Preventing the Preventable: Rhonda Rhyne on Using AI to Predict and Prevent Cardiovascular Disease
Heart disease is a global health concern, affecting millions of people worldwide. But what if there were more effective ways to predict and prevent this life-threatening condition? In this episode, I had the opportunity to converse with Rhonda Rhyne, CEO and President of Prevencio and author of 'Key to the Corner Office'.
Rhonda discussed the innovative work that Prevencio is doing in terms of attacking cardiovascular disease along with her unique experiences as a female leader in the biotech industry.
Rhonda's journey to the top has not been a cakewalk. As one of the youngest female CEOs in the biotech industry, she faced several unique challenges. But Rhonda is not one to back down from adversity. Instead, she used her experiences to create change.
Watch the Full Episode Below
Rhonda Rhyne
Rhonda Rhyne is a highly accomplished healthcare executive with a Bachelor of Pharmacy and an MBA. The majority of her career has been spent within the cardiovascular medicine industry, primarily in medical devices. With experience in General Electric Medical Systems and Cardiodynamics, she became fascinated by the biomarker world. Currently, Rhonda is the CEO and President of Prevencio, a company that is revolutionizing blood tests for cardiovascular disease.
The discussion then veered into the realm of heart disease diagnostics, where Prevencio is making significant strides. Rhonda discussed Prevencio’s HART Tests.
Two groundbreaking tests HART CADhs (“The Here and Now”) and HART CVE (“The future”) offer some much-needed hope in this arena.
These blood tests have an almost 90% accuracy for whether you have heart disease and are at immediate risk of a heart attack through the HART CADhs.
The HART CVE determines whether you have a one-year risk of a heart attack, stroke, or cardiac event.
We also discussed a few lifestyle topics such as Rhonda’s love for travel and fine wine, revealing that Greece and Italy hold a special place in her heart.
Overall, the conversation was enlightening, inspiring, and highly informative. It was not just about the prevention of cardiovascular disease or women in leadership; it was most importantly, about taking control of one's health and becoming the 'CEO' of one's life.
Takeaways
Cardiovascular disease prevention is not just about medical interventions but also about lifestyle changes and proactive health management.
Machine learning can revolutionize heart disease diagnostics, making them more accurate and potentially life-saving.
A systems mentality is needed in health. For example, with heart and overall cardiovascular health, genetics matter. But lifestyle, nutrition, exercise, body composition, and many other factors are part of the equation.
Regular testing, even at a younger age than mainstream would think is valuable because it’s never too early to get a baseline for where your health stands.
Connect with Rhonda Rhyne and Prevencio
Website — https://prevenciomed.com/
Transcript
Rhonda Rhyne
(0:00)
In trying to prevent cardiovascular disease, as you said, 80% of it is preventable.
(0:07)
And unfortunately, some genetics, but a lot of lifestyle and diabetes and obesity, hypertension, high cholesterol, the way we eat, the lack of exercise, there's just so much that contributes to it that some we can control, some we can't, but we might as well be controlling what we can and monitoring it with heart test.
Julian Hayes II
(0:33)
Welcome everyone to another episode of Executive Health and Life.
(0:35)
I am your host, Julian Hayes II, back at it again with my favorite word, another fascinating guest because today is very fascinating.
(0:42)
It's a topic that's near and dear to my heart as I've seen it just throughout my entire family tree since I've been alive in this world.
(0:49)
And so when we think about high blood pressure, high cholesterol levels, smoking, obesity, diabetes, sedentary lifestyle, even genetics to a certain standpoint, these are the things that are all associated with cardiovascular disease.
(1:01)
And this happens to account for over 1.7, no, sorry, 17 million deaths per year, lifetime I checked.
(1:07)
And every 40 seconds, someone has a heart attack.
(1:10)
I've also read that approximately 80% of premature heart disease and stroke can be prevented.
(1:15)
All this leads me into today's conversation, where we're focusing on preventing the preventable.
(1:20)
To reimagine our approach to cardiovascular disease.
(1:23)
My guest is someone whose entire career has had to focus and has focused, chosen to on cardiovascular disease.
(1:31)
She has more than 25 years of C-suite level medical technology experience, along with a plethora of awards and recognition, including being the Entrepreneur of the Year.
(1:39)
I'm speaking with none other than Rhonda Rhyne, who is currently the CEO and President for Prevencio.
(1:45)
And they're revolutionizing cardiovascular disease through leveraging artificial intelligence She's also the author of Keys to the Corner, all the successful strategies for women by women.
(1:55)
So without further ado, Rhonda, how are you doing today?
Rhonda Rhyne
(1:58)
I am doing great and it's wonderful to be here.
(2:01)
Thank you for the warm welcome and introduction and the opportunity to talk with you.
Julian Hayes II
(2:06)
Well, thank you for joining me.
(2:07)
I really appreciate that.
