Medical Student Research Fellowship for Summer 2005

Mentor: Ellen C. Keeley, MD
Department: Internal Medicine, Division of Cardiology
Room number: Cardiac Catheterization Laboratory, PMH
Mail Code: 8837
Phone number: 214-590-8617
E-mail: ellen.keeley@utsouthwestern.edu
Project title:

Human subjects IRB approved project number (where applicable):

1) IRB File # 0802-455: "Data collection to evaluate baseline characteristics and clinical outcomes in patients undergoing primary angioplasty versus patients receiving thrombolytic therapy for acute ST segment elevation myocardial infarction"
2) IRB File # 0901-472: "Phlebotomy for DNA and plasma sampling"

Animal subjects IRB approved project number (where applicable): NA

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) Patient-based research

Brief Description of Project:

The main project I will be concentrating on this summer (2005) has a four part specific aim:
a) to determine the local inflammatory response in the coronary arterial tree during elective and emergent (for the indication of acute myocardial infarction) percutaneous coronary interventions. This will involve blood sampling from the coronary arterial tree during the interventional procedure. The blood will be processed and markers of inflammation will be measured including brain naturetic protein, myeloperoxidase, and plasminogen activator-1.
b) to assess the severity of the acute phase response during elective and emergent (for the indication of acute myocardial infarction) percutaneous coronary interventions. This will involve sampling peripheral blood during the interventional procedure. The blood will be processed and markers of the acute phase response will be measured including white blood cell count, interleukin-6 levels, and c-reactive protein. Convalescent samples will be obtained 12-24 hours following the interventional procedure.
c) To angiographically evaluate the coronary blood flow in the coronary arteries before and after percutaneous coronary intervention using two standard techniques (TIMI flow and blush scores).
d) To collect demographic information on all patients undergoing percutaneous coronary intervention and to enter all data into a database.

My long-term goal is to be able to assess the contribution of local inflammation and the systemic acute phase response during acute myocardial infarction and to determine whether anti-inflammatory therapy improves clinical outcomes.

Previous Research Activities or Publications with Medical Students:

In the summer of 2004, I had the pleasure of working with Christina Robinson. Christina is now a 1st year medical student here at UTSW. Her summer project was to analyze data from our primary percutaneous coronary intervention database to determine whether, in the midst of a myocardial infarction, the extent of blood flow in the infarct-related artery effected clinical outcomes and if patients with better blood flow had different characteristics. She found that patients with a myocardial infarction who had better blood flow in the infarct-related artery were also more likely to be already taking certain medications. We suspect these medications have anti-inflammatory properties and ameliorated the intense inflammatory response, leading to improved clinical outcomes. Christina's abstract was chosen for oral presentation at the 43rd Annual Medical Student Research Forum. We are now in the process of writing a manuscript and submitting our data to a peer-reviewed medical journal.

In the summer of 2003, I worked with Lily Zhang, a previous medical student here at UTSW now an intern at UCSD. The data she helped to collect is being analyzed and will be used to generate a manuscript on which she will be a co-author.

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