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Margo B. Minissian, PhD, ANCP, discusses evolution of women’s CV health
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For this issue, Cardiology Today spoke with Editorial Board Member Margo B. Minissian, PhD, ACNP, FAHA, a research scientist, clinical lipid specialist and cardiology nurse practitioner at the Barbra Streisand Women’s Heart Center, part of the Smidt Heart Institute at Cedars-Sinai.
Minissian completed her master’s degree in nursing and her PhD in biological research at UCLA. She has published numerous papers on studies focused on topics such as CV prevention, women’s health and adverse pregnancy outcomes. Minissian was a co-author on the 2016 Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk.
Throughout her career, she has also been given several awards recognizing her efforts, including the Distinguished Associate and Outstanding Advocate of the Year awards from the American College of Cardiology, some of which are firsts for a scientist/nurse.
Who has had the greatest influence on your career?
Dr. Minissian: C. Noel Bairey Merz, MD, FACC, FAHA, FESC, my first mentor out of my master’s program. She has been such a pivotal person for developing me into the person I am today.
What I would say about her that makes for some of Dr. Bairey Merz’ strongest qualities is that she is a born mentor. Early on, she connected me with national societies such as the ACC and the American Heart Association and put my name into the hat for leadership opportunities and committee work.
Dr. Bairey Merz has fostered my love for research. I began as a coordinator on her studies and over the years have been able to submerse myself into my career, making it what it is today as a research scientist. She is amazing.
What was the defining moment that led you to your field?
Dr. Minissian: When I was in nursing school, I met a critical care nurse who was very passionate about what she did. Her excitement as an educator helped spark my interest in cardiology as a whole. I have wanted to work in cardiology since I was 18 because of her.
What areas of research in cardiology interest you most right now?
Dr. Minissian: I love all things prevention. My goal in life is to help patients completely divert themselves away from the path of heart disease. When I talk to my patients, I tell them that I’m not a cardiologist, and my goal in life for you is to not have to see a cardiologist.
I am a board-certified lipid specialist. I love the science behind cholesterol, metabolism, statin myalgias, helping patients obtain healthy blood pressures and cholesterol. My most recent research is in women who have adverse pregnancy outcomes and our ability to be able to identify these women very early so we can also change their health trajectory.
What are your hobbies outside of practicing medicine?
Dr. Minissian: I have two children: Thomas, who is 16, and Natalia, who is 11. My children and my husband, Garo, love outdoor activities. We love to go boating and camping.
My No. 1 passion is horse riding. I am a competitive equestrian. My daughter and I compete on a national level for the Arabian horse circuit, and I was reserve national champion in 2015. We work hard and we play hard too. The horses have been a wonderful outreach for me. That is truly my therapy. Where I find my peace is being in blue jeans and my hair in a ponytail on the back of a horse.
What’s up next for you?
Dr. Minissian: I recently joined as a faculty research scientist at the Smidt Heart Institute at Cedars-Sinai. I just submitted a K99/R00 grant to the NIH. I am very excited for my new research endeavors that I have going on at Cedars-Sinai.
It is research that helped us identify women who have had an adverse pregnancy outcome and to help us phenotype out these women. Currently in research, when someone is labeled preterm delivery or preeclampsia, they are lumped together. What we are learning is that these conditions have a lot of heterogeneity among them.
I have a study where we are doing vascular testing and we are putting these women through cardiac MRI to look for preclinical cardiac dysfunction. We are looking to separate women who had preterm preeclampsia from women who have just spontaneous preterm delivery and those women who have preeclampsia who deliver at term. We think that their vasculature is actually very different. Our hypothesis is that some of these women may be having subclinical vascular or cardiac dysfunction years before they start to develop heart disease. It is a 5-year grant, and it will help give us some insight into the blood vessel health of these women.
I have been very fortunate to be on this amazing ride as we have evolved women in heart disease knowledge, research and outreach to the public as well as legislatively. We have been able to see increases, and the data have shown that heart disease deaths have decreased. A lot of that has to do with our ability to work with the WISE project, which has been a pivotal study long-term, it began in 1996. This study has affected the way that we see heart disease in women and to be able to identify it, because the pathophysiology can be quite different. – by Darlene Dobkowski