1. < Message from the Chair

Nicholas Brownell, MD and Alexandra Klomhaus, PhD Awarded American Heart Association Grant to Explore Social and Economic Impacts on Heart Failure Care

Heart failure (HF) is a significant health and economic issue which affects 6.2 million people in the United States. It has a high mortality rate with 50% of patients dying within five years. It also has a significant economic burden with annual costs exceeding $30 billion. In their AHA funded project, Nicholas Brownell, MD a cardiology fellow in the STAR program and Alexandra Klomhaus, PhD aim to determine how social and economic factors impact HF care and whether different patient sub-groups receive varying treatments over time.

Drs. Brownell and Klomhaus will utilize the Social Vulnerability Index (SVI), a database generated by the Centers for Disease Control and Prevention (CDC), which shows a community's ability to respond to hazards. It is made up of four components:

The SVI is reported on a 0-100 scale. Higher numbers mean worse community vulnerability. Higher SVI scores are associated with higher death rates from cardiovascular disease. It is significant that SVI has not been examined in HF patients. They predict that a higher SVI would be associated with worse health outcomes among heart failure patients and that this finding will be consistent over time.

The researchers will use the Get With The Guidelines - Heart Failure (GWTG-HF) database to examine 10-years' worth of data to determine whether high SVI scores are associated with lower rates of HF medication use, longer hospital stays, and increased rates of death in the hospital. They will examine each SVI component to determine its individual association with outcomes. This analysis will allow Brownell and Klomhaus to evaluate how social determinants of health impact HF prescription patterns and health outcomes. They anticipate finding disparities in the treatment and care for HF patients and seek to identify interventions that will improve equitable treatment of HF.

“Our study supports the AHA’s mission of promoting equity and improving cardiovascular health. Our findings could clarify trends and themes in patients who currently receive worse HF care. This could lead to targeted treatments for improved HF care in the future,”

States Dr. Brownell.

Ronald Reagan UCLA Medical Center Nationally Recognized for Commitment to Improve Valvular Heart Disease Outcomes

We continue to celebrate excellence in cardiology by announcing that Ronald Reagan UCLA Medical Center has been recognized by the American Heart Association for achieving the Target: Aortic Stenosis™ Honor Roll award through its commitment to improving care for this under treated heart valve disease.

Aortic stenosis (AS) is one of the most common and serious heart valve disorders. More than 1.7 million Americans over age 65 have severe aortic stenosis, and without valve replacement, as few as half survive beyond two years.  However, many patients are unaware or undiagnosed, which is why the American Heart Association continues to drive efforts for timely diagnosis, appropriate treatment, improved quality of care initiatives and comprehensive patient and caregiver resources to combat the disease.

Join me in congratulating the following cardiology LEADERS and their teams who led the efforts to achieve this prestigious distinction. They include:

DoM LEADERS Spotted Across the Nation

From coast to coast, department of medicine (DoM) LEADERS continue to shine on the national stage at meetings where they showcase our excellence in research, education, patient care, and community engagement. Let’s see where DoM faculty have been this summer so far…

UCLA Division of Endocrinology at the ADA’s 84^th Scientific Sessions

The 84^th Scientific Sessions, hosted by the American Diabetes Association, brings together diabetes experts from around the world to discuss the latest advancements in diabetes research, and to network, and foster partnerships that will advance our understanding and treatment of diabetes. The DoM showcased the world-class research that takes place in our department, and I am pleased to highlight a few of those speakers and poster presentations.

Utibe Essien, MD, MPH participated in a panel discussion “Ripple effects after the advent of highly effective anti-obesity pharmacotherapy – pharmacoequity in the United States.” He noted that approximately 72 and a half million adults are currently obese in the US – and there are significant racial and ethnic disparities in obesity rates and obesity-related death in the US. Despite the availability of novel therapies to treat obesity, prior research, including his previously published studies in JAMA Health Forum and JAMA Network Open, has shown racial and ethnic disparities in access to SGLT2 inhibitors and GLP1-RA therapies.

