The DCRI started with the heart—we trace our roots to the 1969 launch of the Duke Databank for Cardiovascular Disease. For decades, our work has changed practice to improve care for patients with heart conditions. Today, our 40 cardiovascular faculty build on that legacy, practicing in specializations such as cardiovascular prevention and interventional cardiology.
Many of our studies also start with the heart—but they don't end there.
DCRI cardiologists consider novel approaches as they’re tasked with caring not only for the heart, but for the whole patient. And for the challenges they cannot solve, they have the power to partner with colleagues from the DCRI's seven other therapeutic areas, or with researchers from across Duke University.
A History of Landmark CV Studies
Since the DCRI’s inception, we have led pivotal cardiovascular trials that have delivered on our mission to improve patient care around the world through innovative clinical research. Our landmark studies include:
- GUSTO-I (1993), which at that time was the largest comparative thrombolytic trial in history.
- PREVENT (2003), which found that long-term, low-intensity warfarin therapy can prevent recurrent blood clots in the veins.
- ARISTOTLE (2011), which led to apixaban becoming the most widely initiated drug for stroke prevention in patients with atrial fibrillation.
Focusing on the Future of CV Research
We continue to work at the forefront of clinical research innovation by pursuing a new type of cardiovascular research—one that expands beyond the heart and addresses other conditions. And it all starts with asking the right questions.
Could treating heart failure affect outcomes for patients with atrial fibrillation?
As practicing physicians, our faculty are experts in treating heart conditions like atrial fibrillation. Our research shows that treating a patient’s additional conditions may improve overall outcomes.
Could a diabetes drug be used to treat patients with chronic kidney disease?
New evidence in the field shows that a specific diabetes medication can also be used to effectively treat heart failure—even for patients without diabetes. A DCRI study investigates whether a drug in the same class could be useful in treating patients with chronic kidney disease without diabetes.
What could the future of diabetes drug approval look like?
While cardiovascular safety remains an important consideration, evidence generated over the last decade shows that medications used for diabetes are relatively safe and often reduce cardiovascular risk. A recent article in Circulation highlights discussions from a February 2018 DCRI Think Tank that focused on the need for an easier approval process in order to provide the most benefit for patients with diabetes.
How can we combine our expertise to improve patient care?
As evidence emerges that supports novel treatments that could have implications for other body systems, it’s critical for our cardiologists to consult with their colleagues to ensure patient safety and quality of life. At the DCRI, we’re actively working on collaborative projects that have a direct impact on patients.
How can we make sure patients get the treatments they need?
Even when we team up across specialties to bridge the gaps in patient care, ensuring that patients actually receive evidence-based therapies can be challenging. This DCRI study focuses on interventions that can help bolster adoption of novel therapies in clinical care.
What's the best course of treatment for patients with end-stage renal disease and atrial fibrillation?
Leveraging our expertise in conducting comparative effectiveness studies, we determine the best treatments for specific subsets of a broader patient population.
What factors should we consider as we treat older patients?
Although all patients can benefit from receiving care that addresses comorbidities, some subsets of patient populations need special consideration. For example, clinicians caring for aging patients must also think about their patients’ physical function, among other variables.
PRAGMATIC CLINICAL TRIAL
Could statins help prevent dementia?
Statins are typically used to prevent cardiovascular events, but their effectiveness is unknown in patients aged 75 or older. A DCRI pragmatic trial will examine whether statins could also help prevent the onset of dementia or physical disability.
How can we provide the best care when there is no evidence?
We’re leading the way forward by weighing in on challenges in care that don’t yet have evidence to support decision-making. As patients living with HIV survive longer and have a higher risk of developing cardiovascular disease than in the past, clinicians must think differently about treating these conditions in tandem.
Research that Reflects Real-World Care
We know what patient care looks like in the real world. DCRI researchers often use real-world data from studies and registries to draw new insights on patient care, sometimes revealing disparities in care among different groups of patients. Click the links on the right to learn more.
Studies using real-world data have revealed:
- Patients who experience a stroke may be less likely to receive a statin than patients who experience heart attacks.
- The quality of care received after experiencing sudden cardiac arrest in the hospital is more likely to be suboptimal for patients who are on dialysis.
- Oral anticoagulants are underused and aspirin is overused to treat atrial fibrillation in patients with advanced chronic kidney disease.
Expertise across conditions that affect the heart. A well-rounded approach to cardiovascular research that keeps patients at the forefront. This is what the DCRI brings to each project in our portfolio. Click the button below to learn more about our cardiovascular work.