Valentin Fuster

Valentí Fuster Carulla is an American-Spanish ^[1][2][3][4] cardiologist. He specializes in the prevention and treatment of heart disease, coronary artery disease, atherosclerosis, and thrombosis.

Dr. Fuster currently serves as Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital, and Director of the Zena and Michael A. Wiener Cardiovascular Institute, the Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, and the Richard Gorlin, MD/Heart Research Foundation Professor at Icahn School of Medicine at Mount Sinai.^[5]

He is Editor-in-Chief of the Journal of the American College of Cardiology (JACC), past President of the American Heart Association, past President of the World Heart Federation, and a member of the Institute of Medicine of the National Academy of Sciences.

In his native Spain, he also serves as the General Director of the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) in Madrid, Spain and Chairman of the SHE Foundation (Science for Health and Education).

Life and career

Fuster serves as physician-in-chief and Director of Mount Sinai Heart, the Zena and Michael A. Wiener Cardiovascular Institute and the Marie-Josee and Henry R. Kravis Center for Cardiovascular Health. He is also the Richard Gorlin, MD/Heart Research Foundation Professor at Icahn School of Medicine at Mount Sinai.^[5] Fuster was the President of Science, and is now the General Director of the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) in Madrid, (Spain).^[6]

Fuster took over as editor-in-chief at the Journal of the American College of Cardiology in 2014.^[7] Among the positions of distinction that he holds are past President of the American Heart Association,^[8] past President of the World Heart Federation, Member of the Institute of Medicine of the National Academy of Sciences^[9] where he serves as Chair of the committee on Preventing the Global Epidemic of Cardiovascular Disease,^[10] former member of the National Heart, Lung, and Blood Institute Advisory Council,^[11] and former Chairman of the Fellowship Training Directors Program of the American College of Cardiology. Thirty distinguished universities throughout the world have granted him Honorary Doctorate Degrees.^[5],

Fuster was born in Barcelona after the end of the Spanish Civil War. His early aptitude for tennis let him to compete at a national level , and it was through tennis that he met his future mentor – Pedro Farreras, the author of the standard Spanish textbook of medicine. After Farreras suffered a heart attack at age 45, he encouraged Fuster to study cardiology. Fuster pursued his degree at the University of Barcelona, graduating with a MD in 1967, first in his class,. He then completed an internship at the Hospital Clinic in Barcelona. Encouraged by his tutor, he then went to the University of Edinburgh Medical School for his PhD on the role of platelets in myocardial infarction.^[12]

While completing his PhD in Edinburgh, Fuster served as a Research Fellow in Cardiology at the Royal Infirmary of Edinburgh from 1968 to 1971,.^[12] After completing his PhD in 1971 from the University of Edinburgh Medical School, Fuster spent several years at the Mayo Clinic, first as a resident and later as Professor of Medicine and Consultant in Cardiology,.^[12] In 1981, he came to Mount Sinai School of Medicine as head of Cardiology. From 1991 to 1994, he was Mallinckrodt Professor of Medicine at Harvard Medical School and Chief of Cardiology at the Massachusetts General Hospital,. He returned to Mount Sinai in 1994 as Director of the Zena and Michael A. Wiener Cardiovascular Institute and in 2006, he was named the Director of Mount Sinai Heart.^[13]

Positions and distinctions

• Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital^[5]
• Director of the Zena and Michael A. Wiener Cardiovascular Institute^[5]
• Director of The Marie-Josée and Henry R. Kravis Center for Cardiovascular Health^[5]
• The Richard Gorlin, MD/Heart Research Foundation Professor, Icahn School of Medicine at Mount Sinai.
• Past President of the American Heart Association,
• Past President of the World Heart Federation ^[14]
• Member, the Institute of Medicine of the National Academy of Sciences,
• Past member, the National Heart, Lung and Blood Institute Advisory Council,
• Former Chairman, the Fellowship Training Directors Program of the American College of Cardiology,
• Member, Scientific Advisory Board of Vasogen, Inc.,
• General Director of the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) in Madrid, Spain^[15],
• Member, La Sociedad Mexicana para el Estudio de la Hipertension Arterial,
• President, Paul Dudley White Society,
• Chairman, NHLBI Review Committee of the CV Program,
• Editor-in-Chief, Journal of the American College of Cardiology (2014–present) ^[16]

Honors and awards

Partial list contains 12 of over 150 awards and honors:

• 1993 Distinguished Scientist Award, American College of Cardiology^[17]
• 1996 Principe de Asturias Award of Science and Technology (the highest award to Spanish-speaking scientists, given by the son of the King of Spain), Fundacion Principe de Asturias, Oviedo, Spain ^[18]
• 2001 James B. Herrick Award, Council of Clinical Cardiology of the American Heart Association^[19]
• 1992 Andreas Gruntzig Award of the International Society of Interventionalists (Paris)^[20]
• Lewis A. Conner Memorial Award, American Heart Association
• 2005, 2009 Distinguished Researcher Award, Interamerican Society of Cardiology^[21]
• 2001 Gold Medal Award, American Heart Association
• 2007 Gold Medal Award, European Society of Cardiology, Vienna, Austria
• 2008 Polzer Prize, European Academy of Science and Arts ^[22]
• 2009 ACC Distinguished Teacher Award, Orlando, FL
• 2009 International Arrigo Recordati Award for his Scientific Achievement
• 2011 The LeFoulon Delalande Grand Prize, Institute of France, Paris, France
• 2012 AHA Research Achievement Award, Los Angeles, CA^[23]
• 2012 AHA "Legend of Cardiovascular Medicine"
• 2012 Honorary NYPD Surgeon
• 2013 Camino Real Award, Research Institute of North American Studies "Benjamin Franklin", University of Alcalá
• 2013 Society of Cardiovascular Computed Tomography Arthur S. Agatston Cardiovascular Disease Prevention Award
• 2013 American Heart Association/American Stroke Association Ron Haddock International Impact Award
• 2013 European Journal of Clinical Investigation, 400 most highly influential biomedical scientists in the world
• 2015 Cardiovascular Research Foundation, career contributions to cardiovascular research and dedication to training the thought leaders of tomorrow

Scientific investigator

Research focus and recognition

Fuster is the recipient of two major ongoing NIH grants,. To date, he has published more than 900 articles on the subjects of coronary artery disease, atherosclerosis and thrombosis,^[24] and he has been the lead editor of two major textbooks on cardiology, "The Heart" (previously edited by J. Willis Hurst^[25])and "Atherothrombosis and Coronary Artery Disease" (with Eric Topol and Elizabeth Nabel^[26]). Fuster is a former editor-in-chief of Nature Reviews Cardiology^[27] and he is the editor of the new "AHA Guidelines and Scientific Statements Handbook",^[28] which compiles all the latest information. In addition, Fuster has received the Lewis A. Conner Memorial Award by the American Heart Association, the James B. Herrick Achievement Award^[29] from the Council of Clinical Cardiology of the American Heart Association, and the 1996 Principe de Asturias Award^[30] of Science and Technology (the highest award given to Spanish-speaking scientists). In 2008, Fuster received the Kurt Polzer Cardiovascular Award from the European Academy of Sciences and Arts.^[31] In 2009, he received the Distinguished Teacher Award of the American College of Cardiology and then later that year, the prestigious International Arigo Recordati Award^[32] for his Scientific Achievement in the development of Cardiovascular Imaging. Finally this June, Fuster received the Lefoulon Delalande Grand Prix, from the Institute of France. In March 2012, during the ACC National Meeting, Fuster was honored as one of the two American "Legends in Cardiovascular Medicine.^[33]

Complex cardiology

Fuster handles some of the most complex cases in New York City,^[34] and is sought by patients from around the world. Since 1992, Fuster has been listed among the Best Doctors in America and New York.^[35] Fuster made news in 2006, when he managed a patient who underwent successful combined heart and lung transplant, which New York Magazine named one of the year's "11 medical marvels".^[36]