(2:08)
And I was doing some research and I went to your Twitter.
(2:11)
I know you're not that active there, but I did read your bio and it said that you're average traveler and a fan of wine.
(2:17)
So I'm curious, do you have a destination that holds a special place with your heart along with a preferred wine?
Rhonda Rhyne
(2:25)
Well, I'll take the wine first.
(2:28)
Really partial toward, of course, California because I had lived in California for so many years but had moved up to Washington State in 2012 and they have world-class wines up here.
(2:41)
So I think that Washington State is taking over for California, but in between those two states, Oregon has some really world-class pinots.
(2:52)
So we're very fortunate in the United States to have such great wines.
(2:57)
I do prefer them over French and several other countries in the world.
(3:03)
And oh gosh, favorite place in my heart for travel.
(3:09)
There's so many, but if I could pick two, I'd say Greece and Italy.
Julian Hayes II
(3:14)
Okay.
(3:14)
Is there a reason or just the landscape, the scenery or something?
Rhonda Rhyne
(3:19)
You know, both.
(3:21)
I think especially the landscape in Italy is just breathtaking.
(3:30)
And Greece is so different because you've got so much water and history.
(3:35)
You've got really history in both, but I really think the lifestyle in both countries and the people are just warm and they know how to live.
Julian Hayes II
(3:46)
Very true.
(3:47)
It's close enough that I think it's in terms of the flow and the pace of lifestyle.
(3:52)
So I was in Portugal.
(3:53)
I stayed there for about six and a half weeks just to get away a little bit.
(3:57)
And I gave away that I was American on a Sunday, I remember, when I was looking for a place to go work and I couldn't find it because most of the places were closed.
(4:05)
And they said, then that's why.
(4:07)
I know you're American then because you're always looking to work.
Rhonda Rhyne
(4:13)
Yeah, we are.
(4:15)
That's supposed to be our day of rest, but I don't think we do a very good job.
Julian Hayes II
(4:18)
Not at all.
(4:19)
But, you know, and speaking of work and everything, you have a very interesting career and backstory.
(4:24)
So let's go back a little bit.
(4:26)
I saw that you started as a pharmacist.
(4:29)
And what led to kind of the transitioning from that?
Rhonda Rhyne
(4:34)
Yeah, good question.
(4:36)
And I think our paths cross a little bit, too, because I had an interest in medicine.
(4:41)
So I graduated high school at 16, went to University of Arizona and had wanted to get a degree that, one, would give me flexibility if I decided not to go to medical school.
(4:55)
But on the other hand, one that would give me a very solid foundation if I went and decided that pharmacy would be a really good balance.
(5:04)
And it's just, it was an incredible background that would have served me well if I had gone to medical school.
(5:11)
I decided not to.
(5:13)
And I really did not want to practice traditional pharmacy.
(5:18)
I did work in retail and hospital pharmacy for a few years.
(5:22)
But I always had a very strong interest in business.
(5:28)
And people logically said, oh, go be a pharmaceutical rep.
(5:33)
And at that time, they were not hiring so many pharmacists to be pharmaceutical reps.
(5:40)
They had really transitioned over to hiring anybody who could go in and regurgitate certain things and have the clinicians write orders for the drugs.
(5:53)
And that just really didn't appeal to me.
(5:55)
So I did what I've done most of my life, is what people said you couldn't do.
(6:01)
And I was very fortunate and got a job in industry with a medical device company, which is very difficult to do if you don't have experience.
(6:11)
And it's ironic, but it was with Quinton Instrument Company, who was really introducing treadmills to help diagnose coronary artery disease.
(6:20)
And fast forward 40 plus years, now we're looking to probably replace the treadmills because they're highly inaccurate, especially in comparison to our cardiovascular test.
Julian Hayes II
(6:33)
I'm going to come back to that, because that's a great point about the treadmills and the tests that you all are doing now.
(6:37)
But there's another question about that.
(6:39)
And this is kind of tied in with your book as well.
(6:41)
What are the keys to the corner office?
(6:45)
And what are maybe two to three differences that are unique to women compared to men when it comes to rising and going to the corner office?
(6:54)
Because I also see that you were one of the youngest female CEOs of a biotech company.
Rhonda Rhyne
(6:59)
Yeah, so I think there's several differences.
(7:03)
One, I think that men are not as concerned with not having all the boxes checked before they step up for a position versus women.
(7:14)
If they don't have one box out of 10 checked, they're like, oh, I'm not qualified.
(7:19)
So I really respect men for stepping up.
(7:23)
And even none of us have done it all before.
(7:27)
And I really think that quality holds a lot of women back.
(7:32)
I also think another quality that really differentiates men.
Julian Hayes II
(7:39)
What is that?
Rhonda Rhyne
(7:51)
It's a national alert.
Julian Hayes II
(7:54)
That's a podcast first.
