Focus on research in acute myocardial infarction and cardiac arrest – including invasive diagnostics and treatment, as well as heart failure, rhythm disturbances, exercise and sports cardiology.
The research group is responsible for the research activity at the Department of Cardiology at Stavanger University Hospital (SUH), and is led by Alf Inge Larsen.
Research areas
The research activity is divided into four subgroups.
Heart failure
Responsible: Kenneth Dickstein and Alf Inge Larsen
Research focusing on characterizing heart failure and treatment options, as well as investigating biological mechanisms associated with recovery.
Myocardial infarction
Responsible: Dennis Nilsen, Stein Ørn and Alf Inge Larsen
Research focusing on strategies to reduce myocardial infarctions, assessing new methods for reducing myocardial injury, and develop new methods to determine the extent of myocardial damage and risk of arrhythmia.
Exercise training in heart disease
Responsible: Alf Inge Larsen
Research focusing on exercise as a treatment option in all aspects of cardiovascular diseases, as well as quality of life.
Response to endurance training in leisure athletes
Responsible: Stein Ørn
Research focusing on the development of new systems to detect heart disease early on and to find optimal levels of physical activity for best health outcome. See also: NEEDED Research Programme (helse-stavanger.no)
Strategy
The general aims are to improve diagnostics and treatment for patients with cardiovascular diseases by:
initiate and run clinical research of high quality at international level
participate in large randomized controlled trials
further develop strong international cooperations
establish a general cardiological biobank
strive to present every patient with the opportunity to participate in a study
Background
It all began with the work of former head physician Leik Woie. He was instrumental in the establishment of the research foundation: Hjertelaget, which was unique on a national level (1988). Woie managed to establish academic medicine in a central hospital where there previously was no university affiliation or tradition of academic work. Thus, the foundation for further academic research on heart disease was made. An important part of Hjertelaget was physical training and rehabilitation, which also became central to the research. The department was well equipped to become an academic department when a formal collaboration with the University of Bergen was established in 2000. Finally, the Central Hospital in Rogaland became Stavanger University Hospital (SUH) in 2005. Research and teaching of medical students became an important part of the hospital's daily production and Leik Woie, as head of the department, was always a key supporter. Kenneth Dickstein continued his research in the 80s-90s. Dickstein later became a central member of the European Society of Cardiology and is one of Norway's most cited researchers. The Department of Cardiology has extensive research production and has educated dozens of doctoral candidates along the way.
The Cardiology Research Group has a long tradition of research on heart failure with emphasis on functional capacity, neurohumoral activation, skeletal muscle, inflammation and haemodynamic changes. The group participated early in both phase 2 and phase 3 studies of drugs for treatment of heart failure. Furthermore, it has had extensive research activity on acute myocardial infarction and cardiac arrest, also with regards to new biomarkers. Finally, there has been a long-term evaluation of exercise in patients with different types of heart disease, where the focus now is on coronary physiological changes after exercise. In line with this, the group has a large study: the NEEDED program, on how participation in exercise races can affect apparently healthy exercisers who are affiliated with, among other things, the North Sea Race.
Projects
Ongoing trials
The BETAMI study investigates whether beta-blockers should be given to all patients after myocardial infarction, or whether it should only be given to selected patient groups. The study is a national multicentre study supported by the Norwegian Research Council, where Stavanger University Hospital is part of the steering group.
Building on the successful results of the COMPLETE study, the COMPLETE-2 study aims to define which lesions benefit from revascularisation based on their physiological significance, rather than assessing the severity of stenosis alone.
This is a large international multicentre study in which 25 countries are participating, and Stavanger University Hospital is the coordinator for Norwegian hospital participation.
The CONCARDPCI study investigates different rehabilitation models in patients with completed emergency treatment: PCI (i.e. coronary artery blockage). The aim of the project is to lay the foundation for a more coherent treatment and rehabilitation pathway, with particular focus on the patient perspective.
The project has broad and interdisciplinary collaboration with the primary health service, patient organisations, self-management networks and seven university hospitals in Norway and Denmark. Stavanger University Hospital is represented in the steering group.
