Research at St. Francis Hospital
The Portfolio Expands
Jane Cao, M.D., MPH, FACC
Director of Research and Education
Research continues to grow at St. Francis Hospital. Last year we had a record high number of more than 50 publications from original research. In addition, there are numerous published review papers, editorial comments, expert opinions and book chapters. While most of the research accomplishment is centered in cardiovascular medicine there is promising research growing in oncology, orthopedic and general surgery, pharmacy, and nursing care.
A year ago we published the first research newsletter. Because of the positive feedback we have decided to publish a new edition every year. The website is your best source for research related news. Nonetheless, our annual newsletter allows us to summarize the most important research accomplishments at St. Francis Hospital. Led by Elizabeth Haag, RN, Administrative Director of Research, our talented research assistants, Jonathan Scheiner and Anne Li, did a fabulous job creating synopses for each of the major publications. They helped to translate advanced research into relatable clinical knowledge. I greatly appreciate their help. Aside from highlighted research, you can read the entire bibliography at the end, which includes all research publications in 2018 and a partial list in 2019.
While the names of the principal investigators appear on the publications most of the time, there are many more individuals – including nurses, technologists, research coordinators, assistants, and scientists – behind each publication, as research is truly a team endeavor. I would also like to thank many of our research volunteers who participate in research studies by placing their full trust in the institution and in the hands of our physicians to make it possible for us to advance medicine by way of research. I also want to express my gratitude to St. Francis Hospital Foundation President, Dr. Alan Guerci and Mr. Herbert McCooey, Chairman. It is the vision and the generosity of the Foundation, for more than two decades, which has made it possible to transform St. Francis Hospital from a clinical institution to a premier research center. We, the research community, are very proud to continually contribute to the advancement of medicine and more importantly to deliver the most advanced diagnostic and therapeutic options to the patients we serve.
The Vision of St. Francis Hospital Research: The President’s PerspectiveCharles L. Lucore, M.D., MBA
At St. Francis Hospital, our vision embraces being the best in all we do to assist our patients during their most vulnerable moments. Our translational research programs provide the opportunity to bring our patients the latest advances in cardiovascular medicine, orthopedics, and oncology that have moved from the bench top to the bedside in nationally recognized centers like St. Francis Hospital. The St. Francis Hospital Research Foundation has had a prominent role in research related to Interventional Cardiology, Electrophysiology, Cardiovascular Surgery, and Cardiac Imaging since its inception by Dr. Alan Guerci over three decades ago. Our Research Center enters this new decade with the hope and promise of bringing more leading edge programs to expand the opportunities that our patients have to receive the latest and greatest advances in translational research extending over many disciplines in medicine.
We now celebrate the expansion of research to medical oncology with the inception of a partnership between Catholic Health Services of Long Island and Roswell Park. Over the past five years,
St. Francis Hospital has become one of the world’s leaders in advanced imaging technology and in coronary physiology testing, being involved in many of the ground-breaking trials that promise to further advance the technique of precision coronary intervention, improving the care of our patients. At the same time, we have been leaders in trials associated with structural heart disease, and were principals in landmark trials that have established Transcatheter Aortic Valve Replacement as a viable option for many with aortic valve disease and are currently participating in important trials related to the treatment of mitral valvular disease. Our Electrophysiology team has trials associated with the determinants of recurrent atrial fibrillation, the role of implantable loop monitors, and the utility of new devices for left atrial appendage closure to prevent thromboembolic events related to arrhythmias. Our research protocols in cardiac MRI, CT, Echo, and PET, include innovative techniques like computational fluid dynamics, artificial intelligence, fast cardiac MR imaging, 4D blood flow imaging, and 3D printing. Our orthopedic and neuroscience groups are expanding minimally invasive treatment options that will expedite the recovery of patients with joint disease and neurovascular conditions like cerebral aneurysms and stroke.
