Steven Nissen
Encyclopedia
Steven E. Nissen is a cardiologist, researcher and patient advocate. He is chairman of cardiovascular medicine at the Cleveland Clinic
, in Cleveland, Ohio.
Nissen received his medical degree from the University of Michigan
School of Medicine in Ann Arbor. He completed his Internal Medicine internship and residency at the University of California, Davis in Sacramento, thereafter completed his Cardiology Fellowship at the University of Kentucky Medical Center in Lexington.
Joining Cleveland Clinic in 1992, Nissen served as Vice-Chairman of the Department of Cardiology (1993–2002), Section Head of Clinical Cardiology (1992–2000) and Director of the Coronary Intensive Care Unit (1992–1997). Most recently, he served as Medical Director of the Cleveland Clinic Cardiovascular Coordinating Center (C5), an organization that directs multi-center clinical trials. Nissen still attends in the Cardiac Critical Care Unit periodically throughout the year.
(IVUS) which allows researchers to see and measure atherosclerosis, the fatty plaque that attaches to the walls of coronary arteries and cannot be detected on an angiogram. In particular, Nissen developed the methodology for application of IVUS in the assessment of the progression and regression of coronary atherosclerosis.
He produced the first images in humans in 1990 and began using IVUS to document the ubiquitous prevalence of coronary artery disease. The technology has been the basis for his research during the last decade and Nissen is currently the principal investigator for several large IVUS atherosclerosis trials.
s, such as Vioxx (rofecoxib
) in 2001, Nissen was one of the first physicians to link it to an increased risk of heart attacks and strokes. Three years later Merck pulled Vioxx from the market when additional studies confirmed that daily, long-term use of the drug could increase the risk of heart attacks and strokes.
A few years later, in 2005, Nissen re-analyzed the data related to the Bristol-Myers Squibb drug Pargluva (muraglitazar,), an experimental type 2 diabetes drug. When an U.S. Food and Drug Administration (FDA) advisory panel charged with reviewing the clinical trial data approved the drug, he immediately began an in-depth analysis.
In 2007, the meta-analysis by Nissen and his co-investigator Kathy Wolksi, published in the Journal of the American Medical Association online on October 20, found that the diabetes drug rosiglitazone
(Avandia) produced by GlaxoSmithKline carried high cardiovascular risks,.
The FDA issued an alert on May 21, 2007, leading to a warning by the Food and Drug Administration and a sales loss of about 75% for the drug.
Also in 2005, Nissen published the results of the REVERSAL trial, a headto-head comparison of the statins atorvastatin (Lipitor) and pravastatin (Pravachol). IVUS images showed that Lipitor had effectively halted the progression of plaque buildup, but coronary disease progressed considerably in those given Pravachol. The study suggested that treatments should aim to lower LDL, or “bad” cholesterol levels as much as possible.
In 2006, Dr. Nissen and his co-investigators reported on The ASTEROID trial
(A Study to Evaluate the Effect of Rosuvastatin On Intravascular Ultrasound-Derived Coronary Atheroma Burden). The study concluded that intensive use of statins resulting in a decreased LDL and increased HDL can reverse the build-up of plaque in coronary arteries, as measured by IVUS.
Cleveland Clinic
The Cleveland Clinic is a multispecialty academic medical center located in Cleveland, Ohio, United States. The Cleveland Clinic is currently regarded as one of the top 4 hospitals in the United States as rated by U.S. News & World Report...
, in Cleveland, Ohio.
Nissen received his medical degree from the University of Michigan
University of Michigan
The University of Michigan is a public research university located in Ann Arbor, Michigan in the United States. It is the state's oldest university and the flagship campus of the University of Michigan...
School of Medicine in Ann Arbor. He completed his Internal Medicine internship and residency at the University of California, Davis in Sacramento, thereafter completed his Cardiology Fellowship at the University of Kentucky Medical Center in Lexington.
Joining Cleveland Clinic in 1992, Nissen served as Vice-Chairman of the Department of Cardiology (1993–2002), Section Head of Clinical Cardiology (1992–2000) and Director of the Coronary Intensive Care Unit (1992–1997). Most recently, he served as Medical Director of the Cleveland Clinic Cardiovascular Coordinating Center (C5), an organization that directs multi-center clinical trials. Nissen still attends in the Cardiac Critical Care Unit periodically throughout the year.
Imaging technology
Nissen is the primary force behind an imaging technology called intravascular ultrasoundIntravascular ultrasound
Intravascular ultrasound is a medical imaging methodology using a specially designed catheter with a miniaturized ultrasound probe attached to the distal end of the catheter. The proximal end of the catheter is attached to computerized ultrasound equipment...
(IVUS) which allows researchers to see and measure atherosclerosis, the fatty plaque that attaches to the walls of coronary arteries and cannot be detected on an angiogram. In particular, Nissen developed the methodology for application of IVUS in the assessment of the progression and regression of coronary atherosclerosis.
