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The Prince Charles Hospital Research Report 2007-2008 - Part ...

  1. 1. 2007–2008 Cardiology Medical Director of Cardiology and Director of Cardiology Clinical Research Centre (CCRC): Associate Professor Darren Walters T: 07 3139 4710 F: 07 3139 4715 E: Clinical Senior Research Clinicians/Personnel: Principal Investigators: Research Centre Associate Professor Darren Walters Professor JHN Bett Dr Russell Denman Co-Investigators: Dr Rod Chua Dr Matthew Pincus International Professional Linkages Dr A Roati Massachusetts General Hospital: Associate Professor Con Aroney Sujith Seneviratne; Fellow in CT imaging Dr Sujith Seneviratne Andrew Mcann; Fellow in interventional Cardiology Registrars: Dr Christian Hamilton-Craig, History of the Research Unit: Dr Rolf Gomes Associate Professor Con Aroney and Professor Nick Tony Lai Bett originally started clinical trials with a nurse John Sedgwick researcher more than 15 years ago. Mahala Huderverdi When Associate Professor Darren Walters was Akshay Mishra appointed Medical Director of Cardiology in 2004, Brendan Bell he continued to support Cardiology Research by Jonathon Ginns establishing the contemporary structure of the Clinical Fellows: Cardiology Research Centre (CCRC) and becoming its Manjeet Juneja Peter Larsen Andrew McCann Tilak Sirisena Research Coordinators (2007-2008): Rebecca Pincus Tom Christensen Clement Lee Michelle Grant, Steve Graves Administrative staff: Katrina Huet T: 07 3139 4711 F: 07 3139 6140 E: Affiliations: University of Queensland CSIRO Australian e-Health Center Associate Professor Darren Walters The Prince Charles Hospital Research Report 13
  2. 2. 2007–2008 There are three main areas of clinical research that the Cardiology unit focuses on and these are : • Cardiovascular device based trials which include cardiac stents, and cardiac structural heart disease Clinical devices such as Core Valve™. • Pharmaceutical trials focusing on novel anticoagulants Research • Electrophysiology and pacing The Clinical Cardiology Research Centre has weekly meetings and is in one of the top enrolling Centre trial sites in the country for cardiovascular trials. The Centre has now assumed national leadership of a number of trials including Saturn and the Resolution Trial. We are independently financial and turn over in excess of one million dollars per inaugural Research Director. This has culminated in year in research funding. the acquisition of space and equipment for its present location. The trial centre has also been kindly supported by a number of benefactors including Mr Lloyd Kyle- Two Research Coordinator positions were established by A/Professor Walters, which resulted in substantial Little who has contributed to the research unit on increase in Clinical Trials for the research centre. an annual basis for the last four years. We have also been the benefactor of the Vellnagel Family necessitating an expansion of the staffing complement Foundation. to two full time Senior Research Coordinators, three Current Research Projects: Clinical Trials The following trial includes a selection of just some of the industry sponsored and investigator driven clinical research studies conducted by the Cardiology Clinical Research Center. ACQUIRE Study: Australian CareLink Quality and Impact of RemotE follow-up evaluation. The ACQUIRE study will be an observational study, designed to evaluated the use of the CareLink remote monitoring device. This device will allow patients who have had a pacemaker or an ICD (Internal Cardiac Defibrillator) implanted, to be able to transfer data from their device back to the hospital via the telephone. It is hoped that this system would operate routinely for those patients who live too far away from a hospital to conveniently attend a clinic for interrogation of their pacemaker or ICD. This would be time saving for the patients, and cost saving for Queensland Health (as the referring hospitals currently pay for patients to travel full time Research Coordinators and a Research back to TPCH for clinics). Administrative Officer. The Center is closely affiliated with Dr Michael Ray, Director of the Haemostasis Researchers: R. Denman; D. Walters; M. Adsett; Research Laboratory and works collaboratively on V. Deen; P. Martin; T. Christensen several investigator initiated research projects. 14 The Prince Charles Hospital Research Report