Rhonda Rhyne
(7:57)
Well, there's a lot of theories behind this national alert going on with the COVID vaccines and a lot of controversy.
(8:06)
So I had to have an alarm to shut my phone off, but I guess I forgot to.
(8:11)
Yeah, anyway.
Julian Hayes II
(8:13)
Well, you know, this is how we do it.
(8:15)
It's live and everything.
(8:16)
So I'm sure that was interesting.
(8:19)
But I guess I can't apologize for that because it wasn't me doing it.
Rhonda Rhyne
(8:23)
Oh, well, there's another quality difference between men and women.
(8:27)
Usually women are always apologizing for stuff they don't do.
(8:31)
And then men are accusing them of things that they didn't do also.
(8:35)
But the women are apologizing.
(8:37)
And I don't think men apologize as much.
Julian Hayes II
(8:41)
Yeah.
Rhonda Rhyne
(8:41)
And then what would be a third?
(8:45)
I just think men allow things to roll off their shoulders a lot more than women do.
(8:52)
And women internalize.
(8:54)
And maybe men do, but they certainly don't appear to internalize and personalize things as much.
(9:00)
And I think you just got to go out there and do the best you can.
(9:04)
My mother always said you can't please everyone.
(9:07)
And I think that's a really valuable lesson.
(9:09)
You cannot please everyone.
(9:11)
You've got to go out there with the best of intentions.
(9:14)
Give it the best you have.
(9:16)
Understand that crap happens.
(9:20)
And just keep moving forward the best you can.
Julian Hayes II
(9:23)
And I read a little bit of your backstory and everything as well.
(9:27)
And do you think that your background growing up and everything, do you think that shaped some of your leadership principles that kind of helped you throughout your career?
Rhonda Rhyne
(9:36)
Absolutely.
(9:36)
A lot of or sufficient trauma, I could say, or one could elect that it was trauma.
(9:47)
And I was very fortunate to have a very strong mother.
(9:50)
And even though she was acting like probably more was falling off her backside than it was, she always kept an extremely positive attitude, said God's on our side, and we're just going to keep moving forward.
(10:03)
And I really do believe if you're raised with different types of adversity, you hopefully learn to overcome them and become much stronger.
Julian Hayes II
(10:13)
Yes, I think it's a gift.
(10:15)
I think about my father and just seeing the struggles that a lot of family members had, that ultimately shaped me into making some of the decisions that I did with my health and changing some of my behaviors and even thought patterns around that and seeking knowledge out there.
(10:30)
So I definitely think any type of adversity, obstacles that we have, it can be a gift if we look at it with that kind of perspective.
(10:39)
Absolutely.
(10:40)
And so I'm curious, what inspired you to join Prevencio?
Rhonda Rhyne
(10:44)
Yeah, well, after I left pharmacy and went into industry, it was mainly medical devices like diagnostic treadmills, digital cath lab monitoring systems.
(10:57)
They were, for the most part, technologies, non-invasive hemodynamics that were at the beginning or leading edge, but they were medical devices.
(11:08)
I describe them as boxes.
(11:10)
And when I was in San Diego with Cardiodynamics, there was a company, BioSite, that had introduced troponin and they were introducing BNP for heart failure, and they're known as biomarkers.
(11:25)
So bio meaning life, markers, just it can be a gene, but it's something in your body that marks or indicates.
(11:34)
And it was just fascinating to see the growth of that industry, which we still don't have a lot of biomarkers out there, but there's a lot of single biomarkers.
(11:48)
And they were very powerful, but they had inherent limitations, especially in cardiovascular disease because cardiovascular disease is so diverse.
(11:58)
So they were very interesting.
(12:01)
And then all of a sudden you have all of these genomics tests that are multiple genes coming out and really advancing the diagnosis and treatment and care of oncology.
(12:15)
But this really had not been done in cardiovascular medicine.
(12:19)
And so I moved up to Washington State in 2012, and because my entire career had pretty much been in cardiology, I had some colleagues that were introducing me to some cardiology opportunities, and I really wanted to go into cardiology or cancer.
(12:40)
But my background was really in cardiology, so that made more sense.
(12:44)
And Prevencio was one of the opportunities that was introduced to me.
(12:48)
And because, one, it was biomarkers, but two, they had the idea of using machine learning to create multiple biomarkers and an algorithm and panel.
(13:01)
So they had the thesis for the company.
(13:03)
They didn't have the correct groundwork and research done.
(13:08)
So I was able to take an idea and capitalize on it.
(13:12)
And we've created seven products, and we've launched two of them commercially for patient use.
Julian Hayes II
(13:20)
I think that's a good entry point into this to discuss.
(13:23)
I think the first one, let's go to the heart test, the CVE.
(13:28)
But I guess before that, listeners may be thinking, okay, how did you come up with the four biomarkers?
