education these caregivers want. Caregivers would like easy access to health care and support groups with caregivers alone. This could help them to handle their life situation.

J.N. Dionne-Odem (@jn_dionneodom) pointed out that caregivers are vital in care for patients with heart failure, but that we have to realize that only 1 in 3 are comfortable giving heart failure care.

A poster presented by Dr. Hiroko Ishida shows the importance of health literacy in caregivers. They found that health literacy of patients with heart failure and their caregivers was independently associated with caregivers burden.

5. Diet, fluid restriction and appetite
Dr Anna Strömberg (@Anna_Submitting) stated the importance of the need for more research in nutrition and fluid restriction and Dr. Lennie presented that we are all on a diet, but that just finding the best food for you, as a person is a challenge. Dr. Martha Biddle advised that cardiac patient should have a healthy, varied diet. She even presented a recipe for a cardiovascular health:

recipe for cardiovascular health slide

Dr. Lora Burke suggests that mobile apps could be a tool for nutrition research to increase adherence. Mobile apps could give feedback to the patients, which could improve dietary choice/eating behavior by make patients more aware of their choices. Dr. Misook Chung presented a poster concluding that diet quality was similar in patients with heart failure regardless their adherence to sodium restriction diet. Christina Andrea’s (@C_Andreae) poster demonstrated that patients who are more physically active have better appetites compared to those who are less physically active. This research underscore that in future studies, a need is for attention on physical activity and appetite.

physical activity and appetite in patients poster

6. Physical activities
Dr. Tiny Jaarsma (@DrJaarsma) presented a new way for patients in cardiac care to be active at home: Exergaming. Exergaming is being physical active with a gaming computer. In her research, (@HFWii) they found that installing such a computer at home with patients with heart failure increased their exercise capacity.

Another promising and alternative way to exercise in community-dwelling older adults, presented by Dr. Marjorie Funk, was Qigong. Qigong is a form of exercise composed of movements that are repeated a number of times, often stretching the body, increasing fluid movement (blood, synovial, and lymph) and building awareness of how the body moves through space. This research showed that Qigong was feasible for older adults and that they accepted this form of exercise. This research group next step is to test this on cardiac patients.

A intervention presented was the Heart Up!, (a text message intervention) showed promising in improving in physical activity and decreasing hopelessness in patients with ischemic heart disease.

Leonie Klompstra Headshot

Leonie Klompstra is a Nurse Scientist at the Linköping University in Sweden. Her primary focus is on heart failure and rehabilitations.


Precision Medicine Through Big Data – A Game Changer

From clinical science supported by data to data science supported by clinicians

AHA Badge
We live in an era of a tremendous amount of information. Scientific research is particularly well suited by the possibilities offered by analyzing large sets of data. In the past, data has been locked up in individual data bases and were not openly shared or available. Over the last two decades access to data has been improved and more open sources for analyses are now available. With advancements in technology, including cloud computing, big data is now available to all researchers. Information gained from big data needs to be translated into knowledge.  Acute and chronic disease is a complex process and often displays itself in a variety of phenotypes with different outcomes. Consequently, data has to be complex in order to identify subgroups, to define disease phenotypes, and precise treatment strategies.

I recently attended the AHA Scientific Sessions meeting the “Early Career Day” to learn more about the AHA – Precision Medicine Platform (AHA-PMP) to access and also upload my own data and use the provided workspace, which is especially great for teams. Additionally, to AHA-PMP other data portals were presented and explored in small groups. These open portals included cardiovascular, cerebrovascular, and diabetes research such as the Cardiovascular Disease Knowledge Portal (CVDKP; broadcvdi.org), cerebrovascularportal.org (CDKP) and the type2diabetesgenetics.org (T2DKP) portal.

The goal of these platforms is to accelerate analyses of the genetics of cardiovascular and cerebrovascular disease as well as diabetes. For example, the CVDKP is an open-access resource that facilitates the translation of genomic data into actionable knowledge for better understanding and treatment of cardiovascular disease. For example data in the CVDKP are from 4 large Consortia namely the Atrial Fibrillation Consortium (AFGen), the Global Lipids Genetics Consortium (GLGC), the Myocardial Infarction Genetics Consortium (MIGen), and the CARDIoGRAMPlusC4D Consortium. The CVDKP was built on the Knowledge Portal platform originally designed for the Type 2 Diabetes Knowledge Portal (type2diabetesgenetics.org), which was produced by the Accelerating Medicines Partnership In Type 2 Diabetes.  It is part of the Knowledge Portal Network, which also includes the Cerebrovascular Disease Knowledge Portal (CDKP: cerebrovascularportal.org). Data in the CVDKP include GWAS data for CVD and other traits (anthropometric, glycemic, renal, and psychiatric traits), exome chip data, whole exome sequence data, disease-agnostic genomic resources and epigenomic data. Further, with evolving results from big data a paradigm shift in science has been recognized. While over the last few decades medicine has been mostly clinical science supported by data; now medicine is about to become data science supported by clinicians and artificial intelligence and machine learning (deep learning)  plays an important role. This new frontier of data science, provides a greater opportunity especially for younger investigators to develop and drive their own projects.

