The candidate, Samia Mora, MD, MHS, is an Assistant Professor of Medicine in the Divisions of Preventive and Cardiovascular Medicine at the Brigham and Women's Hospital, Harvard Medical School. She is trained and certified in Cardiovascular Medicine and has an MHS in Epidemiology from the Johns Hopkins Bloomberg School of Public Health. Her long-term career goal is to become a leader in the field of cardiovascular disease (CVD) prevention and epidemiology. To realize this goal, she has developed a mentor-based research career development plan which provides training to achieve 3 short-term goals: 1) to gain understanding and competence in lipid and lipoprotein risk factors, cardiometabolic disorders, and women's health, 2) to gain experience and skills necessary to design, manage, and interpret large prospective studies and clinical trials, and 3) to develop professional and career-building leadership skills. Current prevention guidelines recommend measurement of standard lipids to assess CVD risk and focus on LDL cholesterol lowering as the primary target of therapy. These guidelines do not recommend the routine measurement of novel lipoproteins since it is unclear whether they contribute CVD risk information beyond standard lipid measurements. The central goal of this research proposal is to ascertain whether novel lipoproteins are better measures of cardiometabolic risk than standard lipids for the primary prevention of CVD and type 2 diabetes. We propose to conduct a comprehensive study of novel lipoproteins (immunoassay-measured apolipoproteins and nuclear magnetic resonance-measured lipoproteins) in relation to incident CVD and type 2 diabetes in apparently healthy individuals and those with the metabolic syndrome, with and without statin therapy.
Specific Aim 1 tests the association of novel lipoproteins in predicting incident CVD and type 2 diabetes.
Specific Aim 2 tests whether novel lipoproteins add to the definition of the metabolic syndrome in relation to risk of CVD and type 2 diabetes.
Specific Aim 3 examines changes in novel lipoproteins that result from statin therapy and their association with CVD risk reduction in individuals with and without the metabolic syndrome.
Despite the extensive burden of CVD and type 2 diabetes, approximately 140 million asymptomatic US adults are classified as low risk by current guidelines that rely on standard lipid tests. There is an unmet need for better risk assessment and cost-effective therapies in this large number of asymptomatic adults. Novel lipoproteins may advance risk detection and therapies for CVD and metabolic diseases.
|Ndumele, Chiadi E; Matsushita, Kunihiro; Astor, Brad et al. (2014) Apolipoproteins do not add prognostic information beyond lipoprotein cholesterol measures among individuals with obesity and insulin resistance syndromes: the ARIC study. Eur J Prev Cardiol 21:866-75|
|Mora, Samia; Buring, Julie E; Ridker, Paul M (2014) Discordance of low-density lipoprotein (LDL) cholesterol with alternative LDL-related measures and future coronary events. Circulation 129:553-61|
|Mora, Samia; Akinkuolie, Akintunde O; Sandhu, Roopinder K et al. (2014) Paradoxical association of lipoprotein measures with incident atrial fibrillation. Circ Arrhythm Electrophysiol 7:612-9|
|Akinkuolie, Akintunde O; Mora, Samia (2013) Are there sex differences in acute coronary syndrome presentation?: a guide through the maze. JAMA Intern Med 173:1861-2|
|Mazer, Norman A; Giulianini, Franco; Paynter, Nina P et al. (2013) A comparison of the theoretical relationship between HDL size and the ratio of HDL cholesterol to apolipoprotein A-I with experimental results from the Women's Health Study. Clin Chem 59:949-58|
|Mora, Samia; Glynn, Robert J; Boekholdt, S Matthijs et al. (2012) On-treatment non-high-density lipoprotein cholesterol, apolipoprotein B, triglycerides, and lipid ratios in relation to residual vascular risk after treatment with potent statin therapy: JUPITER (justification for the use of statins in prevention: an inte J Am Coll Cardiol 59:1521-8|
|Mora, Samia (2012) Aspirin therapy in primary prevention: comment on ""effect of aspirin on vascular and nonvascular outcomes"". Arch Intern Med 172:217-8|
|Khera, Amit V; Mora, Samia (2012) Fasting for lipid testing: Is it worth the trouble? Arch Intern Med 172:1710-2|
|Mackey, Rachel H; Greenland, Philip; Goff Jr, David C et al. (2012) High-density lipoprotein cholesterol and particle concentrations, carotid atherosclerosis, and coronary events: MESA (multi-ethnic study of atherosclerosis). J Am Coll Cardiol 60:508-16|
|Mora, Samia; Wenger, Nanette K; Demicco, David A et al. (2012) Determinants of residual risk in secondary prevention patients treated with high- versus low-dose statin therapy: the Treating to New Targets (TNT) study. Circulation 125:1979-87|
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