(13:36)
And then what's the difference between the biomarkers and genes per se?
(13:42)
Which one will probably give you a better indication when it comes to heart health, if that makes sense?
Rhonda Rhyne
(13:46)
Absolutely.
(13:47)
So let me start with the difference between genes and proteins.
(13:51)
Genes we're born with, they're largely static.
(13:55)
Unless you're exposed to radiation, something really harsh, they're pretty static throughout your life.
(14:03)
Genes tell RNA which proteins to produce.
(14:07)
Proteins are very close to the disease state and are reflective and dynamic.
(14:13)
Even on our test, over the course of three months, if a doctor intervenes, you can see changes in individual proteins in the risk score.
(14:24)
So in a nutshell, genes are pretty static.
(14:27)
Proteins are closer to the disease state and very dynamic.
(14:32)
In the way we selected for heart CVE, CVE stands for cardiovascular events, and this is where my pharmacy background started to come in because our first envisioned test was a diagnostic for, do you have heart disease like obstruction of the heart arteries and an imminent risk of a heart attack?
(14:52)
But after we developed that, I said, you know, our next test would be very interesting to do a risk test that looks at, are you at a one-year, four-year risk of a heart attack, stroke, and cardiovascular death?
(15:08)
And that's an endpoint that the FDA often looks at for cardiac drugs and non-cardiac drugs.
(15:15)
So we had forged a collaboration with Massachusetts General Hospital and Dr. James Januzzi, and they were just finishing a biobank of more than 1,000 patients who had all undergone a coronary catheterization, where you thread a catheter, shoot dye, and you literally look into the coronary arteries.
(15:37)
And that helped us developing our heart CAD test for heart disease.
(15:43)
But on CVE, they also had follow-up for four years.
(15:47)
So we were able to take these 1,000-plus patients.
(15:53)
We took the blood, and we tested it for more than 100 proteins, which is very rare for people to do.
(16:03)
And then we had the follow-up for four years.
(16:05)
And you feed all that information into machine learning, which is a subset of artificial intelligence.
(16:14)
And to be very simple in explaining machine learning, it's a statistical program, so like a software program.
(16:22)
And you feed all this information in, and you tell it, these are the patients that had a whatever time frame.
(16:29)
We did four years and one year.
(16:32)
A heart attack, stroke, cardiovascular death.
(16:34)
And these are the patients that didn't.
(16:37)
And then the machine learning begins to select the either protein or the clinical variable that is most accurate for that endpoint.
(16:47)
And that's your first model.
(16:50)
It's only one protein.
(16:51)
So going back to the limitations of one protein test, they're not as accurate.
(16:56)
But then the machine learning selects a second protein or parameter, and it develops a second model, which is an algorithm or a weighting of those two variables.
(17:06)
And assuming that that increases the accuracy, the second variable, it'll add a third variable.
(17:13)
And assuming that increases the accuracy, there's a new model or new weighting.
(17:17)
It'll select a fourth one.
(17:19)
If the fourth one doesn't add to the accuracy, it kicks it out and adds a new fourth one.
(17:23)
And it builds it up into what I call a commercially non-viable panel, because you don't want a panel.
(17:33)
Some genetic panels have like 50 genes, and they're very expensive.
(17:38)
We wanted a reasonably priced, accurate test.
(17:45)
So we developed what we call a platform.
(17:47)
And it's not a physical platform.
(17:50)
It's a process.
(17:51)
So the machine learning builds up this panel of maybe 20 proteins, 15 clinical parameters that's accurate.
(17:58)
But we've developed proprietarily a process for shrinking that down to about three to five proteins and still maintaining the accuracy.
(18:09)
And the accuracy is really doctors have like individual proteins, but it's that algorithm that gives you the accuracy.
(18:16)
And I'll just pause there if you have any questions, and I can go into the proteins that are in CVE, if that's something of interest to you.
Julian Hayes II
(18:24)
Absolutely.
(18:25)
Now let's go into those.
(18:26)
That was going to be the next question is to go into each of those proteins.
Rhonda Rhyne
(18:30)
Okay, great.
(18:31)
So on heart CVE for our one year risk of heart attack, stroke, cardiovascular death, and it really goes out to four years, but we mark it as a one year because I say to you, Julian, you may have a heart attack in four years.
(18:44)
You may not be as motivated as if I say in one year, and we've got to get.
Julian Hayes II
(18:48)
That's very true.
Rhonda Rhyne
(18:50)
We've got to get working on that.
(18:51)
And there's no other one year risk test out there.
(18:54)
So the four proteins, and I love this because both of our tests that we offer for patient use have what I call an anchor or a well-known protein.
(19:05)
So the first protein in CVE is something called NT-proBNP.
(19:10)
And that is a single biomarker or protein that's used regularly to assess heart damage, especially with heart failure patients or the progress of heart failure, the improvement or deterioration.