However, despite the widely endorsement of sharing data and the availability of open sources and platforms, the rate that these data are accessed and utilized are still low. This is one reason AHA wants to promote these valuable resources further to advance our understanding in medicine and facilitate new therapies.

The perception that open source data are underutilized is supported by recent studies.  A just published analysis showed that for example cardiometabolic study data from patient-level clinical trial data are less accessed than previously assumed. In this study by Vaduganathan et al. data were extracted from ClinicalStudyDataRequest.com, a large, multi-sponsor data-sharing platform hosting individual patient-level data from completed studies sponsored by 13 pharmaceutical companies. Over the last 4 years, the platform had data from 3374 clinical trials, of which 537 evaluated cardiometabolic therapeutics covering 74 therapies and 398 925 patients. Diabetes mellitus and hypertension were the most common study topics with a median follow up time of 79 months. As of May 2017, despite availability of data from more than 500 cardiometabolic trials in a multi-sponsor data-sharing platform, ClinicalStudyDataRequest.com, only 15% of these trials and 29% of phase 3 or 4 clinical trials have been accessed by investigators and almost all researchers were from academic centers in North America and Europe. Of note, only half of the proposals were funded, and most proposals were for secondary hypothesis-generating questions. To date, after a median of 19 months (9-32 months) only 3 peer-reviewed articles have been published.

Further, when analyzed if male and female researchers were requesting data access equally, the investigators found that only 15 % of female researchers accessed data while the majority, with 85%, were men.

In conclusion, during “Early Career Day” I learnt that available open sources for big data analysis are underutilized and researchers who access scientific data are predominately men.  Data platforms provide a huge opportunity for researchers, and especially women, to generate hypotheses which may then lead to (further) funding.

 Tanja Dudenbostel Headshot
Tanja Dudenbostel is an Internist, Hypertension Specialist within Cardiology at the University of Alabama at Birmingham where I divide my time as an Assistant Professor between clinical research and seeing patients in cardiology.



A Personal Take On The Interventional Trials At AHA Scientific Sessions

American Heart Association Scientific Sessions always been inclusive of all cardiology specialties. Despite this breadth of science, each subspecialty in cardiology get enough depth to improve patient’s outcome.

Trials of interventional nature had big presence at the Scientific Sessions 2017. The PRESERVE trial was one of the landmark studies presented at the sessions. The study was run by VA which show the Among patients undergoing coronary angiography with chronic kidney disease, a strategy of IV sodium bicarbonate or oral acetylcysteine yielded no additional benefit for the prevention of death, dialysis or persistent kidney impairment at 90 days. This study put to rest a long debate of IV sodium bicarbonate or oral acetylcysteine use for prevention of acute kidney injury showing no benefit in either strategy. Going forward, interventionalist should feel comfortable not to use either strategies which will decrease complexity of care and cost. This study prove that Veterans Affairs Health System is able to deliver an important study to answer critical and practice changing question.

COMPASS trial is another interventional-related study which has been published before and showed decreased cardiovascular events in patients randomized to ASA plus low dose atherosclerosis versus aspirin alone. in patients with stable atherosclerosis. At the Scientific Sessions, the cost analysis showed decreased cost with ASA plus low dose rivaroxaban compared with ASA alone driven by the lower ischemic events in both CAD and PAD patients, as well the decrease in number of procedures required (i.e. angiogram, intervention, amputations, etc.). However, since the actual cost of this dose of the drug is yet unknown, overall cost savings and cost-effectiveness analyses are unavailable at this time.

Moving along, another important study looking into the antithrombotic regimen for patients with indication for anticoagulation undergoing coronary intervention. The RE-DUAL PCI trial was already published, but what presented at the sessions is sub-group analysis that focused on patients with acute coronary syndrome (ACS) and non-ACS at index event. Majority of patients received clopidogrel, while 12% of the patients received ticagrelor either as part of dabigatran dual therapy or warfarin triple therapy. The dabigatran dual therapy regimen used dabigatran and a P2Y12 platelet antagonist, while warfarin triple therapy combined warfarin, aspirin and a P2Y12 platelet antagonist.  In the study, 83% of cases, DES was used, and were similar in patients with ACS and non-ACS. The study showed, that dabigatran with P2Y12 inhibitor is superior to triple antithrombotic strategy. More bleeding, obviously in the triple therapy group with no efficacy in terms of lower ischemic complications.

