Effects of PCSK9 Inhibition on Cardiovacula Risk

On June 11th, 2018, I was called by the General Hospital in conjunction with the VA Hospital to see if I could sign onto a drug test. I met Danny, Dr. Pricilla Hsue, Brendan Neilan and Smruti Rahalkar as they went over the forms and what was expected of me during the research project. I originally started this test with a different drug about three years ago.The test fell through when the money for the test project fell through. This new test will also consist of a new way to inject the medication. A new fancy automatic injection one takes in the stomach.

Vital Signs: My blood pressure was 130 over 74, my oxygon level was a 9, temperature normal, and the EKG came out normal. Five vials of blood were taken and will be sent to the lab for testing and if approved, I will begin the test phase in a few weeks.

Drug Injection: The drug will be administered with a new type of injection, a tube holding the medication is pushed against the stomach and a button is pressed. There is a window on the side of the five inch tube and as the medicine is slowly absorbed into the body, a yellow covering will close over the window, when the window is all yellow, the injection is finished in about 10 to 20 seconds. I didn't feel anything as the medicine went into the stomach and they said one can inject in the stomach, upper thighs or upper outer arms!

Study Coordinator: Danny Li 1001 Potrero Avenue 5G4 San Francisco, CA 1.415.206.5801

Principle Investigator: Priscilla Hsue, MD 1001 Potrero Avenue 561 San Francisco, CA Fax: 1.415.206.5447

Clinical Research Coordinator Brendan Neilan - Cardiology 1001 Potrero Avenue 5G4 San Francisco, CA Fax: 1.415.206.8037

Senior CRC - Dept. of Medicine Smruti Rahalkar, MAS 1001 Potrero Avenue 5G4 San Francisco, CA Fax: 1.415.206.5461

It will be a blind test and I was told the medication is given with an injection twice a month. They said part of the testing was to see if the medication helped older people fight off age related health problems such as strokes.

Possible forms of testing over the life of the Research Project

If I am considered for this research project, I will do numerous types of tests such as a scan of the left and right temples, a PET Scan (A positron emission tomography (PET) scan is a type of imaging test. It uses a radioactive substance called a tracer to look for disease in the body. A PET scan shows how organs and tissues are working), testing of blood vessels in the arms and so on. I did ask if anything was found in any of these tests, would my doctor and I be made aware of the results in case they were negative. They said of course. So that is a good reason to do these research projects, not only does it help many people but I can have multiple tests I normally do not get so I am able to ascertain my health conditions in a timely manner.

I also will have a Doppler Ultrasound on both upper arms to determine the blood flow and the health of the vascular network. A Doppler ultrasound is a test that uses high frequency sound waves (ultrasound) to measure the amount of blood flow through your arteries and veins, usually those that supply blood to your arms and legs.

A Transcranial doppler ultrasound (TCD) is a safe, non-invasive way of investigating the circulation in your head. It measures the speed and direction of blood flow around the base of your brain, and can be a useful diagnostic test if you have a circulation disorder. The San Francisco General Hospital's Neurology Department will do a TCD Scan on Both Temples for the study of blood flow to the brain usint the following methods.

A headband is placed on the head with contacts on the temples. This device directs high-frequency sound waves to the arteries being tested. A Blood pressure cuff is placed on the left arm. A gas is breathed in to facilitate the viewing of the vascular blood flow and the level of the blood pressure.

I will also have multiple appointments for Neuocognitive Testing including memory, verbal, and various other methods used to determine one's cognitive abillities.