A randomized trial of physiology-guided versus angiography-guided non-culprit lesion complete revascularization strategies in patients with acute myocardial infarction (STEMI and NSTEMI) and multi-vessel coronary artery disease.

More information about the study is available at https://clinicaltrials.gov/study/NCT05701358

Principal Investigator: Dr Jay Shavadia

A Randomized, Comparative Effectiveness Study of Staged Complete Revascularization With Percutaneous Coronary Intervention to Treat Coronary Artery Disease vs Medical Management Alone in Patients With Symptomatic Aortic Valve Stenosis Undergoing Elective Transfemoral Transcatheter Aortic Valve Replacement.

More information about the study is available at https://clinicaltrials.gov/study/NCT04634240

Principal Investigator: Dr Janine Eckstein

The objective of this study is to: 1) quantify the risk of an actionable arrhythmia beyond the first 24 hours of presentation; 2) identify patient-level predictors most strongly associated with this risk; and 3) provide a descriptive cost analysis of the current RUH STEMI telemetry pathway.

Study co-leads: Dr. Haissam Haddad and Dr. Jay Shavadia.

This study aims to improve provincial care for patients who present to the Royal University Hospital (RUH) with acute coronary syndrome (ACS), while investigating primarily, the predictors of adverse post-percutaneous coronary intervention (PCI) outcomes in patients with ACS, subcategorised under NSTEMI/UA and STEMI.

Adverse trends and patterns are also examined for covariates such as demographic characteristics, Indigenous vs Non-Indigenous relationships, patient risk factors, diagnostic investigations and therapeutic measures.

It is hoped that outcomes from this study will facilitate the development of patient-centered treatment algorithms for ACS within the province.

Study co-leads: Dr. Haissam Haddad and Dr. Jay Shavadia.

Sub studies include: 

• Gender Differences in Morbidity and Mortality 
• Short Term Outcomes of Acute Coronary Syndromes by Diabetes Status Cardiogenic Shock and cardiac arrest in STEMI
• Clinical characteristics and outcomes of young patients presenting with ST-segment elevation myocardial infarction
• Comparison of Demographics and Outcomes of NSTEMI/UA in the Pre- and Peri-COVID-19 Pandemic 
• Polypharmacy among ACS patients 
• Depressive symptomatology in ACS patients: correlates and risk factors 
• Demographics and outcomes of ACS by COVID-19 status 
• Cardiovascular Outcomes of Acute Coronary Syndromes in Indigenous Compared with Non-Indigenous Patients 
• Anxiety and Depression in ACS patients with Diabetes Mellitus 
• ACS-related post-PCI clinical outcomes in Saskatchewan 

The BEEFBURGER trial is an investigator initiated, open-label, randomized pilot comparison of beta-blocker continuation versus de-prescription at the six to eight week follow-up following isolated and uncomplicated CABG at a single centre in Saskatoon (RUH). This study aims to establish recruitment feasibility, safety, and patient-reported change in the quality of life, including anginal scores associated with beta-blocker deprescription.

More information about the study is available at https://clinicaltrials.gov/ct2/show/NCT04788186 

Saskatoon site principal investigator: Dr. Jay Shavadia.

Regina site principal investigator: Dr. Andrea Lavoie.

The understanding of how heart muscle weakens (heart failure) following a major heart attack (STEMI) remains unclear but is thought to involve several complexly linked pathways. To improve the understanding of this process, this study aims to evaluate how differently blood proteins are distributed between STEMI patients who develop compared with those who do not develop heart failure, shock, death and/or a repeat heart attack in follow-up.  

By leveraging the advances in serum proteomics using mass spectroscopy analysis and left ventricular imaging using an echocardiogram, the current study aims to integrate the synergistic evaluations of multi-marker proteins and left ventricular (LV) strain imaging to enhance our understanding of LV repair/healing, and their relationship to clinical outcomes in STEMI patients presenting with and without cardiogenic shock at baseline. 

Principal investigator: Dr. Jay Shavadia.

A multicentre, international, controlled, randomized, blinded, 2x2 factorial randomized controlled trial of CoLchicine and spironolactonE in patients with myocARdial infarction. More information about the study is available at https://clinicaltrials.gov/ct2/show/NCT03048825

Principal investigator: Dr. Jay Shavadia.

The ASAP Trial is a five-year, multicentre, randomized controlled trial that will assess the efficacy, safety, and tolerability of aggressive smoking cessation therapy initiated in-hospital following ACS. Patients will be randomized (1:1) to one of two treatment arms: (1) combination therapy of varenicline and nicotine e-cigarettes plus counseling or (2) varenicline plus counseling for 12 weeks, with 52-week follow-up.

ClinicalTrials.gov Identifier: NCT05257629

Site principal investigator: Dr Jay Shavadia.