(19:26)
So that's good.
(19:26)
Doctors are very familiar with NT-proBNP.
(19:29)
They know that it affects and reflects stress on the heart.
(19:33)
The second protein is osteopontin, and osteo meaning bone, and that's when it was first named, but bones have calcium in them.
(19:43)
So they found out that it's really involved also in calcification of the heart arteries and other arteries and also vascular inflammation.
(19:53)
So osteopontin is the second one.
(19:55)
The third protein is something called TMP1, TIMP-1.
(20:00)
It stands for Tissue Inhibitor of Metalloproteinases-1.
(20:04)
It's a mouthful.
(20:05)
A mouthful.
(20:05)
And that deals with plaque rupture.
(20:09)
So it kind of builds on what osteopontin does, and it's also involved with vascular inflammation.
(20:15)
And as you know, heart disease often starts with inflammation.
(20:20)
So these all make sense.
(20:22)
And then the fourth protein is Kidney Injury Molecule-1, or KIM-1.
(20:28)
And that deals with what we refer to as the cardiorenal syndrome.
(20:33)
It was initially a kidney marker, but whenever your kidneys are dysfunctional, your heart's affected and vice versa.
(20:44)
So that protein showed up in both CVE and our CADhs.
(20:51)
So that was very interesting.
(20:53)
So again, the combination in a weighted system or algorithm of those proteins gives us the accuracy of almost 90%.
Julian Hayes II
(21:04)
I'm glad you included the kidneys, the kidney one on there, because that's a relatively unknown fact.
(21:11)
I mean, I knew a lot just because Father, Aunt, and stuff on dialysis, and you see that when you have a kidney, one that's pretty much not functioning anymore, the extra pressure that dialysis and so forth puts on the heart right there.
(21:25)
And so I think that's an unknown thing.
(21:26)
When we think about heart health in general, we don't think about the kidneys and how it's connected.
Rhonda Rhyne
(21:31)
Well, and it's very interesting in all populations, but especially the African American population, there's a lot of hypertension.
(21:42)
And much of that can come from what's going on with the kidneys and the aldosterone system.
(21:49)
So there's just an immense correlation.
(21:51)
And as you say, it's underappreciated.
Julian Hayes II
(21:54)
Now, these things, do they factor?
(21:56)
You don't really need to have those things factor into when you're doing these types of tests, do you?
(22:01)
Like different ethnicities, does that?
Rhonda Rhyne
(22:04)
Yeah, really good question, because many tests out there can be affected by ethnicities.
(22:11)
And we have not found that there's a big factor.
(22:15)
And we've done some sub-analysis.
(22:17)
And actually, sometimes it works even better on African Americans, which may be in part because we do take into account for proteins and that kidney injury molecule, which kidney disease can be more prevalent in the African American situation, as well as hypertension, which those two probably both contribute to heart disease, unfortunately.
Julian Hayes II
(22:44)
Yeah, it's a very interesting thing of just how different ethnicities and our genes and everything.
(22:50)
But if you think about it, it was a survival mechanism.
(22:53)
So it's there to ultimately get us to this point.
(22:56)
But then our environment a lot of times doesn't match up, and our behaviors doesn't match up with our genes and everything.
(23:01)
Because I actually have, if I go by my genetics, I'm in the highest category for salt retention and all that.
(23:08)
And I wouldn't be mindful of that, but I'm into athletics a lot, and I train a lot.
(23:11)
So my salt intake is probably crazy.
(23:14)
But it's something that nevertheless I still monitor and everything with those as well.
(23:18)
So let's go into the – actually, we mentioned this earlier, the treadmill tests compared to the tests that you are doing now.
(23:27)
And is that related because people generally are going to look for the calcification of the artery, right?
(23:35)
When you think about a – what's the test called?
Rhonda Rhyne
(23:41)
Coronary artery calcium score?
Julian Hayes II
(23:43)
I had a brain freeze, and I offer this thing.
(23:45)
Yes, the CAC score, yes.
(23:46)
Is that because the calcium is not as accurate as these biomarkers here are going to be?
Rhonda Rhyne
(23:53)
Yeah.
(23:53)
So there's – so like I said when I started my career in industry, they didn't have coronary artery calcium scores.
(24:02)
They had these treadmill systems where they put you on a treadmill to walk, if you could walk, and they would record the electrical activity of the heart to see if there was something called ST depression or elevation.
(24:18)
Elevation is usually when you're having a heart attack, but when you're under stress, you can have ST segment depression.
(24:24)
And that's sort of electrical.
(24:27)
It's reflecting what might be going on in the heart arteries, but it's not exactly a direct measurement, but it's the best that they had at the time.
(24:36)
Our data shows accuracy of about 52% to 53%, which 50% is like flipping a coin.