Contributions in translational medicine

• The original understanding of a major role played by platelets in atherothrombotic disease, based on long-term experiments in pigs with a deficiency of von Willebrand factor, severe platelet dysfunction, and resistance to atherothrombosis^[37][38]
• The first demonstration of the role played by platelets in CABG occlusion and prevention by aspirin, findings based on platelet imaging in dogs and on our subsequent definitive trial in humans (first trial of aspirin on CAD)^[39][40]
• The first demonstration in humans that coronary plaque rupture occurs in plaques that paradoxically are small and angiographically silent, an angiographic finding that explains the unpredictability of events and led to new diagnostic MRI technology on identification and characterization of arterial plaques at autopsy ^{[41][42][43][44]}
• The first demonstration that a critical substrate of thrombosis following plaque rupture is a lipid-rich plaque (vulnerable plaque) with a high density of macrophages undergoing apoptotic death with a release of tissue factor, findings which are based on a sequence of experimental and clinical studies, in part based on MRI and PET technology^[45]
• The first identification and characterization by new MRI technology (black-blood)of the vulnerable/high-risk plaques and reversibility by statins, findings based on a sequence of animal and human studies that led to the recent interest in cardiovascular MR imaging ^[46]
• The first demonstration in vivo of an important role of HDL in reversing lipid and macrophange-rich plaques, a finding based on the infusion of HDL in cholesterol-fed rabbits (and recently supported by others in CAD patients) and in cross-transplantation of the atherosclerotic aorta from transgenic mice with low HDL into mice with high HDL^[47][48]
• The first demonstration of rapamycin as a powerful inhibitor of post-injury smooth muscle cell migration/proliferation/extra-cellular matric development, which are findings first based on a series of in vitro studies, then documented in pigs and recently confirmed by others in humans by the prevention of restenosis with drug-eluted stents.^[49]
• The first demonstration of the great potency of antithrombins in the prevention of thrombosis in experimental animals, which has also been demonstrated recently in humans by his colleagues in the RE-LY trial on atrial fibrillation with the prevention of arterial embolism in those given oral antithrombins^[50]
• Based on MRI technology, demonstration in animals and humans of the development of neovascularization in the adventitia and media with the purpose to remove oxidized LDL-C from the intima, specifically when LDL-C in blood decreases with statins^[51][52]
• The documentation by MRI technology in animals and of histopathology in humans, that neovasculature, by leaking red blood cells into the interstitium induces an inflammatory reaction that predisposes to the rupture of the internal elastic lamina and eventually to plaque rupture and thrombotic occlusion^[52][53]

Contributions to large clinical trials, global health and education

As a result of this vocation and the clear social need to promote healthy habits, Fuster has created the SHE Foundation (Science, Health and Education) with the aim of improving total health in the population, especially young people.^[5]

SHE foundation

"After a lifetime devoted to medicine and research, Valentin Fuster, MD, PhD is convinced that a change in the population's lifestyle is the only way to avoid the spread of cardiovascular diseases, which are a real epidemic and the main cause of death in the world. "Faced with this evidence and based on the experience gained over his career, Valentin Fuster, MD, PhD promoted the creation of SHE, a non-profit foundation that, while focused on basic and clinical research (Science), is aimed at promoting healthy habits (Health) through communication and Education of the population. "With this goal, the SHE Foundation devotes its efforts to creating a frame of reference for what an education in health means and involves, stressing the acquirement of healthy habits from childhood in order to promote a world in which children, young people and adults have the ability to act positively towards their health."^[54]

Sesame workshop

"Valentin Fuster, MD, PhD, Director of Mount Sinai Heart, is the inspiration for a Muppet doctor on Barrio Sésamo: Monstrous Supersanos,^[55] the Spanish version of Sesame Street which debuted on Spain's Antena 3 just last month. The character named "Valentin Ruster" is helping to educate children to lead healthier lifestyles through exercise and healthy diet. "Fuster serves as an international advisor on Sesame Workshop's Global Health Initiative. Cardiovascular disease is the leading cause of death around the world, and the goal of the initiative is to measure health improvements in children and build global partnerships to address their critical health issues. In fact, many studies show that childhood obesity leads to cardiovascular disease, thru an increase in cardiovascular disease risk factors including high blood pressure, high cholesterol, etc. Globally, in 2010, the number of overweight children under the age of five is estimated to be over 42 million. Sesame Workshop, which has been creating specific content on healthy habits for young children and their families for almost a decade, is now exploring opportunities with Fuster to extend its initiative in the United States.

"Fuster first joined forces with Sesame Workshop in 2006 to collaborate with Plaza Sesamo, the Latin American version of Sesame Street, to promote cardiovascular health and well-being in Colombia. The series there encourages children, parents, teachers, and caregivers in making informed nutritional and lifestyle decisions based on educational television content, community outreach, and evidence-based research."^[56]

FREEDOM trial

The FREEDOM trial, involving 150 institutions around the world, is the largest funded study (NIH) in diabetes and is led by Fuster. It aimed at defining the optimal revascularization strategy for diabetic patients with multivessel coronary disease.^[57][58] The striking benefit of surgical revascularization versus stenting represents unique breakthroughs in the cardiovascular field as presented in the 2012 AHA Scientific Sessions and simultaneously published in the NEJM.^[59]

