The Bob Harrington Show

The education of the clinical trialist is an evolving challenge that involves equal doses of practicality and academic grounding. Dr Renato Lopes joins Dr Bob Harrington to discuss the recent publication of Understanding Clinical Research and their years mentoring investigators. Hear about training solutions, how best to collaborate in an increasingly interconnected world, and the key role that Brazil is now playing in this arena.

Few trials have stirred our imagination—and kept online forums as busy—as the TACT trial. With this controversial study as a backdrop, Drs Bob Harrington and Daniel Mark address the complicated issue of how to interpret unexpected findings. Can we clinical trialists claim to be as open to trial results as we think we are? Or is there something inherent in our pathophysiologic-based system of beliefs that limits our perception of disease? Learn more about the colorful background of TACT and why our reactions to the trial might be indicative of cracks in our approach to research.

Patient adherence—as recently demonstrated in the MI FREE trial—is a notoriously complicated issue that is the focus of several ongoing research projects. Drs Steve Driver and Don Hensrud join the show to discuss their innovative trial presented at ACC 2013, which examined the role of an incentive program in combination with education on healthy living in helping obese patients lose weight. Hear the authors' interpretation of the results, what they might mean for existing weight-loss programs as well as future research, and how this could be a step forward in the promotion of adherence.

With an ever-growing percentage of the population either overweight or obese, the topic of staying trim is a matter of international proportions. Dr Roger Blumenthal joins the show to discuss obesity—how it's measured, its impact on heart disease, prevention, and diet—including a review of the recent clinical-trial results of the Mediterranean diet. Tune in for practical suggestions on counseling patients and a discussion of the latest data.

As technologies advance, has the art of bedside medicine been lost? Renowned author and internist Dr Abraham Verghese joins Dr Bob Harrington to consider the role of humanism in medical practice and the joy of sharing effective tools for patient care. We can cure patients, but how good are we at helping them to heal? is the way of the future.

The FREEDOM trial has added a wealth of data to the debate on revascularization in patients with heart disease. Dr Timothy Gardner joins the show to discuss the revascularization options, what we have learned from FREEDOM, BARI, BARI 2D, and PREVENT, ad hoc PCI, the role of the heart team, and why collaboration between interventionalist and CV surgeon is the way of the future.

Despite cautious and limited guideline endorsement, beta blockers are widely used in cardiovascular disease (and beyond). Why? Our guest Dr Sripal Bangalore discusses his research, which caused a stir in CV spheres but actually does not differ greatly from the guidelines. What is the evidence for beta blockers in CV disease? What are the next steps for this research?

A combination of many issues such as misunderstanding the importance of medications, forgetfulness, finances, and more complex social factors patient nonadherence to drug therapy is a major public concern and an impediment to global health. What's the good of an effective regimen if no one follows it? Dr Niteesh Choudry joins the show to discuss his research including the MI FREE trial and to propose how clinicians and patients, as a team, can rectify the irregular long-term use of medications.

Regenerative therapy using stem cells has—for a long time—shown great potential to impact cardiovascular medicine. What's the current state of the field? Dr Bobby Robbins shares his thoughts about current and future research including his goal to use embryonic stem cells in the human heart within 5 years.

With biomarker research accelerating exponentially, Dr Jim Januzzi joins the show to discuss how the field has evolved, the usefulness of current markers, and what direction the field is taking--from diagnosis to prognosis to treatment of heart disease

The practice of cardiology has taken a beating over the past years. Tough financial times and intense coverage of inappropriate procedures have tipped a balance: the reverence with which cardiologists (and physicians at large) were once held seems to have been replaced by an atmosphere of suspicion and blame. It's unsurprising, then, that recent surveys of happiness among cardiologists detect a trend toward gloominess and professional dissatisfaction. Are we doomed? Private practitioner and theheart.org blogger Dr Seth Bilazarian joins the show to discuss the pros and cons of cardiology in 2012 and express what continues to make his practice enjoyable and fulfilling (despite it all).

Cardiologists now have a wealth of choice for anticoagulation, but with competitors to warfarin crowding the physician's office, it's increasingly difficult to select the most appropriate agent for patients with atrial fibrillation. Dr Elaine Hylek shares her thoughts on the need for the novel anticoagulants, the key lessons learned from recent blockbuster trials as well as from early clinical adoption of the new drugs, and what we need to do to make best use of these agents.

Technology is the key to a radical transformation of medicine, which is shifting from a population-based model to one of individualization. Will cardiologists and medical practitioners be left behind? Dr Eric Topol discusses his recent book, The Creative Destruction of Medicine, and his thoughts on the future of health and care.

Where do things stand with healthcare reform? What is the status of CMS innovation centers, accountable care models (ACOs), and new models for reimbursement? Dr Kevin Schulman, professor of medicine and business administration, joins the show to discuss healthcare reform and its implications on cardiology—and society at-large—in 2012. What are the implications of the trend toward hospital employment vs private practice? Does it make a difference whom we vote for? Beyond the election, what can medical schools do to prepare physicians for the reality of practice in increasingly difficult financial circumstances?

The issue of clopidogrel genomics and CYP2C19 genotyping came to a head with the recent JAMA meta-analysis that questioned the use of clopidogrel loss-of-function gene testing—controversially stating that there is no link between genotype and cardiovascular events. Dr Jessica Mega joins the show to shine light on the rapidly evolving field of clopidogrel pharmacogenomics, examine the scientific data—and the controversy—and share her recommendations for practitioners.