(24:45)
So it's highly inaccurate, and doctors will say, we know that, so they started to do stress echoes where they'd stress you and then put you on a bed and look at the wall motion of the heart, and that's a little bit better.
(24:58)
And then they have nuclear, which has radioactive stuff being injected into you and imaging, which none of it's good.
(25:07)
And our data, again, showed collectively those were all about 0.52 to 0.53. So then they moved on to, and to answer your question, with echoes, you could see sort of the wall motion and more information.
(25:25)
With nuclear, you could kind of see a little bit more, but none of it was perfect.
(25:29)
And then they started with CAC scores, or the coronary artery calcium scores, or coronary CT angiograms, which those latter two both require a CT scanner, but CAC scores are not requiring injection of a dye.
(25:51)
So you're kind of just looking at the calcium, which isn't exactly plaque.
(25:59)
It's not, but it's a reflection of it.
(26:01)
And it doesn't tell you on CAC scores whether that plaque is stable or what they call vulnerable or plaque that can break off.
(26:12)
And with the introduction of statins in the 80s, we started to see less and less people having acute heart attacks and dying.
(26:23)
They still do, but they theorize it's because the statins stabilized a lot of that plaque.
(26:30)
So the limitations with CAC scores is that they're really not differentiating, and you're really looking at calcium versus pure plaque.
(26:39)
And their accuracy is only about 60%, maybe 65% in women.
(26:44)
And then CCTAs, coronary CT angiograms, they are really good at ruling out, saying you don't have heart disease.
(26:55)
But because they're looking at calcium, again, there's a lot of false positives.
(27:00)
So much so that all these tests that I talked about that work up patients to say, do you need to go to the coronary cath lab to have a catheter up your groin or in your arm to go through the heart arteries to visualize what is really going on there?
(27:21)
Upwards of 65% of patients that are worked up by those modalities to go for diagnostic invasive cath are not clinically obstructed.
(27:32)
So it just shows that they're sending 65% of patients for a coronary heart cath that has a risk of heart attack, stroke, and small risk of death, and upwards of 20% chance of kidney disease because of the dye they're injecting.
(27:50)
It's just needless, and it's very expensive.
(27:53)
So we need a better solution.
(27:57)
And Prevencio, maybe you can say we're biased, but we've got higher accuracy, no side effects, more accessibility, lower cost of these other modalities.
Julian Hayes II
(28:08)
Well, it seems also easier.
(28:11)
It's easier to do a blood test than to go through all of that.
(28:15)
And if I already have a propensity for my kidneys and everything, and even if I didn't have a propensity for kidney health or anything like that, that's still putting unnecessary stress and potential damage to my kidneys.
Rhonda Rhyne
(28:28)
You're so right, Julian.
(28:29)
And I call that accessibility.
(28:32)
It's so easy because it's a blood test.
(28:34)
And we were actually seeing a decrease in cardiovascular disease or stabilization from like 2011 to 2019 in the United States.
(28:45)
And when COVID hit, for a number of reasons, they were limiting the care that you could get.
(28:53)
Patients didn't want to go in.
(28:54)
There were limited personnel.
(28:56)
And a lot of these tests, especially in the hospital, are only done on the weekends.
(29:02)
I'm sorry, they're not done on the weekends.
(29:04)
They're not done after hours.
(29:05)
So we've seen a reversal in the progress or improvement that we had made in cardiovascular disease because during COVID and the subsequent years, we just weren't able to get the diagnostic and risk assessments that patients needed and ultimately care.
Julian Hayes II
(29:26)
The way I look at it, it's like a drain that was backed up.
(29:28)
And then that drain finally got released maybe a year or two ago.
(29:32)
And now there's this backlog for all the reasons you mentioned.
(29:36)
And so I definitely understand that because I definitely, I was experiencing that as well, just the different types of hurdles and everything you had to go through during that period.
(29:45)
So let's go over the differences.
(29:48)
So we discussed the CVE, and that's kind of giving me an outlook into the future.
(29:53)
One year, we'll say one year, but it's usually longer than that, but one year just to increase the stakes of it, which I totally agree we should do.
(30:03)
So the next one is, is that more of the CADhs?
(30:07)
Is that more of a present focus?
(30:10)
How would you explain the difference?
Rhonda Rhyne
(30:12)
We call, first of all, HART, H-A-R-T is our brand name.
(30:17)
So HART-CVE and HART-CADhs, CAD stands for coronary artery disease, that means heart disease.
(30:24)
The HS stands for one of the proteins, high sensitivity troponin is in it.
(30:29)
So yes, we describe CAD as a diagnostic, the here and now.
(30:36)
This is, are you at imminent risk of a heart attack or what is your risk for having a heart attack?
(30:42)
And then the other one is up to a one-year risk.
(30:48)
So it's the future and it expands beyond heart attack.
(30:52)
And we've had patients who, you know, they'll take a CVE test and it's high and the CAD isn't as high.