  3. 3. 2007–2008 B.E.A.C.O.N II: A multi-centre clinical registry of BioMatrix drug - eluting stent in Asia-Pacific countries. A prospective, multi-centre, observational, patient data registry program compiling data on patients receiving the BioMatrix Stent with the objective of assessing clinical outcomes in patients receiving the BioMatrix DES Stent during treatment of Real World, All-comer Patients. The primary endpoint for the study is Major Adverse Cardiac Events (MACE) defined as a composite of cardiac death, myocardial infarction (Q and Non Q wave), or ischaemia driven Target Lesion Revascularisation (TLR) at 12 months. Secondary endpoints consist of safety and efficacy data. The registry intends to enrol approximately 1000 patients from up to 15 participating centres within Singapore, Malaysia, Indonesia, New Zealand, Australia and Patients will be approached prior to their angiogram/ Thailand. Up to the first 20 patients per site (total of angioplasty procedure and given information 250) enrolled in the registry will have angiographic regarding the trial. If these patients have a blockage assessment at the 9 month follow-up visit to assess in a coronary artery that is suitable for inclusion in efficacy secondary endpoints. Other follow-up includes the trial, they will be randomised and treated with the clinic visits at 30 days, 6 months, 12 months with ECG allocated device. and phone contact at 90 days and 2 - 5 years annually. COREVALVE INTERNATIONAL REVALVING REGISTRY: Researchers: D. Walters PERCUTANEOUS AORTIC VALVE REPLACEMENT (PAVR) CAP PROJECT: WITH THE COREVALVE REVALVING SYSTEM. Information and Computer-based technologies for Secondary Prevention of CVD in Community Care Settings Care Assessment Platform Project,. Collaboration with the Australian Center for eHealth. This is project funded in excess of $ 500 000 and is a collaboration between Q Health and CSIRO that aims to show evidence that ICT enabled home-based care process of cardiac rehabilitation patients provides equally good or better outcomes than traditional hospital based rehabilitation processes not using ICT tools. Researchers : D Walters, A Fairfull, A Sarela, Mohanraj Karunanithi. Core valve percutaneous aortic valve replacement CARE II: Aortic valve disease consist of aortic stenosis and aortic A prospective, randomized, multicentre study to regurgitation. Accounting for the vast majority of aortic evaluate the safety, efficacy and performance of the valve disease, aortic stenosis prevalence is between CardioMind Coronary Stent Systems for treatment 1% and 2% in the over 65 year old population and of stenotic lesions in small diameter native coronary approximately 4% in the over 85 year old population. It arteries. is mainly calcific stenosis due to senile degeneracy. This trial will evaluate the CardioMind “Sparrow” The ineluctable development of the disease leads to Coronary Artery Stents, in small narrowed coronary need for (surgical) valve replacement with a mechanical blood vessels. The major benefit of these stents is they or a biological prosthesis (heterograft or allograft). are self expanding and do not require dilation with a Today’s standard of care for heart valve replacement balloon. This makes them thinner, more flexible, able requires open-heart surgery. During the operation, to manoeuvre through tighter blockages and reach surgical access to the heart necessitates an incision narrowings in more difficult positions. through the skin and muscle and requires the chest cavity to be opened. At the time of the procedure, the The Prince Charles Hospital Research Report 15
