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Joseph Alpert: instrumental in defining MI
Alpert juggles professional duties with an interesting mixture of hobbies, creative talents.
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There are only so many hours in a day, but Joseph S. Alpert, MD, seems to utilize all of them to their fullest.
His busy medical and academic career, about which he is passionate, is complimented by his love of music, travel and exercise. His daily routine reads like a lesson in successful time management.
Defining MI
Alpert is well-known in the cardiology community for his work creating a universal definition of MI (for more see round table on page 10). Alpert and colleague Kristian Thygesen, MD, decided to work together at pinning down a workable document to ensure uniformity in MI diagnosis.
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Special assistant of clinical faculty development and professor of medicine at the University of Arizona. Member, Coronary Heart Disease Section, Cardiology Today Editorial Board. |
“Ten years ago, Kristian and I were at the American College of Cardiology meeting and were talking over dinner about how we had heard a number of research papers that day on the treatment of patients with MI that were somewhat contradictory,” Alpert told Cardiology Today. “We both agreed the reason was that they defined MI differently. We thought that what we really ought to do was come up with a physician’s statement that we could use not only for trials but throughout the world in all hospitals. We had a big task force meeting, and we published our first big paper in 2000 in the Journal of the American College of Cardiology and the European Heart Journal.”
The initial version of the definition caused some controversy, especially among some cardiologists.
“The most controversial period was after we published the first guidelines. We basically said that if a patient has elevated troponin after they have had an angioplasty, this was a heart attack because they occluded the artery and did some damage that caused a heart attack,” Alpert explained. “You can imagine that the angioplasty people were not too happy about that because nearly 20% to 30% of angioplasties will have a tiny injury like that.”
The definition has since been revised and adjusted as new research is presented, with the most recent revisions published in several journals last October.
“A lot more information came along since then, and what we did was actually made it more difficult to call it a heart attack post-angioplasty,” said Alpert. “We now assert that you have to bump your troponin more than three times the normal limit for there to be an MI.”
Academics and teaching
Alpert graduated from Yale University and obtained his medical degree from Harvard. Following his internal medicine and cardiology residency at Peter Bent Brigham Hospital and research fellowships with the Massachusetts Heart Association and the National Institutes of Health, Alpert became a staff cardiologist at the Naval Regional Medical Center in San Diego.
In 1978, Alpert returned to Massachusetts to become director of the cardiac unit at Peter Bent Brigham Hospital and assistant professor of medicine at the University of Massachusetts. Alpert remained a professor of medicine at the University of Massachusetts until 1992 when he was appointed the chair of the department of medicine at the University of Arizona College of Medicine. He held that position until stepping down to join the administrative team of the dean of the University of Arizona College of Medicine in 2006.
Alpert has always considered his work in academia one of his proudest accomplishments, and he has received academic and teaching awards at every institution where he has worked.
“I am very big on teaching and training the next generation,” Alpert said. “I have had some very good mentors in my career, and I hope to be as good to all of the young people that I have worked with as [my mentors] were to me.”
Enthusiasm for exercise
An avid runner, Alpert is also passionate about exercise physiology and the effects of exercise on the heart. He has spent time studying the hearts of high-endurance athletes and runners to determine if excessive exercise actually injures the heart. He has even been involved as a participant in running studies.
“It used to be thought that when high-level athletes would show left ventricular hypertrophy on their electrocardiograms, people took that as ‘too much exercise hurts the heart,’” Alpert said. “That turned out to be totally false. Your heart is just like your bicep muscle; if you do enough push-ups, your bicep muscle gets bigger. You have to distinguish between what we call physiological hypertrophy, or exercise hypertrophy, and pathological, or disease hypertrophy.”
Alpert also prescribes exercise to many of his patients as a supplement to their regular medication.
“My motto is that you only have to exercise on the days that you eat,” Alpert said. “I can tell you that there is a long list of health benefits of exercise, like lowering BP, lessening the chance of developing diabetes, increasing bone strength and even halting the development of dementia and Alzheimer’s disease. The list goes on and on.”
Creative hobbies
When he gets time away from the office, Alpert indulges in a variety of creative hobbies and interests. He travels the world extensively, frequently visiting his wife’s family in her native country of Denmark.
“Besides daily exercise, I love to read,” Alpert said. “I sometimes even read on the stationary bike. I love to read novels and sometimes historical books, like David McCullough’s book on John Adams.”
Perhaps his most beloved hobby, however, is playing music with his wife of 43 years.
“I love to play music, and I actually play the recorder,” Alpert said. “My wife plays the piano and harpsichord, and we play a lot of Baroque duets by Handel, Mozart, Bach and Vivaldi. We try to do that almost every day if we can.”
Although his creative juices are constantly engaged, Alpert joked that releasing an album of his performances is not in the foreseeable future.
“I am a long way away from that stage of my musical life.” – by Eric Raible
For more information:
- Thygesen K, Alpert J, White H. Universal definition of myocardial infarction. Eur Heart J. 2007;28:2525-2538.