The Fourth Left Atrial Appendage Occlusion Study.

The purpose of the LAAOS-4 study is to determine if closure of the left atrial appendage using a closure device called the WATCHMAN FLX™, in addition to taking oral anticoagulant medications, is more effective at reducing strokes and blood clots in your body, than taking oral anticoagulant medications on their own.

More information about the study is available at https://classic.clinicaltrials.gov/ct2/show/NCT05963698

Principal Investigator: Dr Stephan Wardell

Librexia ACS is a randomized, double-blind, placebo-controlled, event-driven study to demonstrate the efficacy and safety of milvexian after a recent acute coronary syndrome.

More information about the study is available at https://clinicaltrials.gov/study/NCT05754957

Principal Investigator: Dr Jay Shavadia

A phase III, double-blind, randomized placebo-controlled study, will evaluate the potential of dalcetrapib to reduce the occurrence of fatal and non-fatal MI in 2,000 patients with a documented recent acute coronary syndrome (ACS) and the AA genotype at variant rs1967309 in the ADCY9 gene.

More information about the study is available at https://classic.clinicaltrials.gov/ct2/show/NCT05918861

Principal Investigator: Dr Jay Shavadia

A Research Study to Look at How Ziltivekimab Works Compared to Placebo in People With a Heart Attack.

More information about the study is available at https://clinicaltrials.gov/study/NCT06118281

Principal Investigator: Dr Jay Shavadia

Semaglutide for post-ACS: Treatment Impact on Weight Loss and Cardiovascular Risk Factor Levels Among Individuals Without Diabetes.

Principal Investigator: Dr Jay Shavadia

Anti-Platelet Therapy in Spontaneous Coronary Artery Dissection (APT-SCAD) Trial.

A randomized controlled trial comparing moderate (aspirin for 3mths) versus intensive antiplatelet therapy (aspirin+clopidogrel 3mths, then clopidogrel alone to 12mths) in acute SCAD patients being treated conservatively.

Principal Investigator: Dr Janine Eckstein

An industry-sponsored clinical study to evaluate the accuracy of the Emergency Care for Heart Attack and Stroke (ECHAS) prehospital mobile app and sensor triage system in identifying patients with stroke, myocardial infarction (MI), or related conditions requiring emergency evaluation. 

Study lead: Dr. Jay Shavadia.

https://clinicaltrials.gov/ct2/show/NCT05230069

NACMI registry is a multicentre database of case reports of patients who present with ST-segment elevation or new left bundle branch block (LBBB) on ECG and are COVID-19 positive or have suspected COVID-19. This study will be beneficial in identifying patterns of myocardial injury, developing a risk model for cardiac complications, understanding short and long-term major adverse cardiac events, and designing clinical trials testing different treatment modalities.

Saskatoon site principal investigator: Dr. Jay Shavadia.

A pilot randomized control trial with the objective to evaluate the feasibility for safe examination of continued metformin therapy in patients with type 2 diabetes mellitus, undergoing invasive coronary angiography.

Study lead: Dr. Jay Shavadia. 

This was designed as a retrospective-prospective study to investigate heart failure management among in-patients in cardiac care wards in Saskatoon hospitals, in view to create a standardized algorithm for management of heart failure for professional training and quality improvement. We believe the outcomes of this study could be expanded to other cardiac centres and hospitals across the province.

Study leads: Dr. Haissam Haddad and Dr. Jay Shavadia.

This longitudinal study evaluated the differences, feasibility and patient satisfaction for two models of care (telemedicine versus traditional clinical care) delivered to patients with heart failure.

Study leads: Dr. Hassaim Haddad and Dr. Alex Zhai

This study investigated the effect of continuous electrocardiogram (ECG) monitoring beyond 48 hours, against periods of actionable arrhythmias in STEMI patients, post-reperfusion.

Study lead: Dr. Jay Shavadia

A retrospective descriptive study investigating the risk, and procedural characteristics of patients with cardiovascular artery disease treated with CABG.

Study lead: Dr. Jay Shavadia.

This was an offshoot of the larger ACS prospective study, investigating the changes in trends for HbA1C, LDL, emergency room re-visit rate and hospitalization rates between identified groups of Diabetes mellitus (DM) patients who have had a cardiac event (intervention group) compared with DM patients who have not had any cardiac events.

This collaborative study was co-lead by Dr. Rabia Shahid and Dr. Haissam Haddad. 

• Haddad H, Okpalauwaekwe U, Sharma N, Shavadia JS, Zhai A, Haddad T. Anticoagulation in Cardiac Patients. In: Precision Anticoagulation Medicine 2020 (pp. 77-102). Springer, Cham
• Haddad H, Okpalauwaekwe U. Anticoagulation in Patients with Atrial Fibrillation and Artificial Valves: Translating International Guidelines for Clinical Practice. In: Precision Anticoagulation Medicine 2020 (pp. 79-87). Springer, Cham.
• Shavadia JS, Sharma N, Haddad H. Atrial Fibrillation and Combination Antithrombotic Therapies in Patients Undergoing PCI. In: Precision Anticoagulation Medicine 2020 (pp. 88-93). Springer, Cham.

