Heart Institute Enrolls Most Patients in Landmark International Study; Dr. Metzger Co-Authors Article in New England Journal of Medicine About Results

March 1, 2016 - For the third time since the summer, an internationally renowned and respected interventional cardiologist with the Wellmont CVA Heart Institute has been published in the country’s premier medical journal.

Chris Metzger, M.D., recently co-authored an article about a nine-year study called ACT 1, a landmark clinical trial in which the heart institute was the No. 1 worldwide enroller of patients. The study has been posted on the New England Journal of Medicine’s website and will soon be published in the print edition.

This is the latest example how the heart institute has advanced medical care. It has served as the No. 1 or No. 2 enroller in the United States and across the globe in at least 25 top research trials, including being the current leading enroller in four major trials. The heart institute now has about 25 studies that are actively enrolling patients or soon will.

The ACT 1 trial included multiple facilities in the United States and studied patients who had narrowing of the area where the carotid artery divides into other arteries even though they showed no symptoms. Their condition was caused by plaque buildup, and they were at risk of having a stroke.

The study’s conclusion was carotid artery stenting is just as effective as carotid endarterectomy, which is a more invasive surgical procedure. This result is a benefit for patients whose age or anatomy might not make them an ideal candidate for carotid endarterectomy.

“This trial will influence how patients with asymptomatic carotid stenosis are treated throughout the world,” said Jerry Blackwell, M.D., the heart institute’s president. “It’s appropriate for Dr. Metzger to have an integral role in this study, as he has helped shape the quality of care with his extensive work in carotid artery stenting on the national and international stages. Our involvement in this essential study reiterates how patients in our region have access to leading-edge care from dynamic physicians at the Wellmont CVA Heart Institute.”

In addition to Dr. Metzger’s service as lead investigator, other members of the heart institute team played an important part in the study’s success. They included Rahul Sakhuja, M.D., another interventional cardiologist; Stanley Gall, M.D., a cardiothoracic surgeon; Terrie Walker, director of clinical research; and Josh Lester, lead research coordinator for ACT 1.

“This collaborative approach by several members of our team has enabled us to develop one of the broadest and strongest research centers in the country,” Dr. Metzger said. “Through our participation in these trials, we have emerged as leaders in developing innovative approaches for the treatment of cardiovascular disease. By serving as a host site, we are investing in the future of medicine, one that delivers tremendous promise for patients who rely on us to better their lives.”

In July, Dr. Metzger was one of the authors of another article published in the New England Journal of Medicine, which discussed a clinical trial that examined use of drug-coated angioplasty balloons in the treatment of peripheral artery disease. He also was a co-author of another article that appeared in the journal in November, which discussed a clinical trial about a new absorbable stent to treat blockages in the heart arteries.

Dr. Metzger was one of 15 physicians to contribute to the articles in July and November and one of nine to participate in the newest article. The heart institute was the No. 1 enroller of participants in all three trials.

One of the participants in two of the studies is Ken Rosenfield, M.D., who serves as section head of vascular medicine and intervention at Massachusetts General Hospital, the largest teaching hospital of Harvard Medical School. He and Dr. Metzger have partnered on a number of scientific trials and educational programs.

This includes training of Harvard medical fellows by Dr. Metzger at Holston Valley Medical Center, which has been ranked for 2016 by CareChex, a division of Comparion, as No. 1 in the country in medical excellence for interventional carotid care.

In addition to the heart institute and Massachusetts General, prestigious academic facilities that contributed to the latest study include the University of Wisconsin, the University of Pittsburgh and the University of Miami.

“We are extremely proud of the outstanding work performed by Dr. Metzger and other members of the heart institute, “ said Bart Hove, Wellmont Health System’s president and CEO. “We rival and, in many cases, surpass the work occurring at major academic research centers, and our physicians and staff have firmly established a reputation for excellence. The comprehensive range of services we provide from more than 60 expert providers across multiple disciplines ensures patients in our region receive superior care from the heart institute.”