  4. 4. 2007–2008 angina pectoris and moderate chronic kidney disease undergoing percutaneous coronary intervention. Cardiology DNB-001, the study drug, has been evaluated in the laboratory, and has shown that it may have the potential to protect against damage to the heart and Clinical to the kidneys as might occur during Percutaneous Coronary Intervention. The study will examine whether it is safe to take the drug and whether the drug can help prevent heart and kidney damage during Research percutaneous coronary intervention. Researchers: D. Walters; S. Seneviratne; M. Juneja; A. Roati; JHN Bett; R. Chua; M. Pincus; R. Pincus Centre ECG CHANGES FOLLOWING CARDIAC ARREST. Patients admitted to hospital following cardiac arrest are often considered for urgent coronary angiography body’s circulation has to be maintained using extra- for exclusion of coronary artery disease. Whilst the corporeal blood circulation. Then, the heart must be need for this in the setting of obvious cardiac ischaemic stopped and the aorta opened to access the valve. The (typical ECG changes) is obvious, often the ECG surgeon excises the defective valve and implants the changes are non-specific for cardiac ischaemia. To date valve prosthesis. After heart activity resumes, the extra no study has attempted to document the ECG changes corporeal circulation is discontinued and the chest is found in this patient population in the acute and closed. General anaesthesia and cardiopulmonary subacute period following cardiac arrest. bypass can lead to severe disorders of vital functions Researchers: D. Walters; R. Denman; J. Fraser; R. (heart and lungs, brain, kidneys and liver) in the ageing Gomes population, and ultimately, can result in death. LANCELOT ACS: For these reasons, less invasive techniques have A randomised, double-blind, placebo-controlled study emerged. Percutaneous procedures have been of the safety and tolerability of E5555 and its effects on performed routinely for treatment of peripheral and clinical events and biomarkers in patients with non-ST- coronary vascular disease for decades. They also segment elevation acute coronary syndrome. have been used for acute valve disease; balloon mitral and aortic valvuloplasties are performed as The primary objective of the study is to investigate salvage procedures in non-operable patients with the safety and tolerability of E5555 at three dose multiple high-risk or co-morbid conditions. A number levels in patients with acute coronary syndrome. The of differing devices and techniques that could allow secondary objective is to determine the effect of E5555 for percutaneous treatment of mitral, pulmonary and on major adverse cardiac events as well as effect of aortic valves (thus avoiding open-heart surgery) are E5555 on high-sensitivity C-Reactive Protein levels and under development. effect of the study drug on marker of endovascular inflammation. Researchers: D. Walters; C. Aroney; P Pohlner and P Tesar. CT CORONARY ANGIOGRAPHY IN THE ASSESSMENT OF PATIENTS WITH CHEST PAIN: An investigator driven study of the CT Coronary angiography compared to standard chest pain assessment service with exercise stress testing for evaluating patients with chest pain. Researchers; S Seneviratne, M Hansen, N Bett , D Walters, J Ginns. DANUBE: A phase IIa, multi-centre, double-blind, randomised, placebo-controlled trial to evaluate the efficacy, safety and pharmacokinetics of DNB-001 in patients with Clement Lee, Senior Study Coordinator 16 The Prince Charles Hospital Research Report
  5. 5. 2007–2008 Researchers: JHN Bett; D. Walters; R. Chua; S. Seneviratne; T. Christensen. PROTECT PCI: An international study in which data will be collected of patients who are suitable for stenting and who will be treated with one or more drug eluting stents. The primary objective of this study is to compare the stent thrombosis rate of the Endeavour Zotarolimus Eluting Coronary Stent System versus the Cypher Sirolimus-eluting Coronary Stent in a patient population requiring stent implantation. Participants will be followed up for 5 years after the implantation of the stent. Cardiac health will be assessed at a clinic visit at 1 month and then patients will be contacted by phone at 6 months. To check