Cardiovascular Research

Since 1915 the Henry Ford Health System and the Division of Cardiology have shared the common mission of improving human life through excellence in the science and art of health care and healing. This mission is carried out by physicians and researchers who are dedicated not only to unmatched clinical care, but also to ground breaking scientific activities. Our bioscientific and clinical staff are engaged in more than 2,000 active basic science, translational, and clinical studies spanning from the bench to the bedside. Studies range from whole-animal physiology to cell and molecular biology to bioengineering to clinical projects. Henry Ford scientists and physicians also participate in and lead many clinical trials that determine how to best treat disease. In fact much of our activities focus on studies that directly seek to understand mechanisms of disease and improve patient care. We are particularly proud of research teams from the Department of Public Health Sciences and the Center for Health Policy and Health Services Research who collaborate with members of the Henry Ford Medical Group as well as researchers in other states to enhance the quality of health care nationwide.

cardio research forum

Henry Ford Health System’s research program is one of the largest, most well-funded, and successful in Michigan. We receive about $86 million in annual funding from external sources, including the National Institutes of Health (NIH), other governmental sources, businesses and private foundations. In addition Henry Ford provides about $12 million in support of the research enterprise. We rank fourth in Michigan in total NIH funding and rank first in Michigan for NIH-research funding for non-university based health care systems. We are in the top 20% of all institutions granted funding by NIH and U.S. Public Health Service.

Research programs in the Cardiovascular Division are among the most robust in the Health System. Opportunities are equally strong in each subspecialty of Cardiology. Fellows take full advantage of all of our research programs and routinely present at regional, national, and international society meetings. In 2018 our Division produced more than 150 manuscripts and abstracts, and Fellows are traditionally involved in many of the projects. Fellows also have the advantage of being paired with excellent research mentors who help guide them through their research activities from hypothesis generation, to IRB submission, to manuscript submission. Through didactic sessions, journal clubs, and one on one meetings Fellows are taught how to conduct thoughtful, ethical, and well performed cardiovascular research. To make the research experience even more appealing at Ford, Fellows have paid access to biostatisticians to help them with their research projects as well as institutional grants from the Graduate Medical Education Department to fund their projects.

Below you will find an example of recent activities within the Cardiovascular Division. We look forward to future Cardiology Fellows bringing with them new ideas and joining in the scholarly activities of our Division. The distinct advantage of training at Henry Ford is that you will be assured an outstanding clinical as well as academic training that will prepare you for a future life as a clinician and a scholar.

