Showing 6 ideas for tag "factors"

Goal 2: Reduce Human Disease

Does lowering circulating lipoprotein(a) levels influence cardiovascular outcomes?

A comprehensive research strategy and plan is needed to determine the most efficient, safe, cost-effective and widely applicable strategy to decrease circulating levels of lipoprotein(a) and to determine whether lowering circulating lipoprotein(a) levels will reduce the risk of developing cardiovascular disease such as a heart attack or a stroke as well as the progression of atherosclerosis or aortic stenosis.

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

Approximately 20% of the population are characterized by elevated circulating levels of lipoprotein(a), regardless of age, gender or blood cholesterol levels. Estimates suggest that up to 90% of the variation in plasma lipoprotein(a) levels could be due to genetic factors, which makes lipoprotein(a) the most prevalent inherited risk factor for cardiovascular diseases (CVD). Large-scale genetic studies have shown that Lipoprotein(a) was the strongest genetic determinant of CVD such as atherosclerosis and aortic stenosis. Lipoprotein(a) is one of the strongest predictors of residual CVD risk and has been shown to improve CVD risk prediction in several population-based studies. Lipoprotein(a) is also one of the strongest known risk factors for spontaneous ischemic stroke in childhood.
A comprehensive research strategy aiming at identifying, evaluating interaction with other risk factors, treating and educating patients with elevated lipoprotein(a) levels would result in substantial reductions of health care costs in the US and around the globe by reducing the burden of CVD while simultaneously improving the quality of life of these patients.

Feasibility and challenges of addressing this CQ or CC

The list of pharmaceutical agents that reduce lipoprotein(a) levels is steadily increasing. There are approximately half a dozen strategies that have been shown to significantly and safely lower lipoprotein(a) levels. One of the challenges of this research strategy will be to determine which of these strategies represent the most efficient, safe, cost-effective and widely applicable approach to lower lipoprotein(a) levels and CVD outcomes.
Increasing awareness on lipoprotein(a) and CVD will also be of utmost importance for this effort as relatively few physicians perform lipoprotein(a) testing and even fewer patients are aware of their lipoprotein(a) level. The first sign of high lipoprotein(a) is often a heart attack or stroke. Our challenge will be to identify patients with high lipoprotein(a) that could be enrolled in trials of risk characterization and lipoprotein(a)-lowering.

Name of idea submitter and other team members who worked on this idea Sandra Revill Tremulis on behalf of the Lipoprotein(a) Foundation Scientific Advisory Board

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Goal 2: Reduce Human Disease

Prevent the Development of COPD

What can be done to prevent the development of COPD in individuals at increased risk. Quitting smoking before the development of COPD can prevent COPD development. What can be done to prevent COPD for individuals with other identified ris factors

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Details on the impact of addressing this CQ or CC

Several risk factors have been identified that identify individuals at risk for developing COPD including low birth weight, poor maximally attained lung function and the presence of asthma. Strategies to prevent COPD development in these individuals are needed.

Feasibility and challenges of addressing this CQ or CC

The Lung Health Study demonstrated that smoking cessation prevents COPD progression. Studies of similar size and duration should be organized to address other risk factors.

Name of idea submitter and other team members who worked on this idea COPD Foundation, COPDF MASAC

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18 up votes
3 down votes
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Goal 2: Reduce Human Disease

Adult cardiovascular risk in patients with congenital heart disease

Do patients with congenital heart disease have the same, higher, or lower risk for coronary artery disease as they age into adulthood?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

By improving our understanding of cardiovascular risk in patients with congenital heart disease we may be able to improve our surveillance for disease and intervene earlier to address this risk factors. The adult population with congenital heart disease is undergoing rapid growth.

Feasibility and challenges of addressing this CQ or CC

The adult population with congenital heart disease is undergoing rapid growth. Novel uses of electronic health records (EHRs) and registries may enable us to answer these questions in a cost-efficient manner.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

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12 down votes
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Goal 2: Reduce Human Disease

Kinetic analysis of transcriptional regulation by aberrant transcription factors in vivo

Aberrant transcription factors, such as leukemia fusion proteins, promote diseases by deregulating transcription of target genes. Recent genome-wide studies have provided new insight into transcriptional deregulation by aberrant transcription factors. Most of these studies have not used cells with synchronized transcriptional activities at specific repression/activation steps and, therefore, may have limited value in... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Critical Challenge (CC)

Feasibility and challenges of addressing this CQ or CC

These studies are feasible. Transcriptional regulation of a population of cells may be synchronized by epigenetic drugs, or by using inducible expression/knockdown approaches. Alternatively, it may be possible to overcome the heterogeneity issue by single-cell-based analysis. Next, time-dependent genome-wide studies may be applied to the cells to reconstruct dynamic transcriptional pathways associated with aberrant transcription factors. These approaches may be generally applicable to the study of other disease-related transcriptional and signaling molecules.

Name of idea submitter and other team members who worked on this idea Jinsong Zhang

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Goal 2: Reduce Human Disease

Risk scores for valvular heart disease

What is an appropriate risk score for intervention in valvular heart disease?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

Details on the impact of addressing this CQ or CC

More accurate risk estimates would provide clinicians with clearer guidance in selecting how and when to intervene in valvular heart disease.

Feasibility and challenges of addressing this CQ or CC

The advent and rapid advance of transcatheter therapy for valvular heart disease makes this an opportune time to develop metrics to determine whether transcatheter or surgical intervention is most appropriate and when.
The decision to intervene, as well as the type of intervention, is based on individual risk scores such as the STS risk estimate or the Euroscore. However, these scores are derived only from surgical patients and do not take into account procedure-specific impediments, major organ system compromise, comorbidities, or the frailty of the patient.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

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