2020

• Muhammadzai HZ, Shavadia J, Okpalauwaekwe U, Haddad H. Antemortem diagnosis of nonbacterial thrombotic endocarditis in a patient with previously resected pancreatic adenocarcinoma: a case report. European Heart Journal: Case Reports. 2020 Oct;4(5):1.
• Haddad H, Bergeron S, Ignaszewski A, Searles G, Rochdi D, Dhage P, Bastien N. Canadian Real-world Experience of Using Sacubitril/valsartan in Patients with Heart Failure with Reduced Ejection Fraction: Insight from the PARASAIL Study. CJC Open. 2020 Apr 26.
• Shavadia J, Minhas R, Orvold J, Basran R, Wells C, Devilliers J, Pearce C, Eckstein J, Pausjenssen E, Haddad H, Mangipudi R. Metformin Continuati Versus Interruption Following Coronary Angiography: Contemporary Risk of Lactic Acidosis. A Pilot Single-Center Randomized Control Trial. Canadian Journal of Cardiology. 2020 Oct 1;36(10):S112-3.
• Rana M, Shavadia J, Okpalauwaekwe U, Mohammadzai H, Haddad H. Regional Variations in Rehospitalization and Mortality Risk Among Acute Coronary Syndrome Patients in Saskatchewan. Canadian Journal of Cardiology. 2020 Oct 1;36(10):S87-8.
• Shavadia J, Okpalauwaekwe U, Rana M, PausJenssen E, Haddad H. Cardiovascular Profile and Outcomes of Acute Coronary Syndromes in Indigenous Compared with Non-Indigenous Patients: An Observational Analysis from Northern Saskatchewan. Canadian Journal of Cardiology. 2020 Oct 1;36(10):S7-8.

2021

• Shavadia J, Lubiantoro E, Wells C, Okpalauwaekwe U, Haddad H. Cardiovascular Outcomes of Acute Coronary Syndromes in Indigenous Compared with Non-Indigenous Patients in Northern Saskatchewan. Canadian Journal of Cardiology. 2021 Oct 1;37(10):S11-2
• Zamir N, Shavadia J, Miranda N, Coverett K, Parekh D, Shoker M, Haddad H. Actionable Arrhythmias in Low-Risk Stemi Patients: The Role of Continuous ECG Monitoring Beyond 48 Hours of Reperfusion. Canadian Journal of Cardiology. 2021 Oct 1;37(10):S13-4.
• Parekh D, Shavadia J, Shah L, Flores Miranda N, Shokar M, Masud R, Okpalauwaekwe U, Haddad H. Cardiogenic shock and cardiac arrest in STEMI: characteristics and outcomes in northern Saskatchewan. Canadian Journal of General Internal Medicine. 2021 May; 16 (1): 50-51.

CCS Conferences

2020

• Shavadia JS, Okpalauwaekwe U, Masud R, Pausjenssen E, Haddad H. Cardiovascular Profile and Outcomes of Acute Coronary Syndromes in Indigenous Compared with Non-Indigenous Patients: An Observational Analysis from Northern Saskatchewan. 2020 Canadian Cardiovascular Congress [abstract]. October 22-25, 2020, at Edmonton Convention Centre, Edmonton, Alberta, Canada.
• Masud R, Okpalauwaekwe U, Muhammadzai H, Shavadia JS, Haddad H. Regional variations in rehospitalization and mortality risk from cardiovascular disease in Saskatchewan. 2020 Canadian Cardiovascular Congress [abstract]. October 22-25, 2020, at Edmonton Convention Centre, Edmonton, Alberta, Canada.
• Shavadia J, Minhas R, Orvold J, Basran R, Wells C, Devilliers J, Pearce C, Eckstein J, Pausjenssen E, Haddad H, Mangipudi R. Metformin Continuation Versus Interruption Following Coronary Angiography: Contemporary Risk of Lactic Acidosis. A Pilot Single-Center Randomized Control Trial. 2020 Canadian Cardiovascular Congress [abstract]. October 22-25, 2020, at Edmonton Convention Centre, Edmonton, Alberta, Canada.

2021

• Shavadia J, Lubiantoro E, Wells C, Okpalauwaekwe U, Haddad H. Cardiovascular Outcomes of Acute Coronary Syndromes in Indigenous Compared with Non-Indigenous Patients in Northern Saskatchewan [abstract/poster presentation]. 2021 Canadian Cardiovascular Congress (virtual conference). October 20-23, 2021.
• Zamir N, Shavadia J, Miranda N, Coverett K, Parekh D, Shoker M, Haddad H. Actionable Arrhythmias in Low-Risk Stemi Patients: The Role of Continuous ECG Monitoring Beyond 48 Hours of Reperfusion. [abstract/poster presentation]. 2021 Canadian Cardiovascular Congress (virtual conference). October 20-23, 2021.

