Translational Study of Hostility, Atherothrombosis & CAD

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DESCRIPTION (provided by applicant): This K23 application is a request to enable Dr. Daichi Shimbo to develop into an independent, translational researcher with expertise in preventive cardiology. He has training in cardiology and has had some previous experience in conducting basic science research, but lacks some fundamental skills that would allow him to become an independent researcher in this field. His short-term goals are to strengthen his theoretical, methodological, and statistical skills in clinical trials, in the basic sciences, and in preventive cardiology. His long-term goals are to develop an independent lab funded by external sources, to train and mentor future clinical researchers, and to develop a network of research scientists devoted to preventive cardiology. This award will aid Dr. Shimbo in attaining his short- and long-term goals by providing time and resources for him to acquire knowledge and expertise in the following five modules: (1) clinical trials design, (2) statistics, (3) basic science methodology relevant to patient-oriented research, (4) preventive cardiology, and (5) medical research dissemination. The NIH-sponsored K30 Research Curriculum, the Integrative & Behavioral Cardiology Program, and the Cardiovascular Biology Research Laboratory make Mount Sinai School of Medicine an ideal environment for this training. Dr. Thomas Pickering is an ideal sponsor of this award because of his world-renowned expertise in preventive cardiology. Because established risk factors do not account for all patients who develop the acute coronary syndromes (ACS), the search for "non-classic" risk factors has emerged. Evidence suggests that one such factor, hostility, independently predicts ACS events. The exact biological mechanisms underlying the hostility-ACS link have not been elucidated. Inflammation and platelets play central roles in the development of the ACS, and thus hostility may increase ACS risk through the inflammation and platelet-thrombosis pathways. The goals of the proposed research program are (1) to examine whether higher levels of hostility are associated with increased levels of inflammatory markers and platelet reactivity, and (2) to examine whether hostility reduction decreases levels of inflammatory markers and platelet reactivity. Data from this translational research program will allow Dr. Shimbo to establish an empirical foundation from which to apply these data to the development of effective preventive interventions for hostile patients.