The Foundation of the La Jolla Cardiovascular Research Institute is devoted to physician-initiated research designed to improve the quality of patient care and clinical outcomes. Since 1995, Dr. Russo and his research group have conducted multiple studies including:
AVID (Angiography Vs. IVUS-Directed stent placement) enrolled 800 patients randomized to standard care or stent placement guided by IVUS in 20 centers. This landmark study changed clinical practice and established criteria for optimal stent placement guided by IVUS.
The Left Main IVUS Registry enrolled 250 patients in 15 centers and determined that IVUS was superior to angiography for the assessment of left main coronary artery disease and established criteria for a significant obstructive lesion and the need for revascularization (bypass surgery/stent).
The MagnaSafe Registry enrolled 1500 patients at 22 centers and demonstrated that clinically-indicated non-thoracic MRI at 1.5T can be performed with standard pacemakers and ICDs at no significant risk when patients are screened and the device is appropriately programmed.
The CDAC Study (Cognitive Dysfunction After Coronary revascularization) is multicenter trial designed to determine the change in cognitive function, and change in neurologic structural/functional imaging for patients who undergo CABG compared to a non-randomized control group who undergo percutaneous coronary intervention (PCI). Neurocognitive decline has long been recognized as a potential complication of coronary artery bypass grafting surgery (CABG) with or without the use of cardiopulmonary bypass. Despite much research, controversy persists regarding the prevalence, severity, and duration of post-operative cognitive changes.
There are three fundamental types of medical research:
(1) Basic science research which probes the basis of the biologic process and greatly improves our knowledge of biology in general and a disease process in particular. However, the findings from this type of research, even if it leads directly to drug development may not be implemented in clinical care for 10-20 years in most cases.
(2) Pharmaceutical and device vendor/manufacturer research in its latter stages is performed for the purpose of gaining FDA approval for the marketing of a product. This type of multi-million or in some cases billion dollar research is designed, funded, and conducted by industry. These studies must have a very high likelihood of demonstrating a favorable result for the manufacturer’s product for the effort and expense to be undertaken. Keep in mind that it is believed that approximately 75-90% of national professional society treatment guidelines in cardiology (American Heart Association, American College of Cardiology) are based upon the results of pharmaceutical and device industry research.
(3) Physician-initiated or investigator-initiated clinical research is designed, conducted, funded, and published by a physician-scientist. This type of research is performed for the purpose of improving patient care and clinical outcomes using available or approved medications, medical devices, or treatment strategies. The results of physician-initiated research, if favorable, may be implemented immediately. In addition, negative results are also reported which may not be true of industry-initiated studies.
The La Jolla Cardiovascular Research Institute (LJCVRI) under the direction of Dr. Russo began its work in 1994 and has involved the collaboration with more than 20 dedicated staff members and collaborators including research scientists, biostatisticians, research coordinators, nurses, Residents in Internal Medicine and fellows in Cardiovascular Disease (see LJCVRI.org). The research group is dedicated to physician-initiated single and multi-center studies designed to improve clinical care. Research efforts are funded through competitive grants, unrestricted educational/research industry grants, and multiple philanthropic sources. The Foundation of the LJCVRI is a tax-exempt 501(c)3 California corporation, and donations made to the Foundation are used exclusively for the performance of physician-initiated research.