(31:02)
And the cardiologist will work up with a stress echo and say, no, you don't have heart disease.
(31:08)
And one of our patients went on to develop brain infarction, like four of them, two right away and two a couple of years later.
(31:18)
And that's brain infarctions, like for another word for a stroke.
(31:22)
So just because you don't have heart disease here and now, you kind of want to know what's going to happen in the next year.
(31:31)
But what that one year does is it allows you and your physician to get very intense in your treatment.
(31:39)
And the majority of patients are not maximized on the treatment.
(31:44)
But if you have a CADhs very high today, that says you better go in for an intervention, a coronary catheterization to look inside those arteries and see if you need a stent or coronary bypass.
Julian Hayes II
(32:00)
Okay.
(32:01)
That's an easy way to think about it.
(32:03)
Present, future, very easy distinction between those two.
(32:07)
And the other ones that are not direct to consumer now, right?
(32:12)
And so what are some of the other tests that are available or in the works?
Rhonda Rhyne
(32:16)
Yeah.
(32:17)
So those two tests that we just talked about, in 37 states are available direct to consumer.
(32:23)
And, you know, in all states are available for your physician or physician assistant or nurse practitioner to prescribe.
(32:33)
And we do have Medicare reimbursement, Medicare Advantage.
(32:37)
The other tests are used right now for research use purposes.
(32:42)
And we have a number of them, one for Kawasaki disease, which is, it's a little bit different from our other, it's in cardiac, but it is a disease that afflicts children.
(32:57)
And primarily they're coronary arteries and there's no diagnostic for it.
(33:04)
And if they're not, there's no diagnostic.
(33:06)
So how do you, how do you diagnose them and get them treatment, which is so critical so that they don't develop these ballooning of the heart arteries.
(33:15)
And it's a rule out process.
(33:17)
Children have to go back to the emergency room two and three times, and all this time they're really being hurt.
(33:23)
But that's one of the real exciting ones.
(33:25)
But we also have for acute kidney injury, peripheral artery disease, which is closely related to heart disease, aortic stenosis, and amputation.
Julian Hayes II
(33:38)
Oh, wow.
(33:39)
The amputation, how does that, is that looking at the same, is it, do you know which proteins yet or is that still in the works?
Rhonda Rhyne
(33:47)
It's a number of proteins and kidney injury molecules, one of them.
(33:51)
And it's just, again, taking all that data, feeding it in, saying these patients have an amputation, these didn't, and seeing what the parameters were.
(34:04)
And all this information is available on our website.
(34:07)
For anybody that would like more information, we have our manuscripts and different presentations.
(34:16)
To date, we've had 33 peer-reviewed manuscripts and presentations.
(34:22)
So very well published.
(34:23)
And we're very fortunate to be in collaboration with Massachusetts General Hospital, University of Hamburg in Germany, and Inova in Northern Virginia.
Julian Hayes II
(34:32)
And I'll include the website on the show notes.
(34:34)
And it's a well-put-together website with a lot of information.
(34:37)
So I thought it was well-designed and just in everything.
(34:41)
And so I heard that Medicare, Medicaid reimburses.
(34:46)
Is it other insurances as well?
(34:49)
Say if it's like just a 40-year-old who just has, I don't know, Cigna or something.
Rhonda Rhyne
(34:54)
Yeah.
(34:55)
So right now it's Medicare and Medicare Advantage.
(34:59)
We're working on Medicaid.
(35:01)
And we'll be working with other insurance companies to get it for people who are not of Medicare age or don't have Medicaid.
(35:11)
It's a long process.
(35:13)
But again, even if you're in a state that's not direct to consumer, you can get these tests from your physicians for cash pay for under $400.
Julian Hayes II
(35:25)
Oh, that's just, I don't know if I want to say the word steal, but that's compared to some of the other diagnostic tests out there.
(35:35)
That's crazy value.
(35:37)
That's amazing.
Rhonda Rhyne
(35:38)
And it's just a blood test.
(35:40)
There's no side effects.
(35:42)
And it's very trendable.
(35:45)
So like I said, the proteins are very dynamic.
(35:48)
So if you're dealing with someone that's relatively healthy, very healthy and stable like myself, you'll see the numbers over six months, a year, two years are consistent.
(36:00)
But on patients who aren't as stable or they're having interventions done by their clinician, you'll see those numbers move.
(36:09)
So it's very exciting.
(36:12)
And because it's a blood test and very reproducible or not, depending on the results, that's different from imaging or even treadmills, where you've got a lot of variability, technician dependence, interpretation dependence.
(36:28)
There's a lot of artifacts, especially in those CT machines, if you can't hold your breath.
(36:35)
For coronary CT angiograms, they'll give you a drug to limit your respiration and heart rate, which a lot of patients can't do.
(36:44)
So again, there's no limitations, no side effects.
