BC Cardiovascular Community at the Canadian Cardiovascular Congress

Rising Stars – Dr. Carolyn Taylor

Carolyn TaylorDr. Carolyn M Taylor, MD, MPH, is a clinical assistant professor at the University of British Columbia and a member of the Divisions of Cardiology at St Paul’s Hospital and Vancouver General Hospital. With fellowship training in Cardiac Disease Prevention (Harvard University) and Coronary CT Angiography (Massachusett’s General Hospital), Dr Taylor is actively involved in clinical and research activities in these fields. Dr Taylor focuses her clinical time in the Healthy Heart cardiac rehabilitation program at St Paul’s and Vancouver General Hospital and in the Prevention/Lipid Clinic at St Paul’s Hospital. Additionally, Dr Taylor works in the advanced cardiac imaging department and cardiac intensive care unit at St Paul’s Hospital. Prior research training includes a Masters of Public Health (2008) from Harvard University and completion of the UBC Clinical Investigator’s Program (2009). She is currently involved as a primary and co-investigator of numerous single centre and multi-centre research studies in the areas of non-invasive imaging, cardiac prevention and risk factor modification. Dr Taylor is the recent recipient of the St Paul’s Hospital Physician Scholar Award (2011-2014).

Lay summary of program/project:

Every year 80,000 Canadians suffer a heart attack. Half of these individuals have no warning signs or symptoms. More than 25,000 Canadians who experience a heart attack die prior to reaching hospital. Treatments exist that dramatically reduce the risk of a heart attack. Because of costs and potential side effects, these treatments are only used in individuals at high likelihood of suffering a heart attack. Currently doctors attempt to identify individuals at high likelihood of suffering a heart attack by assessing risk factors. However, using risk factors to predict heart attack risk is imperfect. The majority of Canadians who subsequently suffer a heart attack have zero or one traditional risk factors and are not identified as needing preventive treatment to reduce their heart attack risk. Even if specialized tests, such as imaging of the heart arteries, are used to identify individuals at high risk of heart attack, doctors are not easily able to predict which individuals will subsequently suffer a heart attack. Evidence suggests that specific appearances of the heart arteries may be associated with the highest risk of heart attacks; however, the study of these specific appearances has been limited. Further study is required to better understand and better prevent heart attacks.

Medical summary of program/project:

Acute plaque rupture is the most common mechanism of acute myocardial infarction (AMI).  Currently, no risk prediction model exists to identify those at risk of plaque rupture. Coronary Computed Tomography Angiography (CCTA) can non-invasively identify adverse plaque characteristics (APCs) and preliminary work suggests that these APCs are associated with subsequent plaque rupture.  We are actively investigating and validating these potential markers of AMI risk in conjunction with investigators from the COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter (CONFIRM) Registry. The CONFIRM registry is a well-characterized cohort of over 20,000 men and women undergoing CCTA with comprehensive baseline and outcome data. A total of 424 individuals within this cohort suffered an AMI following CCTA, representing more than 25 fold the number of AMIs observed in any prior natural history study of atherosclerotic plaques. Through a nested case-control study within the CONFIRM cohort, our team will study APCs and their association with both patients at high risk of AMI (“vulnerable hosts”) and coronary plaques that may be prone to rupture (“vulnerable plaques”).