Essien notes, “We think a lot of these disparities are driven by challenges with the ABCs: Access to obesity specialists, Bias in obesity treatment, and the high Cost of these newer therapies. To improve pharmacoequity in obesity we need multilevel solutions at the patient, provider, payor, pharmaceutical and policy level.”

Tannaz Moin, MD, MBA presented an overview of the Real-World Effectiveness of Interventions of the Type 2 Diabetes Mellitus Prevention (REALITY) Network, which is funded by the CDC, to examine the long-term effectiveness and cost-effectiveness of the Diabetes Prevention Program/Intensive Lifestyle Interventions (DPP/ILI) in real-world settings. The REALITY Network is comprised of four sites, including UCLA (led by Drs. Moin and Duru), University of Michigan, Northwestern University and Emory/VA. These teams are working collaboratively to analyze data (EHR and claims) from diverse US settings to address key evidence gaps. Dr. Moin presented some of the early results from UCLA and the University of Michigan, demonstrating the one- and two-year effectiveness and cost-effectiveness of DPP, and an overview of the upcoming network wide meta-analysis, which will examine the five-year rates of incident type 2 diabetes among national cohorts of adults at risk for developing type 2 diabetes.

Effective diabetes management is critical in inpatient settings to ensure patient safety and optimal outcomes. Estelle Everett, MD explored the challenges and benefits of using insulin pumps and CGMs in the inpatient setting, and how we can integrate these technologies efficiently into hospital workflows.

In addition to these talks, several faculty presented posters highlighting findings from their latest research studies. They included:

• Hugo Torres and Tannaz Moin “Financial Strain in Diabetes Management: The Impact of Insurance Type and Income”

• Allyson Malone, Norman Turk, Kenrik Duru, Lauren E Wisk, Carol Mangione, Jessica Paige, Samuel Thomas, Christina S Han, Amanda Vu, Ruth Madievsky, Keith C Norris, Tannaz Moin.  “Type 2 Diabetes Risk Perception and Health Behaviors Among Women with History of Gestational Diabetes Mellitus”

• Vanessa Schmidt, Kyrstin Lane, Roger M Lee, Mathew Freeby. - “Hypoglycemia and Hyperglycemia among Elderly Patients in Long-Term Care Facilities”

Thank you to members of the UCLA Division of Endocrinology and GIM/HSR for your LEADERShip at the ADA meeting and in the DoM.

RCMAR CHIME Shines at the RCMAR Annual National Meeting in DC

On behalf of RCMAR CHIME at UCLA, I am pleased to share photos from their participation at the Resource Centers for Minority Aging Research’s annual national meeting in Washington DC on June 26-28, 2024. The UCLA Center for Health Improvement of Minority Elderly (CHIME) is one of 18 Resource Centers for Minority Aging Research (RCMAR) funded by the National Institute of Health/National Institute of Aging (NIH/NIA). CHIME’s mission is to help reduce health disparities between minority and non-minority older adults. The focus of their work is the training and mentorship of under-represented junior-level faculty who will advance their career by conducting research on minority elders.

The following DoM LEADERS shone bright at the national meeting:

David Lee, MD, MBA presented a poster on his project entitled, “Identifying Implementation Factors for the Adoption, Adaptation, and Sustainment of a Comprehensive Dementia Care Program.” 

Utibe Essien, MD, MPH discussed his pilot project entitled, “Achieving Pharmacoequity in Older Adults with Atrial Fibrillation.” 

Homero del Pino, PhD, CHIME research education co-director, served as a reviewer in the R01 Grant Review Panel. 

Keith Norris, MD, PhD reviewed posters and mentored scientists from other sites.

Thank you to the DoM LEADERS who represented us proudly at the RCMAR national meeting!

Dale

P.S.

This past Saturday, I was in Salt Lake City to attend the memorial service of one my mentors who recruited me to the University of Utah, as an assistant professor nearly 25 years ago. His legacy was manifested by wonderful tributes from hundreds of people whose lives he influenced. I am reminded how much we influence those who entrust their training to us.

Bon Voyage Guy Zimmerman.

---