The FAME 3 study is a large international multicentre study, in which Stavanger University Hospital is the only participating Norwegian hospital.
The purpose of the study is to assess whether PCI (i.e. percutaneous coronary intervention) performed based on the FFR index (a measure of coronary blood flow) will give the same outcome as coronary artery bypass surgery in patients with coronary artery disease.
Since 2013, the NEEDED study has evolved into a NEEDED research program that develops new systems to detect erly onset heart disease and find optimal levels of physical activity for highest health benefits.
The NorEx trial is a national multicentre study, led by NTNU, to evaluate exercise training after myocardial infarction. SUH has so far included 500 patients, and is part of the steering committee.
A sub-trial at SUS is also investigating physiological mechanisms, including coronary flow measurement, using a newly developed invasive method.
The PRADA II study is a national multicentre study as a follow-up to the PRADA study. The aim is to gain new insight into the prevention of cardiotoxicity using the drug sacubitril/valsartan as a protective treatment for the heart during breast cancer therapy.
The SMASH 1 study is a collaboration with Akershus University Hospital to establish new methods for early detection of serious heart rhythm disorders. Patients with implanted defibrillators are being studied to better understand the mechanisms of severe cardiac arrhythmia and to identify high-risk patients.
The WESTCOR study is a collaboration with Haukeland University Hospital aiming to compare the safety and effectiveness of the standard procedure for suspected acute coronary syndrome against an algorithm that uses point-of-care troponin tests, in order to start optimal treatment option as rapidly as possible.
The BIOSTAT-CHF study is a large European study, which included over 2500 patients in 60 hospitals in 13 different countries in Europe, where SUS was the only study centre in Norway.
This study had a comprehensive approach to identify patients with treatment outcomes versus those who had no effect, using clinical characteristics, genomics, transcriptomics, metabolomics, proteomics and biomarkers. These data represent a major step towards personalized medicine in patients with chronic heart failure.
ESC CTR surveys I and II were conducted to map real-life practices between different institutions and countries in Europe, on the use of CRT.
CRT is a highly recommended adjunctive therapy to heart failure medicine to reduce mortality and further severe disease. The results of the surveys received attention in the European scientific communities, and are initiated and run by researchers at SUS.
The HORIZONS-AMI study was an international multicenter study funded and led by the Cardiovascular Research Foundation. The main objective of the study was to establish the safety and efficacy of bivalirudin in acute myocardial infarction, as well as to the safety and efficacy of a slow-release medication-dispensing stent. The study ran from 2008 to 2010, and Stavanger University Hospital was the national coordinator and part of the project's steering group.
MITOCARE was a large European multicentre study to investigate the efficacy of a drug to prevent tissue damage during treatment of myocardial infarction.
The NORSTENT trial was a large national multicentre study that included over 9000 participants, and where SUS was one of 8 study centres.
The purpose of the study was to compare long-term effects, as well as differences in risk of death or further myocardial infarction, when treated with two different types of stents after myocardial infarction.
The OPTIMAAL trial was a SUH-initated drug study comparing the efficacy of two drugs in the treatment of high-risk patients after acute myocardial infarction.
The PROSPECT II study was a large multicentre study aimed to assess the ability of intravascular imaging for identifying non-obstructive coronary plaques that may cause future adverse events.
SMARTEX-HF is a multicentre study, led by NTNU, to investigate whether high-intensity interval training is more effective than moderate-intensity exercise for patients with heart failure.
The SYNDEX study is a study to investigate the effects of high-intensity aerobic interval training in patients with angina and no obstructive coronary artery disease, both on the functional capacity and quality of life.
The TRA 2°P-TIMI 50 study is a multicentre study conducted by the TIMI Study Group, which is an academic research organisation at Bingham & Women's Hospital and affiliated with Harvard Medical School in Boston, USA (TIMI STUDY GROUP (timi.org)) involving the Research Group of Cardiology at SUH.
The study investigated whether a new drug, combined with standard preventive treatment, in patients with atherosclerosis would reduce the risk of myocardial infarction and stroke in this patient group.
SUH was the national coordinator and part of the steering group.
