Atherosclerotic disease remains the leading cause of death in the United States. Despite current guidelines promoting more intensive lipid therapy, there continues to be significant residual risk for ischemic events, as shown in the TNT and AIM-HIGH studies. However, identification of risk factors for the residual cardiovascular risk under the current anti-atherosclerotic therapies remains challenging. The question stands: Can a better understanding of plaque characteristics, the mechanism of plaque change and the role of select biomarkers in atherosclerotic disease offer predictive value of the residual risk and consequently, more effective treatment options? Ultimately, CARL’s goal is to improve cardiovascular outcomes through a better understanding of atherosclerotic disease.
The Clinical Atherosclerosis Research Lab (CARL) aims to further the understanding of atherosclerotic disease through Human Subjects clinical research studies, using a combination of imaging, clinical and biomarker measurements, and collaboration with Endocrine, Radiology and within the Division of Cardiology. Studies undertaken and planned range from decades long prospective studies to short term biomarker studies.
The CARL group works to provide a setting in which Human Subject volunteers are recognized for the value of their contribution to research and in which the protection of Human Subjects is paramount.
Some of the current CARL projects:
- Carotid Plaque Characteristics by MR
Multiple studies are working on the question of whether increased plaque lipid composition or vessel wall thickness by MRI is associated with increased risk of cardiovascular events. Additionally, they are examining the association of clinical risk factors, lipids, lipoprotein heterogeneity, inflammatory markers and carotid plaque characteristics.
MRI Reproducibility of Carotid Plaque Assessment
The objectives of this research project are: (1) Establish a standardized carotid MRI protocol, at multi centers with 3T whole body MRI scanners, that provides information on plaque burden, tissue composition and plaque neovasculature and inflammation. (2) Determine the impact of scanner site on reproducibility of MRI derived variables. The success of this project will help support multicenter clinical investigations using MRI.
HDL Proteomics for Heart Disease Detection
The goal of the proposed work is to demonstrate that the HDL protein signals can be used to improve the accuracy of composite MI risk scores, which will be achieved by examining samples collected from subjects with vascular disease.