the blood flow through the stent, the patient will have a repeat angiogram 8 months following the initial implant. They will again have a clinic visit at 1 year and 2 years, then phone follow-up continues annually until 5 years post implant. Patients will be randomised in a 1:1 fashion to either placebo plus standard medical care (including aspirin Researchers: D. Walters; M. Pincus; A. Roati; R. Chua; and clopidogrel) or to TRA (oral 40mg loading dose and JHN Bett; S. Seneviratne; C. Lee a daily 2.5mg) once daily plus standard medical care. SATURN: The primary endpoint of the TRACER trial is the Study of coronary Atheroma by inTravascular composite of cardiovascular death, MI, stroke, Ultrasound: effect of Rosuvastatin versus atorvastatin. rehospitalisation for recurrent ischaemia, or urgent The primary objective of SATURN study is to compare coronary revascularisation. The study is event driven the effects of rosuvastatin 40 mg with atorvastatin 80 and will be considered completed when the last mg on the percent atheroma volume (PAV) as measured patient enrolled has been followed for 1 year and the by intravascular ultrasound (IVUS) imaging following predefined number of endpoint events have been 104 weeks of treatment in patients with coronary artery achieved. disease (CAD). Following 104 weeks of treatment in Researchers: JHN Bett; R. Chua; C. Lee. patients with CAD, the secondary efficacy objectives of the study are: (1) to determine whether rosuvastatin MPhil supervision Completed: 40 mg or atorvastatin 80 mg shows regression of PAV M Phil supervision completed in the targeted coronary artery as measured by IVUS; Dr Michael Ray supervised Dr Darren Walters’ MPhil (2) to compare the effects of rosuvastatin 40 mg with atorvastatin 80 mg on the total atheroma volume of the targeted coronary artery as measured by IVUS; and (3) to compare the effects of rosuvastatin 40 mg with atorvastatin 80 mg on lipid and lipoprotein metabolism. The safety objective is to assess the safety and tolerability of rosuvastatin 40 mg and atorvastatin 80 mg during the 104 week treatment in patients with CAD. Researchers: D. Walters; JHN Bett; R. Chua; M. Pincus; S. Seneviratne; A. Small; A. Roati; T. Christensen. TRACER: A multicentre, randomised, double-blind, placebo- controlled study to evaluate the safety and efficacy of SCH 530348 in addition to standard of care in subjects with acute coronary syndrome: Thrombin Receptor Antagonist for Clinical Event Reduction in acute coronary syndrome (TRACER). The Prince Charles Hospital Research Report 17
  6. 6. 2007–2008 Cardiology Dr Tilak Sirisena’s current project involves using Clinical CT coronary angiography in biomarkers for risk stratification of patients undergoing non cardiac surgery. There are also a series of collaborations within the unit. Research Dr Walters collaborated with Natalie Kelly on her project to determine outcomes following ASD closure in the catheter lab. This project won the affiliate’s prize at Centre the cardiac society annual scientific meeting 2007. We are also currently collaborating with Dr Tau Boga in Echocardiography Suite to write up the outcomes for a septal occlusion closure device in the cardiac Clinical Research Fellows: catheterisation laboratory. Dr Andrew McCann Dr Manjeet Junega Dr Walters’ Presentations: Dr Tilak Sirisena • Interventional Cardiology Conference, USA 2008 Dr Peter Larsen • Asian Cardiac Interventional Therapeutics Program, Thailand 2008 Dr Andrew McCann undertook research on Indigenous health and rheumatic fever and subsequently • International Heart Forum in Beijing, China 2007 presented a paper entitled ‘Outcome for indigenous • Chinese Interventional Program, Hong Kong 2007 patients undergoing mitral valvuloplasty’ and • Euro PCR Barcelona 2007 compared this to a cohort of non-Indigenous patients • ANZET Symposium 2007-2008 over 10 years who underwent mitral valvuloplasty for • Kokura Live Program 2006 in Japan rheumatic heart disease. • Singapore Live 2005 & 2008, His paper was presented at the Cardiac Society of • Annual Symposium at the University