This is a NIH Pathway to Independence Award (K99/R00) grant proposal, intended to promote the career of Dr. Christy Avery, PhD, a post-doctoral fellow at the University of North Carolina, into a path of independent research. The Candidate is a trained epidemiologist with a significant track record of research in the field of cardiovascular disease epidemiology. Her goal is to integrate these skills with focused training in clinical research to become an independent scientist at the interface of basic science, clinical practice, and population research. The topical area for the proposed experiential development is translational research in heart failure. During the mentored K99 phase the Candidate will expand her clinical research skills by interacting with clinical specialists who are productive scientists in heart failure research, engaging in formal didactics, attending multidisciplinary seminars, journal clubs, and scientific meetings, participating study activities with her mentors, and by leading a project that develops novel heart failure classification tools applicable to clinical practice and population research. These activities will be supervised by mentor Dr. Gerardo Heiss MD PhD, Kenan Professor of Epidemiology and co-mentor Dr. Patricia Chang, MD MHS FACC, Assistant Professor of Medicine. In addition, a team of collaborators with complementary areas of expertise will supplement Dr. Avery's training in specific areas. Together, the mentor, co-mentor, and collaborators are fully committed to assisting the Candidate reach her research training and career development goals and to ensuring the Candidate's successful transition from postdoctoral fellow to independent researcher. During the independent R00 award phase, the Candidate will apply the tools developed during the K99 component in the cohort of the ongoing Atherosclerosis Risk in Communities (ARIC) Study. For this purpose the ARIC study investigators are making available data on the cohort's follow-up calls, their physician visits, emergency department visits and hospitalizations, and the associated diagnoses. This information base will be combined with outpatient and inpatient Medicare claims data and reports by participant's treating physicians to estimate the burden of heart failure and its patterns of diagnosis and care in ARIC Study participants. The Candidate also will characterize the transition from heart failure managed in outpatient settings to acute/decompensated heart failure events requiring hospitalization. The proposed research is both novel and of major potential for translation, with possible relevance for early diagnosis and proactive management of heart failure as well as for health services allocation and program evaluation. The short term benefits from this study will be a contribution to the under- studied area of quantifying the outpatient burden of HF and its secular trends in communities.

Public Health Relevance

Heart failure is a common, costly, disabling, and often fatal disorder that places a tremendous burden on healthcare systems worldwide. Estimates of the community heart failure burden are essential for health services allocation and program evaluation, yet few programs quantifying the burden of heart failure currently exist. Results from this study will help measure the prevalence of heart failure and how it has changed through time in the United States.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Transition Award (R00)
Project #
5R00HL098458-04
Application #
8319476
Study Section
Special Emphasis Panel (NSS)
Program Officer
Cooper, Lawton S
Project Start
2011-08-15
Project End
2014-05-31
Budget Start
2012-06-01
Budget End
2013-05-31
Support Year
4
Fiscal Year
2012
Total Cost
$248,988
Indirect Cost
$80,753
Name
University of North Carolina Chapel Hill
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Caughey, Melissa C; Loehr, Laura R; Cheng, Susan et al. (2015) Associations between echocardiographic arterial compliance and incident cardiovascular disease in blacks: the ARIC study. Am J Hypertens 28:81-8
Hardy, Shakia T; Loehr, Laura R; Butler, Kenneth R et al. (2015) Reducing the Blood Pressure-Related Burden of Cardiovascular Disease: Impact of Achievable Improvements in Blood Pressure Prevention and Control. J Am Heart Assoc 4:e002276
Seyerle, Amanda A; Young, Alicia M; Jeff, Janina M et al. (2014) Evidence of heterogeneity by race/ethnicity in genetic determinants of QT interval. Epidemiology 25:790-8
Wyss, Annah B; Weissler, Mark C; Avery, Christy L et al. (2014) Single nucleotide polymorphisms in nucleotide excision repair genes, cancer treatment, and head and neck cancer survival. Cancer Causes Control 25:437-50
Caughey, Melissa C; Avery, Christy L; Ni, Hanyu et al. (2014) Outcomes of patients with anemia and acute decompensated heart failure with preserved versus reduced ejection fraction (from the ARIC study community surveillance). Am J Cardiol 114:1850-4
Patel, Mehul D; Kalbaugh, Corey A; Chang, Patricia P et al. (2014) Characteristics and outcomes of patients with acute decompensated heart failure developing after hospital admission. Am J Cardiol 114:1530-6
Avery, C L; Sitlani, C M; Arking, D E et al. (2014) Drug-gene interactions and the search for missing heritability: a cross-sectional pharmacogenomics study of the QT interval. Pharmacogenomics J 14:6-13
Avery, Christy L; Der, Jane S; Whitsel, Eric A et al. (2014) Comparison of study designs used to detect and characterize pharmacogenomic interactions in nonexperimental studies: a simulation study. Pharmacogenet Genomics 24:146-55
He, Qianchuan; Avery, Christy L; Lin, Dan-Yu (2013) A general framework for association tests with multivariate traits in large-scale genomics studies. Genet Epidemiol 37:759-67
Deo, R; Nalls, M A; Avery, C L et al. (2013) Common genetic variation near the connexin-43 gene is associated with resting heart rate in African Americans: a genome-wide association study of 13,372 participants. Heart Rhythm 10:401-8

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