Julian Hayes II
(36:49)
Awesome.
(36:49)
And the last, one of the last questions here, actually this will be the last question.
(36:53)
What are one to two things that you're most excited about and for the coming future for Prevencio?
Rhonda Rhyne
(36:59)
Yeah.
(37:00)
So first of all, it's been a dream of mine.
(37:04)
I've been with the company 10 years to offer our tests for patient use, and we're just really getting going with that.
(37:12)
So really expanding the number of clinicians that are using our test to the benefit of their patients.
(37:21)
And that has been increasing, and we really are seeing some very interesting results, putting together some case studies.
(37:30)
So foremost, helping patients, because that was our dream.
(37:35)
And then the second one is helping patients also, but it's with the Kawasaki disease diagnostic.
(37:41)
And those first two tests that are offered right now, we not only developed them and internally validated at Massachusetts General Hospital, but we externally validated as the Institute of Medicine recommends at two different institutions, and one of them was international.
(37:56)
And that's what we desire to do with all of our tests before offering them for patient use.
(38:02)
So on Kawasaki disease, we are in the process of doing a multinational external validation before we offer that for patient use.
(38:13)
And we could offer it now, but we just...
(38:17)
Whenever you're dealing with patients' lives, and I'll say especially children, you really want to make sure you've robustly externally validated.
Julian Hayes II
(38:26)
Absolutely.
(38:27)
It's better to...
(38:28)
This is where it pays to be very conservative before just rushing something out there just to get it out there.
(38:33)
So I think that's the way that things should be done.
Rhonda Rhyne
(38:38)
Yes, and Julian, given that you've given me the consideration of this wonderful podcast time and your history, I would love to offer you to take both of our tests, and hopefully we're not doing a case study on you, but...
(38:57)
We'll do a case study showing how you have overcome your genetic and family history disposition.
Julian Hayes II
(39:04)
Yes, so I would definitely take you up on that, and I think I will actually just do some separate videos and document it on it and just be a proponent of that.
(39:14)
Because I'm 37.
(39:15)
It's never too early to start, because if anything, you're going to get a baseline.
(39:18)
That's why I always encourage people just to...
(39:20)
I don't care how you feel now.
(39:22)
It's a good baseline to maybe when I'm 60, I can say, oh, this is how I was at 37, so I think it's good to do that.
(39:28)
So I'm looking forward to it.
(39:30)
These things always make me nervous.
(39:31)
Even when I go to get blood work, it makes me nervous, even though I eat really good and everything, but there's just something nervous about, like, am I doing everything that I'm supposed to be doing?
(39:41)
But so that's a healthy nervousness that I have.
Rhonda Rhyne
(39:46)
Well, I recommend doing these at least every year, and I guess this takes us back to the beginning of our podcast, where you said, in leadership or business, what's the difference between men and women?
(39:58)
Well, in health, women are much more proactive.
(40:02)
Maybe they're not as fearful, or they figure ignorance is not bliss.
(40:07)
And yes, men tend to really avoid knowing the truth about their health in general, and you should be very proud of the proactiveness you've taken in trying to prevent cardiovascular disease.
(40:21)
As you said, 80% of it is preventable.
(40:25)
And unfortunately, some genetics, but a lot of lifestyle and diabetes and obesity, hypertension, high cholesterol, the way we eat, the lack of exercise, there's just so much that contributes to it that some we can control, some we can't, but we might as well be controlling what we can and monitoring it with heart tests.
Julian Hayes II
(40:48)
Absolutely.
(40:49)
And that's a great way to end the conversation here, is prevenciomed.com
(40:54)
Is that the best place to go for more information?
Rhonda Rhyne
(40:56)
It is, and people like to say Provencio, but it's Prevencio, like preventing.
Julian Hayes II
(41:01)
Did I just say Pro?
Rhonda Rhyne
(41:03)
Nope, you said it right.
(41:04)
You said it right.
(41:05)
Yep, P-R-E-V-E-N-C-I-O.
Julian Hayes II
(41:08)
Funny enough, so when I was going over this, right, and I practice names no matter what, and then I always practice company names, and the first time, I kid you not, I did say Pro accidentally, and I saw Pre right there, and I still said Pro in my head.
Rhonda Rhyne
(41:22)
And so many people did, and when I was consulting with the company, I said that too.
(41:28)
So now I just roll my eyes.
(41:32)
I'm like, that was part of the tagline, preventing the preventable.
(41:36)
We are, but maybe they'd get Provencio too.
Julian Hayes II
(41:39)
Absolutely, and so this has been an awesome conversation, and I look forward to keeping up with the progress and everything that's being done here.
(41:45)
And for listeners out there, and for those who are watching this in the future, and even now, stay awesome, be limitless, and as always, go be the CEO of your health and your life.
(41:53)
Peace.
(41:55)
♪♪♪