of Qld at Glen Australia and New Zealand, subsequently the paper Eagles Kuala Lumpur was published as a lead article in Heart, Lung and • University Medical College 2007 Circulation in February 2008. • Update on Endeavour Trial Program Manila, Dr Manjeet Juneja completed a clinical research Philippines, 2007 fellowship with us. He was from the Apollo Centre in • Rotary Humanitarian Mission in Rangoon, Burma, Madras, India. His project was ”The use of Bivalirudin 2005-2007 versus Heparin in Patients with Acute Myocardial • Member of the International Liaison Committee on Infarction.” The paper was presented at AHA and Resuscitation 2006-2008 Cardiac Society and he also presented his research at Peer reviewed and published manuscripts: the Euro PCR conference in 2007. Dr Juneja won a bronze medal for poster presentation • IIb or not IIb. J Am Coll Cardiol. 2008 Oct at the Euro PCR conference and his paper has been 7;52(15):1277-8; author reply 1278. Mishra A, submitted for publication in Euro Interventional Journal Walters D. in 2008. • Invasive management and late clinical outcomes in contemporary Australian management of Dr Peter Larsen undertook research work on the acute coronary syndromes: observations from acute coronary syndrome project. a web based risk the ACACIA registry. Med J Aust. 2008 June stratification for ACS patients. His work with Margaret 16;188(12):691-7.Chew DP, Amerena JV, Coverdale Dahl (ACS Coordinator) was presented at the ACHE SG, Rankin JM, Astley CM, Soman A, Brieger DB; conference at the Cardiac Society of Australia and New ACACIA investigators. Zealand annual scientific session 2008. This research won the poster prize at the meeting. 18 The Prince Charles Hospital Research Report
  7. 7. 2007–2008 • Percutaneous balloon mitral commissurotomy in indigenous versus non-indigenous Australians. Heart, Lung & Circulation. 17(3):200-5, 2008 June. McCann, Andrew B. Walters, Darren L. Aroney, Con N. • 2007 addendum to the National Heart Foundation of Australia / Cardiac Society of Australia and New Zealand Guidelines for the management of acute coronary syndromes 2006.Medical Journal of Australia. 188(5):302-3, 2008 March 3.Aroney, Constantine N. Aylward, Philip. Chew, Derek P. Huang, Nancy. Kelly, Anne-Maree. White, Harvey. Wilson, Michelle blood (2007). Clinical Orthopaedics and Related • Variations in the application of cardiac care in Research, (456), pp. 238-242. Jong M.D., Ray M., Australia.Medical Journal of Australia. 188(4):218- Crawford S., Whitehouse S.L., Crawford R.W. 23, 2008 February 18.Walters, Darren L. Aroney, Constantine N. Chew, Derek P. Bungey, Linden. • Trends in intra-aortic balloon counterpulsation: Coverdale, Steven G. Allan, Roger. Brieger, David. comparison of a 669 record Australian dataset with the multinational Benchmark Counterpulsation • Treatment options and strategies for acute Outcomes Registry. Anaesth Intensive Care. 2007 severe pulmonary embolism.Intern Med J. 2008 Feb;35(1):13-9.Lewis PA, Mullany DV, Townsend S, Aug;38(8):657-67.Hamilton-Craig CR, McNeil K, Johnson J, Wood L, Courtney M, Joseph D, Walters Dunning J, Walters DL, Slaughter R, Kermeen F. DL. • Telmisartan, ramipril, or both in patients at high • Easier, more effective, evidence-based guidelines risk for vascular events.N Engl J Med. 2008 Apr for resuscitation: understanding the changes to 10;358(15):1547-59. Epub 2008 March 31.Yusuf S, the Australian Resuscitation Guidelines 2006.Heart Teo KK, Pogue J, Dyal L, Copland I, Schumacher H, Lung Circ. 2007 Feb;16(1):2-6. Epub 2006 December Dagenais G, Sleight P, Anderson C. 18. Walters D. • Improvement after Angioplasty and Stenting of • Interventional Practice In Australia and New Pulmonary Arteries Due to Sarcoid Mediastinal Zealand – Current Trends. Indian Heart Journal Fibrosis – A Case Report.Heart Lung Circ. 2008 .2007: 59:2 suppl B16-20.Juneja, M. S., Walters, Mar 28. Hamilton-Craig CR, Slaughter R, McNeil K, D.L., Kermeen F, Walters DL. • Comparison of abciximab with “high-dose” • Patient delay in responding to symptoms of tirofiban in patients undergoing percutaneous possible heart attack: can we reduce time to care?. coronary intervention.International Journal of Medical Journal of Australia. 