Patient Centered Approaches to Preventing ASCVD Events

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7. Project Summary/Abstract As a cardiologist cross-trained in epidemiology, Dr. Mora has devoted her career to patient-oriented cardiovascular prevention research, focusing on modifiable risk factors, particularly lipids. Her independent contributions to the field of prevention resulted from a succession of in-depth studies examining the clinical utility of alternative lipid testing for cardiovascular risk prediction and management. She has served as a primary research mentor for more than twenty pre- and post-doctoral trainees in patient- oriented research projects. This has been highlighted in recent years by the achievements of her mentees in presenting their work nationally and internationally, with recognition by the American Heart Association Young Investigator Award and Best of Science abstract sessions. At the national level, Dr. Mora has also been active in promoting cardiovascular careers for women postdoctoral fellows. The candidate's experienced Mentoring Committee, ongoing patient-oriented research, exceptional institutional resources, and cost-effective collaborations provide a nurturing environment for the training and career development of junior investigators in patient-oriented cardiovascular disease research. The new research aims proposed in this award will evaluate lipid-related risk of atherosclerotic cardiovascular disease (ASCVD) among two populations of patients: those who are treated with statins and those who suffer from premature myocardial infarction. This has important clinical implications as new therapeutic strategies targeting lipids are rapidly emerging and already in clinical use. Currently, statin therapy is the cornerstone of dyslipidemia management and cardiovascular prevention and treatment. However, the majority of events (70%) among statin-treated individuals remain unprevented and common (1 in 7 statin-treated individuals). To this date, the mechanisms underlying this “residual risk” are unclear. While it is commonly believed that the risk factors responsible for ASCVD events among statin- treated individuals are the same as those among statin-naïve individuals, new data suggest there may be differences. Furthermore, while overall ASCVD mortality has declined in the US in the past decade, there has been no decrease or even an increase in mortality in younger adults recently, in particular for women. The impact of the study is to improve clinical outcomes by identifying lipid-related determinants of vascular risk and to grow and strengthen Dr. Mora's patient-oriented research program into a formal individualized program of mentoring with a focus on lipid risk factors. In sum, the proposed mentoring and research activities of this K24 project will provide numerous excellent training opportunities for junior investigators interested in patient- oriented cardiovascular research.