Coronary Artery Disease: The New Big C
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Published 2024-07-29
www.medscape.com/viewarticle/999964?src=soc_yt
-- TRANSCRIPT --
Robert A. Harrington, MD: Hi. I'm Bob Harrington, and I'm here at the American College of Cardiology (ACC) meetings in Atlanta. I always love to use these meetings as an opportunity to catch up with friends and colleagues to talk about what they're working on.
For those of you who have listened to the podcast for a long time, you know that one of the things I really like to do is to talk to physician writers. Sometimes, it's fiction; sometimes, it's nonfiction. Today, we're going to talk to a colleague from Stanford who has written a new book on heart disease and cancer. We'll get into that in a moment.
I'm here with my good friend and colleague, Mike McConnell. Mike is the chief health officer at Toku and is also a clinical professor of medicine at Stanford — and still seeing patients and reading images.
Michael V. McConnell, MD, MSEE: Yes.
Harrington: Excellent.
McConnell: Great to be here.
Harrington: Mike, you sent me a copy of the book, and I really enjoyed reading it. It's a nice read with a provocative title. Tell us what the title is.
McConnell: The title is Fight Heart Disease Like Cancer.
Sudden Cardiac Death on My Watch
Harrington: That grabs your attention. You're a preventive cardiologist. You're also an engineer. We're going to unravel both of those as to how you came to this. One thing I really like is that you use both stories and evidence.
As I would expect from a clinical scientist, it's heavy on the evidence. You're not saying anything that's not based in the literature, but you're telling stories. There are some pretty powerful stories. One of the early stories is the unfortunate death of your father-in-law. That seems like it profoundly affected how you think about this.
McConnell: I would say that was the first time I thought that I needed to write a book someday. My daughters were only 10 and 13. My father-in-law was a very prominent scientist who actually developed many cancer detection blood tests and was quite interested in doing the same for heart disease. Unfortunately, he was not particularly good about seeing the doctor.
He gave a big talk and was on a van back from the talk. When everybody got off the van, he was still sitting there. He had sudden cardiac death.
People take cancer quite seriously. Heart disease kills more people than cancer, yet we don't seem to take it as seriously as we should. That happened on my watch in many ways.
Harrington: You bring that up with your wife, his daughter, obviously, and your daughters. You bring up this notion that it happened on your watch. I think you used that phrase.
McConnell: Yes. In the book, I talk about some of the things I've tried to do. On the other hand, it reinforced that we have to give tougher talk to our patients, that taking a few more extra steps or dropping a donut here and there from your diet is not really enough, for many people, to prevent this catastrophic disease.
Harrington: Speaking to talking tough or making changes, you ask your patients whether they would rather have heart disease or cancer. Uniformly, people pick heart disease. You started talking to people in the language of the cancer diagnosis. Talk a little bit about that.
McConnell: I think that's a great example of where the science and the stories came together. As I started my research career, much of it was trying to develop new tools to image stenoses in coronary arteries. I think we now recognize that that's really late-stage disease. As the field was evolving, my research was evolving toward whether we can pick up earlier plaque, and then, as you know, whether a plaque is biologically active or inflamed became more important.
We shifted more toward molecular imaging. Then, I started realizing I was imaging more like an oncologist doing a PET-CT because yes, there'll be a tumor there, but is it growing? How active is it? We should shift everybody's focus more toward early disease detection and how to reverse the biology so that it never becomes late-stage disease and so we don't have your father or your father-in-law having a sudden myocardial infarction.
Transcript in its entirety can be found by clicking here:
www.medscape.com/viewarticle/999964?src=soc_yt