Alvaro Alonso, M.D., M.P.H., Ph.D.

Alvaro Alonso, M.D., M.P.H., Ph.D. Assistant Professor, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, St. Paul, Minnesota Risk Prediction of Atrial Fibrillation: Clinical, Biological, and Genetic Markers Administered by the NHLBI Division of Cardiovascular Sciences, Epidemiology Branch FY 2009 Recovery Act Funding: $492,694 Additional Funding: Risk Prediction of Atrial Fibrillation: Clinical, Biological, and Genetic Markers Administered by the NHLBI Division of Cardiovascular Sciences, Epidemiology Branch FY 2010 Recovery Act Funding: $474,529 More information about the grant Total funding: $967,223

Research Focus: A heart rhythm disorder called atrial fibrillation affects more than two million Americans. Doctors lack a reliable way to identify people whose lifestyles, genetics, or health conditions put them at high risk.

A team of scientists funded by an NHLBI Recovery Act grant seeks to fill this knowledge gap by developing a more precise atrial fibrillation risk assessment tool. The tool will build on a model created last year by researchers in the landmark Framingham Heart Study. Since that model was based on people living in Framingham, Massachusetts, the new study will test whether it applies to the diverse population of the United States.
The researchers will pool existing data from five population studies conducted across the U.S. to create a sample of more than 30,000 people with over 3,000 cases of atrial fibrillation. Then they will examine the data for biological markers of atrial fibrillation.

"Results from this collaboration will have greater generalizability than results restricted to any one of individual studies," says co-private investigator Alvaro Alonso, M.D., Ph.D., an assistant professor at the University of Minnesota's School of Public Health.

Besides Framingham, the population studies are:

• Age, Gene/Environment Susceptibility-Reykjavik Study
• Atherosclerosis Risk in Communities Studies
• Cardiovascular Health Study
• The Rotterdam Study

These groups already collaborate as part of the ongoing Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium.

"In the past, each scientific study would develop its own risk prediction score, leaving clinicians and patients confused," says co-PI Emelia J. Benjamin, M.D., Sc.M., a professor at Boston University School of Medicine and one of the creators of the Framingham risk assessment model. "Rather than competing, the five community-based studies have collaborated to create one model to predict new-onset atrial fibrillation."

The researchers will determine whether previously unknown biological or genetic markers help to further classify people's risk of atrial fibrillation. They will then develop new statistical methods to rank those risks.

Potential Outcomes: The model is meant to help identify high-risk patients and find the right therapies for them. Doing so could help improve public health, since atrial fibrillation is associated with a higher incidence of stroke, heart failure, and death. It could also lower future health care costs.

The researchers plan to publish their risk model on the Web so doctors and their patients can easily determine a person's risk of atrial fibrillation and compare it to other men or women of the same age.

Economic Impact: The Recovery Act funds will support the hiring of two statisticians, enabling the team to "dramatically accelerate the pace so that this very complicated project can take place within two years," according to Dr. Benjamin.

Dr. Alonso adds that the Recovery Act grant has given him the resources to collaborate with an "outstanding group of researchers" from different institutions across the U.S. and abroad.

Facilitating Mentorship: The team pairs junior and senior investigators to advance early researchers' careers and encourage them to excel at clinical and translational medicine.

"I have the joy of mentoring clinicians and scientists in the early stages of their careers," says Dr. Benjamin.

Benefiting Public Health: "Even though I am a physician by training, I decided that working as an epidemiologist would allow me to have a more beneficial impact on public health," says Dr. Alonso. "I study the distribution of health and disease in the population, and the factors affecting it. I aim to understand better why some individuals have disease. This helps the development of population- and individual-based preventive strategies and also new treatments."

'The best job in America': "Being a clinical cardiologist and a research scientist is a phenomenal honor," Dr. Benjamin says. "The incredible cooperative spirit of my colleagues in the CHARGE consortium is dramatically accelerating the pace of scientific discovery. People in the Framingham Heart Study have participated for up to 61 years, and their only compensation is the knowledge that their generous participation has led to breakthroughs in the prevention of cardiovascular and other diseases.

"I've got the best job in America," she adds. "I'm always busy and never bored - the field is always changing, and I'm always learning."

Outside the Lab: "Outside my work," says Dr. Alonso, "I enjoy spending time with family and friends, the company of a good book, or making the most from the wonderful cultural scene in the Twin Cities."

Dr. Benjamin says, "I have the great good fortune of having a husband, a 19-year-old son, and a 16-year-old daughter who have been very supportive of my career and who bring joy to my life." Her hobbies are reading and spending time with family and friends.

By Sheila Walsh and Stephanie Dutchen

• Read more about this grant in a news release from Boston University

Last Updated:August 10, 2010