A wonderful biology teacher at my public high school in Brooklyn got me excited about becoming a scientist, and I entered college with the naive goal of curing cancer. A close family friend had died from a brain tumor when I was a child, and that sparked something in me. I wanted to take on a challenge that had the potential to help people on a global scale, and so I went to graduate school and then medical school to become a physician and scientist.
My plans were changed by experience and opportunity. During my medical residency and fellowship, I was mentored by leading experts in cardiac care and research. I became passionate about heart disease, both as a doctor treating my own patients and as a scientist whose findings could improve care for a condition that is the number one cause of death and disability in the United States. I have used clinical trials, which are the gold standard for providing evidence on how to care for patients, to examine different treatments for coronary artery disease and contribute to the knowledge we have on this topic.
The most important treatments for ischemic heart disease, which is most often caused by a blocked coronary artery, are medications and lifestyle changes that stabilize the plaque and prevent the disease from progressing. There are two other treatment options: stenting, which is a nonsurgical procedure to open the blockage and restore blood flow, and surgery, which creates a bypass around the blockages.
Stenting is proven to save lives for patients having a heart attack. Surgery and stenting save lives for patients with a blockage in the left main coronary artery, which is the most vital one. Both procedures are effective, but both have certain risks. Whether they are beneficial when routinely used in addition to medications and lifestyle changes across a range of types of patients with ischemic heart disease has been a major focus of my clinical trials. As study chair of the ISCHEMIA trial, I was able to lead one of the largest studies funded by the National Institutes of Health. The trial has improved our understanding of ischemic heart disease and has the potential to improve the way we treat the condition.
What I appreciate about working at NYU Langone is our customized approach to care. When a person comes to us with a blocked artery, we look at the individual’s overall medical history and health. We always do what’s best for the patient, based on the latest and best scientific data.
My career was born from my desire to have a positive impact, and I appreciate the opportunity to search for answers that can improve the lives of people who have heart disease.
Conditions and Treatments
- acute coronary syndrome
- coronary artery disease
- heart attack
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Over the past several decades, clinical research activities in the Division of Cardiology have contributed substantially to the cardiovascular literature and have greatly influenced the practice of clinical cardiology. In 2003 the Cardiovascular Clinical Research Center (CCRC) was established under the direction of Dr. Judith Hochman. Considered one of the world's leading cardiovascular clinical trialists, Dr. Hochman's studies in the areas of cardiogenic shock and coronary artery disease have transformed the guidelines for treating patients with heart disease. The CCRC serves as the clinical coordinating center for international and national multi-center trials and as the organizing entity for numerous local trials as well. The CCRC has helped support participant enrollment in a wide range of clinical trials and has helped administer the division's expanding portfolio of clinical research.
Dr. Hochman is Senior Associate Dean for Clinical Sciences, Co-Director of the NYU-HHC Clinical and Translational Science Institute, Harold Snyder Family Professor and Associate Director of the Leon Charney Division of Cardiology, and Director of the Cardiovascular Clinical Research Center (CCRC) [http://medicine.med.nyu.edu/cardiology/cardiovascular-clinical-research-center-ccrc] at the New York University Grossman School of Medicine. Her particular areas of interest include the management of ischemic heart disease, both acute and chronic, with a special interest in the role of revascularization with either PCI or CABG, the pathophysiology and management of cardiogenic shock, and optimized management of stable coronary disease, including based on sex differences. She is currently the Study Chair of ISCHEMIA EXTEND, an NHLBI/NIH-funded extended follow-up of the ISCHEMIA multicenter international randomized clinical trial. This trial compared two strategies for the management of patients with stable coronary artery disease: routine invasive management with the intent to revascularize using contemporary PCI or CABG plus optimal medical therapy, versus routine optimal medical therapy alone, with cardiac catheterization reserved for refractory symptoms or an acute ischemic event. The trial demonstrated no net difference in the primary outcome, which included major cardiovascular events; there was early risk with PCI and CABG procedures, with subsequent reduction in myocardial infarction. Longer-term follow-up demonstrated a reduction in CV death, but this was offset by an increase in non-CV death with the invasive strategy; all-cause mortality was similar. An initial invasive strategy improved quality of life in those with baseline angina. The findings resulted in new recommendations in the American College of Cardiology/American Heart Association and the European Society of Cardiology Practice Guidelines.
Dr. Hochman was the Study Chair of the NHLBI-funded Occluded Artery Trial (OAT), which tested the hypothesis that late opening of the infarct related artery (PCI/stent) will reduce the risk of death, MI and Class IV HF. OAT demonstrated no benefit for late angioplasty for persistent total occlusion late post MI and a trend toward excess reinfarction and led to new recommendations against performing this procedure in the ACC/AHA Guidelines (NSTEMI and STEMI, PCI) and the European Society of Cardiology Guidelines. These findings proved durable over the long- term (>6 years). In a subset of patients in the NHLBI-funded angiographic OAT ancillary study (TOSCA 2) less LV remodeling was seen with PCI. However, the NHLBI-funded myocardial viability ancillary study did not confirm that and importantly, the presence of retained viability in the zone supplied by the infarct-related artery did not correlate with improvement in EF or LV size with PCI. Patients in both the PCI and medical therapy only groups had significant improvement in EF over one year, with no difference between the groups.
She was the Study Chair of the NHLBI-funded SHOCK Trial, which demonstrated a one year and long-term durable survival benefit for emergency PCI or CABG and led to a change in the US and European guidelines. Translation of this trial and the recommendations led to increased use of revascularization in community-based studies with associated reduced mortality. She has investigated the role of systemic inflammation and excess nitric oxide in the genesis and persistence of cardiogenic shock and was Study Chair for phase 2 and phase 3 studies of nitric oxide synthase inhibition in refractory cardiogenic shock- SHOCK 2 and TRIUMPH. SHOCK 2 was an NHLBI Small Business Innovation Research program–funded trial; that phase 2 study and TRIUMPH were the first randomized trials to test a pharmacologic agent for cardiogenic shock. These trials demonstrated a dissociation between improvement in blood pressure and clinical outcomes, eg death. There was reduction in death despite a significant increase in BP with the NOS inhibitor. Dr. Hochman has served on numerous steering and executive committees for multi-center acute and chronic ischemic heart disease clinical trials.
During COVID-19 pandemic, she developed and led, as Study Chair, ACTIV-4A (Accelerating COVID-19 Therapeutic Interventions and Vaccines 4 ACUTE (ACTIV-4A) trial and oversaw CONTAIN and COMPILE studies.
She has served as a member of the FDA Cardiorenal Advisory Panel and chair and member of numerous Data and Safety Monitoring Boards (DSMBs) on trials sponsored by NIH and industry. In recognition of her scientific contributions she was awarded the 2014 AHA Clinical Research Prize and the 2016 ACC Distinguished Scientist Award (Clinical Domain), and the 2023 AHA Distinguished Scientist Award.
American journal of medicine. 2023 Nov 02;
Journal of the American College of Cardiology. 2023 Sep 19; 82(12):1175-1188