187(5):293-8, 2007 Cardiology. 109(1):16-20, 2006 Apr 28.Gunasekara, Sep 3.Finn, Judith C. Bett, John H Nick. Shilton, Athula P. Walters, Darren L. Aroney, Con N. Trevor R. Cunningham, Carol. Thompson, Peter L. • Early invasive versus conservative strategies for • Investigation of factors relating to unstable angina & non-ST-elevation myocardial neuropsychological change following cardiac infarction in the stent era Cochrane Database of surgery. Perfusion. 22(1):27-33, 2007 January. Systematic Reviews. 3:CD004815, 2006.Hoenig, M Raymond, Paul D. Radel, Michael. Ray, Michael J. R. Doust, J A. Aroney, C N. Scott, I A. Hinton-Bayre, Anton D. Marsh, Neville A. • Increased CD40 ligand expression on platelets • The next generation Endeavor stent: 4 month is associated with cardiovascular events after clinical and angiographic results from the Resolute total hip arthroplasty. Journal of Thrombosis & first-in-man trial. Eurointervention. 2007; 3:50-54. Haemostasis. 4(3):695-7, 2006 March.Ray, M J. Meredith IT, Worthley S, Whitborn R, Walters D, Crawford, S A. Crawford, R W. Jabur, M K. Walters, Popma J, Cutlip D, Fitzgerald P D L. • Platelet and leukocyte activation in salvaged blood • Assessment of statistical change criteria used to and the effect of its reinfusion on the circulating define significant change in neuropsychological The Prince Charles Hospital Research Report 19
  8. 8. 2007–2008 Cardiology • Platelet-monocyte aggregates predict troponin rise after percutaneous coronary intervention and Clinical are inhibited by Abciximab.International Journal of Cardiology. 101(2):249-55, 2005 May 25.Ray, M J. Walters, D L. Bett, J N H. Cameron, J. Wood, P. Aroney, C N. Research • Aprotinin and epsilon aminocaproic acid are effective in reducing blood loss after primary total hip arthroplasty - A prospective randomized Centre double-blind placebo-controlled study. Journal of Thrombosis and Haemostasis, 3 (7), 2005 pp. 1421-1427. Ray M., Hatcher S., Whitehouse S.L., Crawford S., Crawford R. • Novel use of sildenafil in the treatment of test performance following cardiac surgery. portopulmonary hypertension.Journal of Heart & European Journal of Cardio-Thoracic Surgery. Lung Transplantation. 24(4):498-500, 2005 April. 29(1):82-8, 2006 January.Raymond, Paul D. Hinton- Chua, Roderick,. Keogh, Anne. Miyashita, Masami. Bayre, Anton D. Radel, Michael. Ray, Michael J. • Measurement of myocardial fractional flow Marsh, Neville A. reserve is a cost-effective way to identify coronary • Intracardiac echo guided valvuloplasty of a artery lesions of indeterminate severity that stenotic tricuspid prosthetic valve in a patient warrant revascularisation.Heart Lung Circ. 2005 with idiopathic hypereosinophilic syndrome. Dec;14(4):239-41. Epub 2005 August 10.Trivedi S, Echocardiography. 2006 Apr;23(4):324-8.Burstow Aroney CN, Walters DL, Bett JH. DJ, West ML, Walters DL. • Balloon aortic valvotomy in pregnancy. • Platelet-monocyte aggregates predict troponin • Aust N Z J Obstet Gynaecol. 2004 December rise after percutaneous coronary intervention and ;44(6):577-9. Radford DJ, Walters DL. are inhibited by Abciximab.International Journal of Cardiology. 101(2):249-55, 2005 May 25.Ray, • Point-of-care testing shows clinically relevant M J. Walters, D L. Bett, J N H. Cameron, J. Wood, P. variation in the degree of inhibition of platelets Aroney, C N. by standard-dose abciximab therapy during percutaneous coronary intervention.Catheter • Acute Coronary Syndrome Data Set Writing Group. Cardiovasc Interv. 2004 Jun;62(2):150-4.Ray MJ, Acute Coronary Syndrome Data Set Working Group. Walters DL, Bett N, Cameron J, Wood P, Aroney C. National data elements for the clinical management of acute coronary syndromes.Medical Journal of • Partially anomalous pulmonary venous connection Australia. 182(9 Suppl):S1-14, 2005 May 2.Chew, treated by interventional catheterisation. Cardiol Derek P B. Allan, Roger M. Aroney, Constantine N. Young. 