FYI from the NHLBI Index
May 2003: Vol. 4, Issue 1
In the News
News from Capitol Hill
- FY 2004 Appropriations Hearings
- Selected Legislation Related to the NIH
- Other Bills and Resolutions
Recent Advances from the NHLBI
- MRI Provides Better Way to Diagnose Heart Attacks
- Low-Dose Warfarin Prevents Recurrence of Blood Clots
- Findings Suggest Revised Approach to Therapy for Atrial Fibrillation
- Hydroxyurea Therapy Improves Survival of Patients Who Have Severe Sickle Cell Anemia
Fiscal Year (FY) 2004 Appropriations Hearings
On April 2 and 8, Dr. Zerhouni testified before the House Appropriations Subcommittee on Labor,
Health and Human Services, and Education on behalf of all NIH Institutes and Centers, including the NHLBI.
The Senate appropriations hearing for the NIH also was held on April 8. At the hearings, Dr. Zerhouni, Dr.
Lenfant, and other Directors highlighted specific areas in which the NIH has made progress over the past years
and described future opportunities. Representative Wicker (R-MS) asked Dr. Lenfant specifically about the
NHLBI-supported Jackson Heart Study, and Senator Specter (R-PA) asked Dr. Lenfant and Dr. Stephen Katz,
Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, about NIH research on
scleroderma. Dr. Lenfant’s written testimony for the Senate Subcommittee on Labor-HHS-Education Appropriations
and program highlights submitted as part of the FY 2004 budget justification are
available through www.nhlbi.nih.gov/funding/fromdir/index.htm.
Selected Legislation Related to the NIH
Representative Kevin Brady (R-TX) introduced the
Pulmonary Hypertension Research Act of 2003 (H.R. 1316) to
expand NHLBI support of research on pulmonary hypertension. If passed, it would require the NHLBI to develop centers
dedicated to research and education efforts on pulmonary hypertension, and a data system for the collection, analysis,
and dissemination of information related to pulmonary hypertension research.
The bill was referred to the House Energy and Commerce Committee.
Representative Carolyn McCarthy (D-NY) introduced the
Diamond-Blackfan Anemia Act (H.R. 894). The bill,
which was referred to the House Committee on Energy and Commerce, would require
the NIH to expand and intensify research regarding Diamond-Blackfan Anemia.
Representative Stephen Lynch (D-MA) introduced the
Women’s Autoimmune Diseases Research and Prevention Act (H.R. 370),
which also was referred to the House Committee on Energy and Commerce. The bill would require the NIH
Autoimmune Diseases Coordinating Committee to expand,
intensify, and further coordinate research on autoimmune diseases in women.
In February, the House passed the Human Cloning Prohibition Act of 2003 (H.R. 534). A similar bill,
S. 245, was introduced by Senator Sam Brownback (R-KS) and referred to the Senate
Committee on Health, Education, Labor, and Pensions.
Another bill, the Human Cloning Ban and Stem Cell Research Protection Act of 2003 (S. 303), was introduced by
Senator Orrin Hatch (R-UT) and has been assigned to the Senate Judiciary Committee.
Other Bills and Resolutions
Senator Richard Durbin (D-IL) introduced the
Donor Outreach, Network, and Timely Exchange (DONATE) Act (S. 376),
which was referred to the Senate Committee on Health, Education, Labor, and Pensions. If passed, the bill
would promote organ donation and facilitate interstate linkage and 24-hour access to state donor registries.
Representative Jeff Miller (R-FL) introduced H. Con. Res. 45 to emphasize the importance of organ, tissue,
bone marrow, and blood donation and support National Donor Day (February 14). The resolution acknowledged the
efforts of many professional and patient organizations, several of which have participated in NHLBI PIO meetings:
- the Juvenile Diabetes Research Foundation International
- the Leukemia and Lymphoma Society of America
- the National Minority Organ and Tissue Transplant Education Program
Representative Cliff Stearns (R-FL) introduced H. Con. Res. 6 to support the
establishment of Chronic Obstructive Pulmonary Disease (COPD) Awareness Month.
Representative Luis Gutierrez (D-IL) and Senator Harry Reid (D-NV) introduced H. Con. Res. 30 and Sen. Con. Res. 33,
which include a statement that the NIH should continue to take a leadership role in
research and should host a symposium to identify research priorities.
Through Sen. Res. 98, Senator Ben Nighthorse Campbell (R-CO) asked President Bush to issue a proclamation
designating October 12-18, 2003, as National Cystic Fibrosis Awareness Week.
Recent Advances from the NHLBI
MRI Provides Better Way to Diagnose Heart Attacks
Advanced magnetic resonance imaging (MRI) technology can detect heart attacks in emergency room
patients with chest pain more accurately and faster than traditional methods. Findings of an NHLBI-supported
study suggest that more patients who are suffering a heart attack could be identified as candidates for treatment to
reduce or prevent permanent damage to the heart if they were assessed with MRI. "Using MRI to detect heart problems
in the emergency department will ultimately save lives," said Dr. Lenfant. "Because patients will be
diagnosed and treated more quickly, cardiac MRIs might save costs as well."
Low-Dose Warfarin Prevents Recurrence of Blood Clots
A study of long-term, low-dose warfarin to prevent the recurrence of two blood clotting disorders, deep vein
thrombosis (DVT) and pulmonary embolism, resulted in such a high degree of benefit to the patients — without significant
adverse effects — that the NHLBI stopped the study early. Compared with those taking a placebo, the participants in the
Prevention of Recurrent Venous Thromboembolism (PREVENT) trial who received warfarin were 64 percent less likely to
experience subsequent episodes of DVT and pulmonary embolism.
Findings Suggest Revised Approach to Therapy for Atrial Fibrillation
The most frequently used initial therapy for patients who have atrial fibrillation is treatment to
restore and maintain normal heart rhythm. However, the Atrial Fibrillation Follow-up Investigation of Rhythm
Management (AFFIRM) found that the "heart rhythm" strategy prevents no more deaths than treatment to merely
control the rate at which the heart beats. Furthermore, researchers found that the "heart rhythm" approach does
not result in a lower risk of stroke, nor does it improve the patient’s quality of life or cognitive function
— all of which had been presumed to be benefits over the "heart rate" strategy.
The "heart rate" strategy may also be
associated with lower health care costs. Drugs used to control heart rate tend to be less expensive, and as Dr. D.
George Wyse, chair of the AFFIRM steering committee, explained, "[investigators] found that patients in the rhythm
control group were more likely to be hospitalized,
and hospital costs account for the majority of total medical costs."
Hydroxyurea Therapy Improves Survival of Patients Who Have Severe Sickle Cell Anemia
An NHLBI-supported study recently revealed that hydroxyurea therapy not only protects adults who have sickle
cell anemia from painful crises and a pneumonia-like illness called acute chest syndrome, but also prolongs their
lives. Even the sickest patients — those who suffered three or more crises a year — benefited. Because severely ill
patients require more emergency room visits and
hospitalizations than those who have less severe disease, the results have important implications both for patient
care and for decreasing health care costs. According to lead
investigator Dr. Martin Steinberg, Director of the Center of Excellence in Sickle Cell Disease at Boston
University School of Medicine, "Presently only a minority of eligible patients are taking hydroxyurea. Our study
strongly suggests that adults with sickle cell anemia and clinically significant complications of their disease, like
frequent painful episodes and the common pneumonia-like events, should take hydroxyurea under the supervision of a
knowledgeable physician. Most people who take this medication will feel better; we now know they will live longer."
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