Polypill

"The prevention of cardiovascular disease is hindered by several factors, including wide variability in the pattern of prescription among physicians, limited access to expensive drugs in emerging countries, and poor adherence to medication. The use of fixed dose drug combinations (polypill) has been recommended to improve accessibility and adherence to treatment. The CNIC, working in a private-public partnership with Ferrer International, has devised a fixed dose combination for secondary prevention. The CNIC-Ferrer polypill project is led by Valentín Fuster and is coordinated by the Translational Research Platform."^[60]

Promoting cardiovascular health worldwide

This is a report recently released by the Institute of Medicine of The National Academy of Science, under the sponsorship of the National Heart, Lung, and Blood Institute. It was the result of deliberations of a 130member committee of experts chaired by Fuster and made available to all governments of the world in order to initiate and/or contribute to global health policy for chronic diseases.^[61]

Promoting cardiovascular health in children

This large scale initiative was carried out in Colombia and Spain under Fuster's leadership,. In Colombia, a randomized control was conducted to assess the effect in children three to six years of age (a time of behavioral development) of knowledge, attitude and habits regarding healthy eating and living an active lifestyle. Children in the 40-hour intervention group showed a significantly larger increase in total score compared to that in the control group. Three years later, children showed a further increase in total score. This finding will be published in the American Journal of Medicine.^[62]

The project's results have led to its expansion into about 25,000 children in Colombia and 20,000 children in Spain,. In Spain's program, a new Muppet character was recently created, inspired by Fuster. The character and his storyline are aimed at educating the children of Barrio Sesame about their hearts and bodies. The two country project will be long running in order to prove that the interventions at such an early age affect adult behavior. The participants will be evaluated each year.

Promoting cardiovascular health in adults of middle-income countries

Health in adults of middle-income countries can be reflected by a pilot project directed by Fuster on the island of Granada in the Caribbean, which has a population of 100,000 people. He is assembling groups of 10 people, with a cardiovascular risk factor profile in an Alcoholics Anonymous format that uses peer pressure to help participants adopt healthier behaviors.^[63] This project is based on a successful risk factor profile pilot study carried out in nearly 3,000 Grenadians and on a recent, also successful, 10-person group study now finishing in a small town in Spain.

Promoting cardiovascular health in adults of low-income countries

Exemplified by an NIH grant awarded to Fuster as a principal investigator, the objective of this project is to address the issue of hypertension in Kenya. Hypertension is the leading global risk factor for mortality, and the global cost of sub-optimal blood pressure is estimated to be very high. The project is demonstrating the effective impact of combining the human factor and high technology. A small portion of the 100,000 population of two town districts - Turbo and Mosoriot - are being trained through automatic machines, to take the blood pressure measurement of their respective neighborhoods; the values are then registered and centralized by the use of smartphones. Hopefully, such an approach will be transferable to other cities and countries.

Research and educational AHA-FORUM

A national program developed by Fuster when he was President of the American Heart Association, having two objectives in mind: 1) To engage potential young researchers with volunteer senior investigators of the AHA, offering as such, free tutorship or mentorship; the success stories of this approach are many. 2) To reinvigorate the Junior-Senior investigator relationships through and annual meeting, the Saturday preceding the Scientific Sessions of the AHA; the yearly attendance counts in the hundreds.

Clinical and educational AHA "Fellows Society of the Greater New York"

A regional program developed by Fuster when he was President of the AHA, New York Cit (2003-2004), the purpose being two-fold: 1)To educate fellows or young cardiologists in training in the greater New York area - including Connecticut, New Jersey, Long Island and the five Boroughs of NYC - about American Heart Association programs and activities. 2) To provide a forum for professional interaction, problem solving and discussion of professional issues among the cardiology fellows. Such a successful program, it is now being extended to other regions of the country including Chicago, Boston, Los Angeles, and Philadelphia.

Centro Nacional de Investigaciones Cardiovasculares

The Spanish Public research institute supported by the Government and by a core group of the most important Spanish private companies (Pro-CNIC Foundation).^[64][65] Under Fuster's leadership, these last five years have been crucial in two aspects: 1)For the development of an outstanding center of research, earning the prestigious award "Severo Ochoa Center of Excellence", as determined by three international committees. 2) The creation of an ambitious and comprehensive training program, the "CNIC-JOVEN," composed of 15 different programs aimed to identify and train the best and brightest talents for cardiovascular research, starting from levels of secondary education forward.