In summary, as we enter the new year, the future of research over the next decade and beyond is bright at St. Francis Hospital as we expand opportunities to afford our patients the latest ground breaking developments in medical research. We will continue to expand our research enterprise to new service lines like oncology, orthopedics, and neurovascular medicine. With the strong support of the St. Francis Hospital Foundation, our patients and the medical community, I am optimistic that research at St. Francis will continue to grow and prosper for the years ahead.
The History of St. Francis Research: A Founder’s Perspective
Alan Guerci, M.D., CEO
St. Francis Hospital began in the 1930s as a sanitarium for children with rheumatic fever. With the advent of penicillin and the near-total eradication of rheumatic fever in the late 1940s and early 1950s, St. Francis had to reinvent itself. It became a heart center, complete with an open heart surgery program, a dog laboratory for surgical research, and its own journal.
St. Francis Hospital became a designated heart center in the late 1970s and conducted regional and national recruiting efforts to attract elite cardiologists and cardiac surgeons. In 1988, Dr. Joseph Levine was recruited from Johns Hopkins to begin an electrophysiology program. Dr. Levine brought with him the first wholly intracardiac lead system for implantable defibrillators and leadership of randomized clinical trials that defined the indications for defibrillator implantation. This included MADIT 1 and DEFINITE, which demonstrated that implantable defibrillators reduce mortality in high risk asymptomatic patients with and without ischemic cardiomyopathy.
Simultaneously, the hospital raised money to endow a clinical research program. This program began with the St. Francis Heart Study, a combination natural history study and randomized clinical trial of electron beam CT scanning to identify and treat patients with high levels of coronary calcification and coronary disease risk. The study demonstrated that the coronary calcium score predicted coronary disease risk more accurately than conventional risk factors and that the combination of coronary calcium score plus risk factors predicted atherosclerotic cardiovascular disease events more accurately than either one alone.
Around the time that enrollment in the St. Francis Heart Study was completed, the hospital developed clinical and research programs in non-invasive cardiac imaging. These programs have complemented research in the cardiac catheterization laboratory and clinical work generally. To date, clinical research has expanded to include all subspecialties of cardiovascular disease and beyond.
Commitment of St. Francis IRB
Mitchell Chorost, M.D.
Chairman, SFH IRB
The St. Francis Hospital’s Institutional Review Board (IRB) is a designated group responsible for reviewing and monitoring research involving human subjects. Created in 1985,the St. Francis IRB consists of members who are well versed in the elements of informed consent, institutional processes of research, compliance with relevant regulations and ethical guidelines. The purpose of the IRB is to protect the rights, welfare and well-being of human research participants, recruited to participate in research conducted or supported by the staff at St. Francis Hospital. This occurs by ensuring compliance with relevant local, state and federal laws and regulations as well as ensuring compliance with CHS, FDA and NIH policies and regulations.
Federal law requires that an IRB review and approve any research involving human subjects before a subject is enrolled into a research study, study procedures begin or data collected. For ongoing projects, an annual review is necessary as is a mid-course review if protocol changes occur or unanticipated participant risks are identified. A legally effective informed consent must be obtained from study participants, or the IRB must approve a request to waive or alter the requirements of informed consent. Additionally, the IRB will provide guidance to investigators to ensure sound research design, scientific integrity, and determining if the research contributes to generalizable know-ledge and is worth exposing subjects to risk.
We are available to answer any relevant research questions and assist in the safe collection of data.
Hearts in Research
“What makes me come to work every day is watching the cutting-edge research that we do change the lives of our patients and their families’ right before our eyes. Not many researchers see their work in practice and that makes all the difference." - Jonathan Weber, Research Analyst
“I am very happy to be part of this research team with cutting edge technology and elite group of personnel that is making differences for the world.” - Josh Cheng, Cardiac MRI Chief Technologist
“I have been a clinical provider in the area of cardiovascular disease for over 30-years. Being involved in research provides me with the opportunity to participate in the development of emerging technologies and therapies. Moreover, I am able to work with leaders in the field and research sponsors that are developing the latest advances.” - Lyn Santiago, Research Manager