2004 April; 14(2):222-4.Walters DL, Radford Sheerin, Noella J. DJ. • Failure of current public educational campaigns • The effect of glycoprotein IIb/IIIa receptor inhibitor to impact on the initial response of patients with on the microcirculation in patients undergoing possible heart attack.Internal Medicine Journal. high-risk coronary stenting; a prospective, 35(5):279-82, 2005 May.Bett, J H N. Tonkin, A M. randomized study. J Thrombolysis. 2003 December; Thompson, P L. Aroney, C N. 16(3):163-6.Wong P, Harding S, Inglessis I, Choi CJ, Walters D, Chang Y, Gimelli G, Jang IK. • Measurement of myocardial fractional flow reserve is a cost-effective way to identify coronary artery • Major pulmonary embolism and shock. Persistent lesions of indeterminate severity that warrant hypotension after thrombolysis treated with revascularisation.Heart, Lung & Circulation. improvised mechanical fragmentation of thrombus. 14(4):239-41, 2005 Dec.Trivedi, Shailendra. Aroney, Med J Aust. 2003 November 3;179(9):495-6. Constantine N. Walters, Darren L. Bett, John Hugh Lapanun W, Walters DL, McCarthy J, Burstow DJ. Nicholas • Coronary stenting for a muscular bridge in a patient with hypertrophic obstructive cardiomyopathy. 20 The Prince Charles Hospital Research Report
  9. 9. 2007–2008 Cardiol Young. 2003 August: 13(4):377-9.Walters DL, Aroney CN, Radford DJ. • Transthoracic left ventricular puncture for the assessment of patients with aortic and mitral valve prostheses: the Massachusetts General Hospital experience, 1989-2000.Catheter Cardiovasc Interv. 2003 April; 58(4):539-44.Walters DL, Sanchez PL, Rodriguez-Alemparte M, Colon-Hernandez PJ, Hourigan LA, Palacios IF • Acute coronary syndrome is a common clinical presentation of in-stent restenosis.Am J Cardiol. 2002 March 1;89(5):491-4.Walters DL, Harding SA, Walsh CR, Wong P, Pomerantsev E, Jang IK. • The use of mechanical devices as adjuncts to • Congenital Long QT Syndrome: Management; intracoronary stenting.Curr Opin Cardiol. 2001 Outcomes and the Role of Cardiac Transplantation. September; 16(5):300-5. Walters DL, Harding SA, Heart Lung Circ. (formerly Asia Pacific Heart Palacios IF, Oesterle SN. Journal). 1999;8:161-164Walters D, Masterson , ML, Radford, DJ. • Adjunctive pharmacotherapy for coronary stenting. Curr Opin Cardiol. 2001 September; 16(5):293-9. Harding SA, Walters DL, Palacios IF, Oesterle SN. • Vascular complications after hemostatic puncture closure device (Angio-Seal) are not higher in overweight patients.J Invasive Cardiol. 2001 September; 13(9):623-5.Wong P, Harding S, Walters D, Hull ML, Jang IK. Associate Professor Con Aroney , Professor Jean Claude Laborde and Associate Professor Darren Walters with a Core Valve implant. The Prince Charles Hospital Research Report 21
  10. 10. 2007–2008 Centre for Professional Linkages: CDAS is the research centre for the Alcohol and Drug Service and has links with the World Health Drug & Alcohol Organisation (WHO), the Australian National Council on Drugs (ANCD), the University of Queensland, Griffith University and Queensland University of Technology. Studies (CDAS) Research Personnel: Ms Donna Simpson Ms Wendy Ducat Mr Jonathon Lee Mr Robert Assan Mr Wilson Mapinga History of the Research Unit: The Centre for Drug and Alcohol Studies (CDAS) is a multi-disciplinary research, education and training team. The purpose of CDAS is to develop, design and implement novel research, to trial clinical interventions, evaluate relevant state policy and program initiatives and to design, develop and deliver innovative education and training. CDAS: Conduct state-wide clinical research projects of critical clinical importance across Queensland Health, with outcomes influencing clinical processes, standards of clinical practice and State and National population health strategies and interventions (l to r): Jonathon Lee and Robert Assan Design, disseminate and evaluate novel clinical interventions for use with people with drug use Alcohol and Drug Services: problems, including those with identified special Name of General Research Area: needs including Indigenous populations