High Risk Plaque (HRP) Bioimage Initiative

With Fuster as a principal investigator, is aimed: a) to discover the role of multi-modality imaging (five technologies) in predicting subclinical disease, b) to identify the most cost-effective imaging technology for potential use in low and medium economy countries, and c) to evaluate whether subclinical isease can motivate the individual to modify his/her lifestyle. The project is successfully involving 6,000 Americans (Chicago and Florida areas) and 8,000 Europeans (Madrid and Zaragoza, Spain).^[66]

Author and editor

Books

• Hurst's the Heart Manual of Cardiology, 12th Edition by Robert O'Rourke, Richard Walsh and Valentin Fuster (Jan 27, 2009)
• The Heart Manual: My Scientific Advice for Eating Better, Feeling Better, and Living a Stress-Free Life Now by Valentin Fuster (Feb 2, 2010)
• The AHA Guidelines and Scientific Statements Handbook (Fuster, The AHA Guidelines And Scientific Statements Handbook) by Valentin Fuster (Jan 6, 2009)
• Atherothrombosis and Coronary Artery Disease by Valentin Fuster, Eric J. Topol and Elizabeth G. Nabel (Nov 8, 2004)
• Platelets in Thrombotic and Non-Thrombotic Disorders Pathophysiology, Pharmacology and Therapeutics Paolo Gresele, Clive P. Page, Valentin Fuster, Jos Vermylen Hardback (ISBN 9780521802611)
• Thrombosis in Cardiovascular Disorders [Hardcover] Valentin Fuster (Author), Marc Verstraete (Author)
• Update on Coronary Risk Factors, An Issue of Medical Clinics of North America [Hardcover] Valentin Fuster, MD, PhD (Author), and Jagat Narula
• La Ciencia de la Salud: Mis consejos para una vida sana (Spanish Edition) by Valentin Fuster (Dec 26, 2007)
• Cardiovascular Thrombosis: Thrombocardiology and Thromboneurology [Hardcover] Marc Verstraete (Author), Valentin Fuster (Author), Fuster (Author)
• La ciencia y la vida/ Science And Life (Spanish Edition) [Paperback] Valentin Fuster (Author), Jose Luis Sampedro (Author)
• [Cardiovascular Magnetic Resonance: Established and Emerging Applications [Hardcover] Albert Lardo (Author), Zahi Fayad (Author), Nicolas Chronos (Author), Valentin Fuster (Author)
• La pequeña ciencia de la salud [Perfect Paperback] Valentin Fuster (Author)
• Monstruos supersanos [Perfect Paperback] Valentin Fuster (Author)
• La cocina de la salud by Valentín Fuster / Ferran Adrià / Josep Corbella (2010)
• La vostra salute mi sta a cuore [Perfect Paperback] Josep Corbella Valentín Fuster
• La buona cucina della salute. La ricetta di un famoso chef e di un grande medico per vivere bene senza rinunce [Perfect Paperback] Valentin Fuster, Josep Corbella Ferran Adrià (Author)
• El Círculo de la motivación [Planeta de Libros] Valentín Fuster con la colaboracíon de Emma Reverter

Editorial

• The Vulnerable Atherosclerotic Plaque: Understanding, Identification and Modification [Hardcover] Valentin Fuster (Editor)
• Evolving Challenges in Promoting Cardiovascular Health by Annals of the New York Academy of Sciences Editorial Staff, Valentin Fuster (Editor) May 2012, Paperback
• Assessing and Modifying the Vulnerable Atherosclerotic Plaque by Valentin Fuster (Editor) with William Insull, Jr., MD June 2002, Hardcover
• Oxidative Stress and Cardiac Failure by Marrick Kukin (Editor), Valentin Fuster (Editor) October 2002, Hardcover
• Platelets in Hematologic and Cardiovascular Disorders: A Clinical Handbook [Hardcover] Paolo Gresele (Editor), Valentin Fuster (Editor), Jose A. Lopez (Editor), Clive P. Page (Editor), Jos Vermylen (Editor)
• Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health] [Paperback] Committee on Preventing the Global Epidemic of Cardiovascular Disease: Meeting the Challenges in Developing Countries (Author), Institute of Medicine (Author), Valentin Fuster (Editor), Bridget B. Kelly (Editor)
• Syndromes of Atherosclerosis: Correlations of Clinical Imaging and Pathology [Hardcover] Valentin Fuster (Editor)
• Efficacy of Myocardial Infarction Therapy [Hardcover] Valentin Fuster (Editor)
• Editor-in-chief of Nature Reviews Cardiology, April 2009

References

External links

• Mount Sinai Hospital homepage
• Fuster on Charlie Rose
• Clinton Global Initiative
• Valentin Fuster quotes on ThinkExist
• Fuster on Complementary Medicine.TV
• SHE Foundation