New Faculty Cardiologist to Lead Novel Preventive Cardiovascular Program

For Carl E. Orringer, M.D., the newest faculty member in the Cardiovascular Division, the move from Cleveland to Miami is a homecoming. Orringer is a triple ’Cane, with a B.A. in chemistry (1970), an M.D. (1974) and a residency at Jackson Memorial Hospital (1977). Thirty-seven years later, he’s back, bringing with him a high-profile cardiovascular disease-prevention program that he developed.

“Everything is coming full circle,” Orringer said. “I feel an allegiance to UM, and bringing the program here is my way of saying thank you.”

That full circle, however, is turning rapidly, so Orringer’s reentry into Miami will be a busy one. He is also president-elect of the National Lipid Association, an organization devoted to the prevention and treatment of dyslipidemia, excessive levels of cholesterol and triglycerides in the blood.

“The programs I will be bringing are for patients with difficult-to-manage cholesterol and triglyceride levels,” said Orringer, who will be associate professor of medicine and Director of the Preventive Cardiovascular Medicine and LDL Apheresis Programs. “Their levels may be too high due to genetic factors, because they can’t tolerate medication, or because they are unable to follow the necessary diet and exercise programs. The goal is to reduce these high levels and prevent development of cardiovascular disease.”

The LDL Apheresis Program will expand the heart disease prevention services already offered at UHealth ¬— University of Miami Health System. “LDL apheresis is indicated for patients whose genetic makeup causes them to have very high LDL cholesterol levels that can’t be controlled with lifestyle modification and maximally tolerated drug therapy,” Orringer explained. “Many of these individuals have no alternative. They come in twice a month, and a portion of their blood is withdrawn via an intravenous line and filtered, removing about 75 percent of the LDL cholesterol. The cleaned blood is then returned to the patient via a second intravenous line.”

The procedure takes two to three hours and will be performed at the infusion center at University of Miami Hospital. Orringer will arrange for the training of personnel involved with the process.

Orringer’s expertise in dyslipidemia has been developed over nearly four decades of medical practice. After completing his residency at Jackson, he spent two years in a cardiology fellowship at what was Peter Bent Brigham Hospital in Boston, before directing the coronary care unit and cardiac rehabilitation program at the Ochsner Clinic in New Orleans.

In 1986, Orringer joined the faculty at the University of Michigan Medical Center, where he developed and directed the preventive cardiology program and was active in patient care, hyperlipidemia-related clinical research and community outreach programs in cardiovascular health. In 1992, he moved to Cleveland, where he developed a community-based preventive cardiology program for University Hospitals Case Medical Center. In 2009, he joined the full-time academic faculty as associate professor of medicine at Case Western Reserve University, where he held the Harrington Chair in Preventive Cardiovascular Medicine.

Orringer is a member of an expert panel at the National Lipid Association, which has developed a new consensus document providing patient-centered recommendations for the management of individuals with lipid disorders. The final version will be published this fall.

“The panel’s goal is to provide practical and evidence-based recommendations to help the clinician properly assess cardiovascular risk and to define rational treatment approaches based upon a wide body of evidence,” said Orringer. “While we recognize and appreciate the great value of the evidence review provided by the recent American College of Cardiology and American Heart Association 2013 guidelines, our patient care recommendations are more aligned with international guidelines.

“The National Lipid Association’s recommendations recognize the uniqueness of each patient, and that many patients do not fit the characteristics of those included in previously published clinical trials,” he continued. “We want to help providers make clinically practical and scientifically based decisions that will enhance the preventive cardiovascular care of their patients.”

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