Contents:

• Overview
• Outstanding and special features of the Program

Overview

The training program in Interventional Cardiology is an ACGME approved, dedicated one year program based at FAHC, the primary teaching hospital of the University of Vermont School of Medicine. Two training positions are available each year. The program places a significant emphasis on a variety of research areas relevant to interventional cardiology as well as providing trainees with experience in all aspects of coronary intervention.

Questions regarding the program should be directed to Matthew W. Watkins, M.D., Director Interventional Cardiology, McClure 1, Cardiology Unit, FAHC, Burlington, VT 05401

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* Excellent academic leadership including Dr. Martin M. LeWinter, M.D. a world recognized expert in cardiac muscle mechanoenergetics and heart failure, and Dr. Burton Sobel, a world recognized expert in coagulation and fibrinolysis has created an educational environment designed to foster excellence in clinical skills development and acquisition of medical knowledge. IC residents are exposed to and have substantial opportunities to participate in basic and clinical research in ischemic heart disease including the SCOR in ischemic heart disease, evaluation of human cardiomyocyte function, examination of intracoronary markers of coagulation and platelet activation in PTCA patients, the interplay of diabetes and CAD and numerous multi-center clinical trials in acute coronary syndromes and new therapeutic devices. The academic nature of the training environment is further underscored by frequent national speakers at the Sugarbush Conference, NECC Conference and Interventional Grand Rounds.

* Full range of patients (including adults with congenital heart disease) and clinical issues in a busy IC program (>900 PCI/year by IC faculty) allowing large but not overwhelming IC resident volume and a full range of current interventional techniques. The program allows for significant time not in the interventional laboratory (approximately 25%) and encourages breadth of clinical expertise and medical knowledge in IC residents.

* Participation in novel research in the treatment of ischemic heart disease including intracoronary angiogenic gene therapy, distal protection devices and drug-eluting stents.

* A collegial atmosphere which provides close faculty supervision of IC residents during all aspects of patient care and IC training.

* Limited commitment of service by IC residents to unrelated CVD program elements (2< weeks/year).

* Participation in the Northern New England Cardiovascular Disease Study Group (NNE). The NNE is recognized as a national leader in patient outcome research and quality improvement related to PCI.

* Substantial integration of research programs between the Department of Biophysics and Physiology, Pharmacology and the Cardiology Unit exemplified by the NIH Training Grant.

* The addition of Drs. Dauerman and Kabbani in 2001 has expanded the IC faculty to four full-time interventional cardiologists and provided a significant expansion of clinical research activity.

Key Faculty, Recent Research Activity

1. David Schneider's research interests in platelet reactivity and intracoronary modulation of coagulation have led to a variety of human protocols involving interventional patients. Current protocols approved by the IRB which involve current IC residents, future IC residents and key faculty include

* Differential effects of Abciximab and Tirofiban on platelet reactivity following PTCA.

* Coagulation and fibrinolysis in coronary artery disease; predictors of unstable coronary syndromes and future events.

* Clopidogrel effects on platelet reactivity in acute coronary syndrome patients undergoing PTCA.

* Is thrombin rebound following PTCA modified by IIB/IIIA inhibitors. Follow-up to previous report of Schneider and Watkins

* Asprin does not potentiate effects of Ticlopidine.

* Core laboratory and steering committee for the BARI II Trial evaluating glucose control and revascularization strategies in diabetic patients with CAD.

2. Matthew Watkins' research interests have focused on therapeutic angiogenesis, treatment of SVG disease and regional outcomes in PCI. Recent protocols involving IC residents include

* AGENT Trial (Circ, 3/02), the first trial of intracoronary gene therapy for angiogenesis in CAD.

* Ongoing clinical trials in therapeutic angiogenesis including initiation of the phase III international trial (AGENT III) and steering committee membership.

* Multiple clinical trials to evaluate distal protection devices for SVG.

* NNE outcomes analysis including improved outcomes in SVG treatment and current regional treatment of acute MI.

3. Harry Dauerman's research interests have focused on coronary inflammation following PCI, the evaluation of new devices in PCI and outcomes in acute MI and cardiogenic shock. Current protocols involving IC residents include

* Inflammatory markers influence PCI outcomes.

* Regional and Interventional outcomes in cardiogenic shock (GRACE registry).

* Drug-eluting stent trials, DELIVER and TAXUS IV (with Dr. Watkins).

4. Samer Kabbani's research activity as a recent IC resident have been continued in his faculty role. Current projects include

* Platelet reactivity influences cardiac outcomes following PCI.

* Coronary perfusion protection with side-hole guide catheters improves PCI outcomes (MESH Trial), a local trial funded by SCIMED.

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