He produced the first images in humans in 1990 and began using IVUS to document the ubiquitous prevalence of coronary artery disease. The technology has been the basis for his research during the last decade and Nissen is currently the principal investigator for several large IVUS atherosclerosis trials.
Advocacy
Nissen has led a number of inquiries as to the scientific integrity of many medications currently on the market. Starting with linked COX-2 inhibitorCOX-2 inhibitor
COX-2 selective inhibitor is a form of non-steroidal anti-inflammatory drug that directly targets COX-2, an enzyme responsible for inflammation and pain. Targeting selectivity for COX-2 reduces the risk of peptic ulceration, and is the main feature of celecoxib, rofecoxib and other members of this...
s, such as Vioxx (rofecoxib
Rofecoxib
Rofecoxib is a nonsteroidal anti-inflammatory drug that has now been withdrawn over safety concerns. It was marketed by Merck & Co. to treat osteoarthritis, acute pain conditions, and dysmenorrhoea...
) in 2001, Nissen was one of the first physicians to link it to an increased risk of heart attacks and strokes. Three years later Merck pulled Vioxx from the market when additional studies confirmed that daily, long-term use of the drug could increase the risk of heart attacks and strokes.
A few years later, in 2005, Nissen re-analyzed the data related to the Bristol-Myers Squibb drug Pargluva (muraglitazar,), an experimental type 2 diabetes drug. When an U.S. Food and Drug Administration (FDA) advisory panel charged with reviewing the clinical trial data approved the drug, he immediately began an in-depth analysis.
In 2007, the meta-analysis by Nissen and his co-investigator Kathy Wolksi, published in the Journal of the American Medical Association online on October 20, found that the diabetes drug rosiglitazone
Rosiglitazone
Rosiglitazone is an antidiabetic drug in the thiazolidinedione class of drugs. It works as an insulin sensitizer, by binding to the PPAR receptors in fat cells and making the cells more responsive to insulin...
(Avandia) produced by GlaxoSmithKline carried high cardiovascular risks,.
The FDA issued an alert on May 21, 2007, leading to a warning by the Food and Drug Administration and a sales loss of about 75% for the drug.
Research
In 2003 Dr. Nissen led a Journal of the American Medical Association study, producing evidence that five weekly infusions of ApoA-I Milano/phospholipids complex, a synthetic form of HDL, can possibly remove significant amounts of plaque from coronary arteries. The lipoprotein enhanced the ability of HDL, or “good” cholesterol to usher fat out of the arteries and into the liver for excretion leading to the purchase of Esperion Therapeutics, the tiny company that had produced recombinant Apo-A1 Milano, by Pfizer for $1.3 billion.Also in 2005, Nissen published the results of the REVERSAL trial, a headto-head comparison of the statins atorvastatin (Lipitor) and pravastatin (Pravachol). IVUS images showed that Lipitor had effectively halted the progression of plaque buildup, but coronary disease progressed considerably in those given Pravachol. The study suggested that treatments should aim to lower LDL, or “bad” cholesterol levels as much as possible.
In 2006, Dr. Nissen and his co-investigators reported on The ASTEROID trial
ASTEROID trial
The ASTEROID trial was a clinical trial published in 2006 that shows the effects of statins on atherosclerosis. Employing intravascular ultrasound , they showed regression of the atherosclerotic plaques in response to a high dose of rosuvastatin...
(A Study to Evaluate the Effect of Rosuvastatin On Intravascular Ultrasound-Derived Coronary Atheroma Burden). The study concluded that intensive use of statins resulting in a decreased LDL and increased HDL can reverse the build-up of plaque in coronary arteries, as measured by IVUS.
Advisor
- Served the U.S. Food and Drug Administration as member of the CardioRenal Advisory Panel from 2000 until 2005, serving as Chairman for final year of his appointment.
- Testified before Congress and serves as a resource to several key members of Congress on health care related issues.
Awards and recognitions
- In 2007, he was named one of the 100 Most Influential People in the world (Time 100Time 100Time 100 is an annual list of the 100 most influential people in the world, as assembled by Time. First published in 1999 as a result of a debate among several academics, the list has become an annual event.-History and format:...
) by Time Magazine. - Outstanding Teacher Award by the Cleveland Clinic Fellows in Cardiovascular Medicine in 2004, 1998, and 1993.
- Gill Heart Institute Award of the University of Kentucky for Outstanding Contributions to Cardiovascular Research in 2004.
Publications
- Dr. Nissen has authored more than 350 journal articles and book chapters, mostly in the field of cardiovascular imaging. (Search National Library of Medicine)
- Editorship of Current Cardiology Report
- Senior Consulting Editor to the Journal of the American College of Cardiology for 5 years
- Serves on the editorial board of eleven other journals.