Recently completed and ongoing clinical trials

Structural heart disease/ interventional cardiology

  • LAMPOON- NIH sponsored trial. Laceration of the interior mitral leaflet to prevent LVOT obstruction during transcatheter mitral valve implantation
  • MITRAL trial: Led by Henry Ford Cardiologist Bill O’Neill and Mayra Guerrero. The purpose of this trial is to establish the safety and feasibility of the Edwards SAPIEN XT™and SAPIEN 3™ device in patients with severe symptomatic calcific mitral valve disease with severe mitral annular calcification.
  • M3: Percutaneous implantation of M3 docking system and transcatheter mitral valve replacement
  • ExCeed: Transcatheter aortic valve replacement with the Centera valve; To establish the safety and effectiveness of the Edwards CENTERA Transcatheter Heart Valve (THV) System in patients with symptomatic, severe, calcific aortic stenosis who are at intermediate operative risk for surgical aortic valve replacement (SAVR)
  • BASILICA: Intentional laceration of the aortic leaflets during TAVR to prevent coronary obstruction
  • Transcaval closure device: Use of a novel device to close transcaval access tracts
  • WATCH-TAVR: Randomized study of WATCHMAN implantation for eligible patients amongst the TAVR population
  • Synecor Conveyor system: Use of a novel device to assist with Transcatheter mitral valve replacement
  • CLASP II: mitral repair with PASCAL device; A prospective, multicenter, randomized, controlled pivotal trial to evaluate the safety and effectiveness of transcatheter mitral valve repair with the Edwards PASCAL Transcatheter Mitral Valve Repair System compared to Abbott MitraClip in patients with degenerative mitral regurgitation (DMR) and who have been determined to be at prohibitive risk for mitral valve surgery by the Heart Team.
  • TIARA: mitral valve replacement with TIARA valve device and transapical delivery system
  • PINNACLE: FLX device for LAA closure; a prospective, non-randomized, multi-center investigation to establish the safety and effectiveness of the Watchman FLX™ Left Atrial Appendage Closure Device for subjects with non-valvular atrial fibrillation who are eligible for long-term anti-coagulation therapy to reduce the risk of stroke but who have a rationale to seek a non-pharmacologic alternative.
  • TRILUMINATE: tricuspid repair with tricuspid clipping; to evaluate safety and effectiveness of the Tricuspid Valve Repair System (TVRS) for treating symptomatic moderate or greater tricuspid regurgitation (TR) in patients currently on medical management and who are deemed appropriate for percutaneous transcatheter intervention
  • Amulet- The Amulet™ device will be evaluated for safety and efficacy by demonstrating its performance is non-inferior to the commercially available WATCHMAN® left atrial appendage closure device in patients with non-valvular atrial fibrillation. Patients who are eligible for the trial will be randomized to receive either the Amulet device or the WATCHMAN device.
  • TENDYNE Clinical Trial- The purpose of this study is to evaluate the safety and performance of the Tendyne Mitral Valve System. The study includes adult patients with symptomatic mitral regurgitation who are not suitable candidates for conventional mitral valve repair or replacement.
  • PARTNER III registry: To establish the safety and effectiveness of the Edwards SAPIEN 3 Transcatheter Heart Valve in patients with severe, calcific aortic stenosis who are at low operative risk for standard aortic valve replacement (AVR).
  • EARLY TAVR: Evaluation of Transcatheter Aortic Valve Replacement Compared to SurveilLance for Patients With AsYmptomatic Severe Aortic Stenosis.
  • Partner II- A prospective randomized, multicenter phase 3 trial evaluating the safety and effectiveness of Edwards SAPIEN XT transcatheter heart valve and delivery systems: NovaFlex (transfemoral) and Ascendra2 (transapical) in symptomatic, calcific, severe aortic stenosis with two population cohorts: 1) patients intermediate risk for surgical AVR (Cohort A - operable), and 2) patients not suitable for AVR (Cohort B - inoperable).
  • COAPT- A phase 3 trial evaluating safety and effectiveness of the MitraClip System for the treatment of moderate-to-severe or severe functional mitral regurgitation (FMR) in high surgical risk subjects.
  • SURTAVI - Safety and efficacy study of the Medtronic CoreValve System in the treatment of severe, symptomatic aortic stenosis in intermediate risk subjects who need aortic valve replacement
  • Mitral Implantation of Transcatheter Valves in Native Mitral Stenosis
  • EVOLVE II- A prospective, randomized, multicenter single-blind non-inferiority trial to assess the safety and effectiveness of the SYNERGY Everolimus-eluting platinum chromium stent (bioabsorbable polymer coating on abluminal surface) for the treatment of symptomatic CAD.
  • ABSORB RCT- ABSORB III cohort will evaluate safety and effectiveness of Absorb BVS (Bioresorbable Vascular Scaffold) System compared to the XIENCE in treatment of ischemic heart disease caused by ≤2 de novo native coronary lesions in separate epicardial vessels.
  • Advance ASO Study: post-market surveillance of ASD closure using the Amplatzer device focusing on identifying risks for erosion events
  • SHIELD RIC: Safety and Effectiveness of Remote Ischemic Conditioning with the AutoRIC Prior to Elective PCI Study
  • CARDIAMP HEART FAILURE TRIAL: Randomized Controlled Pivotal Trial of Autologous Bone Marrow Mononuclear Cells Using the Cardiamp Cell Therapy in Patients with Post Myocardial Infarction Heart Failure
  • ECLIPSE TRIAL: Evaluation of Treatment Strategies for Severe Calcific Coronary Arteries: Orbital Atherectomy vs Conventional Angioplasty Technique Prior to Implantation of Drug-Eluting Stents
  • RADIANCE Il PIVOTAL Study: A Study of the ReCor Medical Paradise System in Stage II Hypertension.
  • Shield II PHP: Clinical Investigation Plan Supporting Patients Undergoing High Risk PCI Using a High Flow Percutaneous Left Ventricular Support Device.
  • Disrupt CAD III: Prospective, Multicenter, Single -Arm, Global IDE Study of the Shockwave Coronary Intravascular Lithotripsy (IVL) System with the Shockwave C2 Coronary IVL Catheter if Calcified Coronary Arteries.
  • ZOLL STEMI COOL TRIAL: A Multicenter, Prospective, Randomized-Controlled Trial to Assess Cooling as an Adjunctive Therapy to Percutaneous Intervention in Patients with Acute Myocardial Infarction
  • IMPELLA DTU PIVOTAL TRIAL: Primary unloading and delayed Reperfusion in ST-Elevation Myocardial Infarction.
  • SHINE CTO TRIAL: Sham-controlled Interventions to Improve QOL in CTOs
  • TELEFLEX CTO-PCI STUDY: Chronic Total Occlusion Percutaneous Coronary Intervention: To evaluate angiographic confirmation of placement of any guidewire beyond the CTO
  • TELEFLEX RINGER IDE STUDY: A Prospective, Multicenter, Single-arm Investigation of the Ringer perfusion Balloon Catheter

