Full Disclosure:
The influential Steve Nissen

Steve Nissen in the cardiology catheterization lab at Cleveland Clinic Photo: Greg Ruffing/Redux

The e-mail was one of many Steve Nissen (M.D. 1978) routinely receives in a day. This one, however, was anything but routine. It said that Time magazine had named him one of the 100 most influential people of 2007.

Nissen thought it was a joke. A friend must have sent it.

“You don’t expect to end up on a list like that if you practice medicine and write research papers,” he says. Nissen chairs the Department of Cardiovascular Medicine at Cleveland Clinic, which he joined in 1992.

It was no joke. Time magazine included Nissen on the list in the section “Scientists and Thinkers,” along with the likes of geneticist Craig Venter and political activist and former Vice President Al Gore. Internationally known for his research into reducing the progression of coronary artery disease, Nissen, a former  president of the American College of Cardiology, has dedicated his career to better understanding the biology of heart disease. He helped pioneer intravascular ultrasound, a type of high-resolution imaging technology that can be threaded through blood vessels into the beating heart, which has been the basis for his research during the last decade.

An activist since his U-M undergrad days protesting the Vietnam War, Nissen today also is well-known as an outspoken and credible voice on public health and policy matters. He recently testified before Congress on drug safety and FDA reform, calling for major changes in drug development and post-marketing surveillance. And since he doesn’t accept honoraria from industry, he’s emerged as a highly credible media resource.

In 2001, Nissen was one of the first to show that COX-2 inhibitors increase the chance of heart attack. In May of this year, he published a paper in the New England Journal of Medicine on a blockbuster drug for diabetes. His research showed that people who take the drug, which reduces blood sugar, are 43 percent more likely to have a heart attack than patients who take a placebo or another diabetes medication. “I had some concerns based on the clinical trial data, and I tend to pursue those scientific questions,” he says.

While many heralded this research, not everyone was happy with the results. A public relations officer from GlaxoSmithKline, maker of the drug, sent an e-mail to several journalists questioning the validity of Nissen’s study. This kind of reaction comes with his work, yet Nissen doesn’t let the negatives stop him.

“I believe that providers and patients have a right to know all of the findings about therapies — positive and negative. The value of full disclosure almost always outweighs the risks of not disclosing such findings,” he explains.

The official GlaxoSmithKline response is that it “strongly disagrees” with Nissen’s results.

Nissen also researches the efficacy of cholesterol drugs using intravascular ultrasound. In a study published in 2004 in the Journal of the American Medical Association, he discovered that statins were more effective in reducing cholesterol and plaques in coronary arteries if doctors used an aggressive dose of the treatment.

Currently, Nissen is involved in clinical trials for the weight loss drug rimonabant, and he’s working on a comparative study of arthritis drugs for patients at high risk for cardiovascular disease. He is the principal investigator for several large intravascular ultrasound atherosclerosis trials.

While he enjoys a relatively quiet life in northern Ohio, Nissen doesn’t hesitate to speak up when necessary. And when he does, people everywhere tend to listen.
 

—Meghan Holohan