U of S Research Day 2020

• Nafisa Absher, Javeria Muhammadzai, Udoka Okpalauwaekwe, Masud Rana, Abbas Khani-Hanjani, Taras Mycyk, Gregory Dalshaug, Marnie Olson, Haissam Haddad, Jay Shavadia. Contemporary profile and short-term outcomes of patients undergoing coronary artery bypass graft surgery: a single centre experience. University of Saskatchewan CoM Undergraduate Research Showcase [abstract/poster]. October 21, 2020. Saskatoon, SK.

SHA Research Showcase

2021

• Revathi Nair, Jay Shavadia, Sam Papp, Love Shah, Udoka Okpalauwaekwe, Andrew Frost, Dominique Kushneriuk, Janine Eckstein, Jason Orvold, and Haissam Haddad. Cardiogenic shock and cardiac arrest in STEMI: The Northern Saskatchewan perspective [abstract/poster presentation]. 2021 Saskatchewan Research Showcase (virtual conference). November 16 and 18, 2021.
• Michael Durr, Jay Shavadia, Udoka Okpalauwaekwe, Sabeena Khan, Haissam Haddad. Comparison of Demographics and Outcomes of NSTEMI/UA in the Pre- and Peri-COVID19 Pandemic [abstract/poster presentation]. 2021 Saskatchewan Research Showcase (virtual conference). November 16 and 18, 2021.
• David (Eunhyun) Kim, Everett Wells, Udoka Okpalauwaekwe, Rama Mangipudi, Brendan Macknak, Elsa Lubiantoro, Jay Shavadia, and Haissam Haddad. Short Term Outcomes of Acute Coronary Syndromes by Diabetes Status: Bridging the Gap with Contemporary Therapies [abstract/poster presentation]. 2021 Saskatchewan Research Showcase (virtual conference). November 16 and 18, 2021.
• Dmitry Neymark, Nathan Braun, Sabeena Khan, Tony Haddad, Idris Bare, Jay Shavadia, and Haissam Haddad. Gender Differences in Morbidity and Mortality of Acute Coronary Syndromes in Northern Saskatchewan [abstract/poster presentation]. 2021 Saskatchewan Research Showcase (virtual conference). November 16 and 18, 2021.
• Michael Durr, Michael Korol, Oluseyi Adegoke, Jay Shavadia and Haissam Haddad. Acute Coronary Syndromes in Northern Saskatchewan: An Overview of Clinical Characteristics and Outcomes [abstract/poster presentation]. 2021 Saskatchewan Research Showcase (virtual conference). November 16 and 18, 2021.
• David (Eunhyun) Kim, Udoka Okpalauwaekwe, Sabeena Khan, Rama Mangipudi, Jay Shavadia and Haissam Haddad. Clinical characteristics and outcomes of young patients presenting with ST-segment elevation myocardial infarction in Northern Saskatchewan [abstract/poster presentation]. 2021 Saskatchewan Research Showcase (virtual conference). November 16 and 18, 2021.

2022

• David (Eunhyun) Kim, Jay Shavadia, Samuel Boctor, Thomas Lowe, Daniel Baik, Rama Mangipudi, Udoka Okpalauwaekwe, Haissam Haddad. Clinical characteristics and outcomes of Young compared with older patients with ST-segment Elevation Myocardial Infarction in Norther Saskatchewan. University of Saskatchewan CoM Undergraduate Research Showcase [Deans project abstract/poster]. October 19, 2022. Saskatoon, SK
• Jay Shavadia Udoka Okpalauwaekwe, Sam Papp, Daniel Baik, Nathan Braun, Haissam Haddad. Cardiovascular outcomes of Acute Coronary Syndromes in Indigenous Compared with Non- Indigenous Patients in Northern Saskatchewan in 2022 [abstract/oral presentation]. University of Saskatchewan, Department of Medicine Research Day. June 03, 2022. Saskatoon, SK, Canada.
• Shavadia JS, Rajan Minhas, Jason Orvold, Rashpal Basran, Calvin Wells, Jacobus DeVilliers, Colin Pearce, Janine Eckstein, Rama Mangipudi, Haissam Haddad. Metformin Continuation Versus Interruption Following Coronary Angiography: Contemporary Risk of Lactic Acidosis. A Pilot Single-Center Randomized Control Trial. [abstract/oral presentation]. University of Saskatchewan, Department of Medicine Research Day. June 03, 2022. Saskatoon, SK, Canada.