and young Alcohol, tobacco and other drug use and related issues people. Alcohol and Drug Services: Provide expert counsel on research and development Clinical Director: and quality improvement activities for the ADS and Dr Jeremy Hayllar State-wide alcohol tobacco and other drugs sector. Major Research Highlights: Alcohol and Drug Services: CDAS was a Collaborating Centre for a World Health Program Manager: Organisation study examining brief interventions with Mr Mark Fairbairn alcohol misuses in 14 countries. The project produced the internationally recognised AUDIT screen for alcohol Statewide Services Program Manager: misuse and an related brief intervention. Dr Carla Schlesinger The development and validation of the Indigenous Centre for Drug and Alcohol Studies (Research) Risk Impact Screen. IRIS is the first Indigenous specific Program Coordinator: screen for mental health and alcohol and other drug Ms Jane Fischer use. T: 3837 5715 The evaluation and dissemination of SmokeCheck, E: a smoking cessation brief intervention and training Address and Affiliations: package. Over 800 health workers Statewide have now Level 4, been trained in SmokeCheck. ‘Biala’ City Community Health Service, 270 Roma Street, Brisbane, QLD 4000 22 The Prince Charles Hospital Research Report
  11. 11. 2007–2008 Current Research Projects: IRIS Screen and Brief Intervention: Indigenous Risk Impact Screen and Brief Intervention Project. The training package is now currently being developed, disseminated and evaluated. Indigenous Smoking Cessation: A smoking cessation brief intervention and training package developed, disseminated and evaluated by the Alcohol and Drug Service. Workforce Development: An action-research project to enhance capacity of services and health staff directed at organisations, teams, individuals and communities Pharmaceutical Misuse: Clinical Trials: As part of a national collaboration, the purpose of The long term outcome of patients undergoing valve this project is to conduct research in on patterns surgery for bacterial endocarditis where intravenous of pharmaceutical misuse and harms by clients drug use is the major risk factor: N. Blackwell; J. undergoing detoxification, are in residential Hallyer; D. Mullany; P. Pohlner; A. Barnett; L. Munck. rehabilitation or on opioid replacement therapy Infectious endocarditis is an extremely serious programs. condition caused by micro-organisms growing in the Nicotine Replacement Therapy: heart, damaging heart valves. Treatment often requires Evaluation of Component Two of the Queensland surgical replacement of the affected valve(s). People Health Smoking Management Policy: Provision of who self-inject with illicit drugs (heroin, speed) risk Nicotine Replacement Therapy (NRT) to Inpatients endocarditis. Injecting drug us is a chronic, relapsing disorder, these patients may be denied appropriate Young People: therapy, even though data suggests they have a AIMS is a structure method for developing rapport and similar prognosis to other patients with endocarditis. speaking with young people about alcohol, tobacco Demonstrating good surgical outcomes will help and other drug use. ensure patients receive the treatment they need. Young People and Tobacco Smoking: A Comparative Analysis of Tobacco Misuse Between Indigenous and Non-Indigenous Teenagers: Implications for Public Health Practice Mindfulness: An USA evaluated method for clinical practice with clients, this project will be the first Australian evaluation of mindfulness. Treatment Outcomes: A whole of Alcohol and Drug Service project aimed at identifying, implementing and evaluating treatment outcome measures for use by alcohol and other drug service programs. Masters Projects (current): Mr Wilson Mapinga. A Comparative Analysis of Tobacco Misuse Between Indigenous And Non-Indigenous Teenagers: Implications for Public Health Practice Publications: For a list of publications please contact CDAS Submissions: (L to R): Donna Simpson and Wendy Ducat For a list of submissions please contact CDAS The Prince Charles Hospital Research Report 23