Another study that provided evidence for what we do in practice was the POISE-2 trials. The goal of the trial was to evaluate perioperative aspirin compared with placebo and perioperative clonidine compared with placebo among patients undergoing non-cardiac surgery. The POISE-2 trial showed that among unselected patients undergoing non-cardiac surgical procedures, neither the perioperative use of aspirin, nor clonidine, was beneficial in reducing the incidence of death or myocardial infarction. However, benefit was observed with aspirin among patients with prior stenting. This is consistent with what most cardiologists are practicing, where they recommend ASA continuation throughout the non-cardiac surgery for patients with previous PCI.

Different studies with different aims related to interventional cardiology presented at the sessions.  AHA Scientific Sessions continues to support all cardiovascular specialties bringing science to practicing cardiologist that answer practice-based clinical questions and, more importantly, saves lives.

Chadi Alraies Headshot
M Chadi Alraies, MD is an interventional fellow and vice chair of Council on Clinical Cardiology Fellow-In-Training & Early Career Committee of American Heart Association.


Are You New To AHA Conferences? Lessons From 2017 Scientific Session

AHA Sessions

“No grand idea was ever born in a conference, but a lot of foolish ideas have died there.”
F. Scott Fitzgerald

As a researcher mostly involved in basic science, you may have numerous ideas that you think are worth pursuing, until you join your peers’ conversation in a conference and then, you realize, that may have been a foolish idea to pursue, precisely as Fitzgerald said.  This is only one beauty of attending conferences and for me, my recent experience at #AHA17 made me to wholeheartedly believe in Fitzgerald’s saying.
I attended this year’s Scientific Session with two mindsets:

  • First, I tried to have a pre-made mindset about the topics I would like to follow-up on (aortic aneurysms, atherosclerosis, and lipid metabolism).
  • Second, I kept a portion of my mind empty and looked for ideas to fill it up with.

By focusing on a specific topic, I was able to explore different projects which were to some extent, related to what I do, I shook hands with many researchers who are active in my field, I had the chance of establishing connections with potential future collaborators, and finally based on all the talks and communications, I killed some foolish ideas. None of these would have been possible without a planned attendance and pre-made mindset

Keeping a blank space in my mind helped me to look for fillers. From getting myself exposed to projects presented in other AHA Councils, to having snacks with scientists who have opposite ideas, the fruitfulness of activities which are usually out of my field of focus not only gave me new ideas to work on but also expanded my networking circle to an extent which I would not expect.

All things considered, #AHA17 was the highlight of my conference participations in 2017 and if you are planning for your next AHA conference attendance, do not forget to come prepared with an open mind to get the most out of the event(s).
Also, as a blogger in the events, it’s best to avoid beer. Sometimes that first draft can get in the way of your novel ideas.

Shayan Mohammad Moradi Headshot

Shayan is a caffeine-dependent Ph.D. Candidate at the Saha Cardiovascular Research Center, University of Kentucky. His research area is focused on vascular biology and lipid metabolism. He tweets @MoradiShayan, blogs at shayanmoradi.com and he is the Winner of World’s Best Husband Award (Category: nagging).


New Hypertension Guidelines: Why Neurologists Should Pay Attention

Scientific Sessions generated a great deal of buzz in the traditional and social media spheres, particularly with regards to the new ACC/AHA High Blood Pressure Guidelines. The lay media was quick to note that nearly half of the US population will now be considered hypertensive, and some doctors expressed concern that some patients may incur undue harm from over-zealous anti-hypertensive therapy.
It is important first to note that the guidelines do not require or recommend that individuals with blood pressure values falling in the “Elevated Blood Pressure” or “Stage I Hypertension” categories be reflexively treated with anti-hypertensive medication. There is room for consideration of overall-risk and prior cardiovascular events. There is an explicit role for non-pharmacological therapy. Some have noted that that while the number of individuals now considered “hypertensive” will increase, the number requiring pharmacological treatment will not increase as dramatically.
That said, why should neurologists pay attention? First, the previously-used term “pre-hypertensive” is decidedly not alarming. The updated guidelines’ use of “elevated blood pressure” is clear and unambiguous; patients and their physicians will be prompted to action earlier. Given that hypertension is a leading risk factor for stroke, we will hopefully see stroke rates decrease with time. Second, neurologists should pay attention because some patients may see us more frequently than their primary care physicians. We should be aware of these guidelines so that we are prepared to appropriately counsel and/or refer patients with elevated blood pressure. A check-in for a migraine or epilepsy medication refill may yield an opportunity to reduce long-term cardiovascular risk!
I look forward to seeing the public health gains materialize from dissemination and implementation of these guidelines.

Neal Parikh Headshot

Neal S. Parikh, MD, earned his MD from Weill Cornell Medical College and completed residency training in neurology at the same institution. He is now an NIH T32 neuro-epidemiology and vascular neurology fellow at New York-Presbyterian Hospital/Columbia University Medical Center. He tweets @ NealSParikhMD and contributes to Blogging Stroke as a blogger.