Electrophysiology

  • APRAISE ATP- Assessment of Primary Prevention Patient Receiving An ICD- Systemic Evaluation of ATP
  • VIVID- Educational Videos to Address Racial Disparities in Implantable Cardioverter Defibrillator Therapy Via Innovative Designs
  • MADIT- SICD- patients with intermediate heart failure and diabetes, randomized to ICD or standard care
  • ASAP-TOO - Watchman or control in patients with absolute contraindications to warfarin
  • SOLVE-CRT- innovative leadless endocardial LV pacing system using ultrasound energy in patients who can't have or don't respond to standard CS biventricular pacing
  • QP Excel - new Biotronik quadripolar CS pacing lead
  • ENHANCE CRT- CRT implant strategy using the longest electrical delay for non-left bundle branch block patients/ A prospective, randomized postmarket pilot study
  • S-ICD PAS- S-ICD® System Post Approval Study

Noninvasive imaging

  • Benefit-1 trial: A Phase III, Open-Label, Multicenter Trial to Evaluate Ejection Fraction, End-Diastolic and End-Systolic Volumes, by Unenhanced and DEFINITY®-enhanced 2D-Echo and Magnetic Resonance Imaging REG-SPECT- Characteristics and outcomes of patients selected to undergo pharmacologic myocardial perfusion testing using regadenoson-facilitated single-photon emission computerized tomography (SPECT)
  • GE-122-020 (ADMIRE-ICD): AdreView™ Myocardial Imaging for Risk Evaluation – A multicenter trial to guide ICD implantation in NYHA class II & III heart failure patients with 30%≤LVEF≤35%.
  • ISCHEMIA trial- (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) – study to determine whether an invasive (INV) strategy of routine early cardiac catheterization with intent for optimal revascularization in addition to optimal medical therapy in patients with stable ischemic heart disease (SIHD) and at least moderate ischemia on stress imaging reduces the incidence of the composite of cardiovascular death or nonfatal myocardial infarction compared with a conservative (CON) strategy of optimal medical therapy alone with cardiac catheterization and revascularization reserved for patients with refractory angina, acute coronary syndrome, acute ischemic heart failure or resuscitated cardiac arrest. Sub-studies include:
    • ISCHEMIA-CKD (for patients who have eGFR <30 or on dialysis). Purpose is to determine whether the INV strategy reduces the incidence of death or nonfatal myocardial infarction compared with CON in participants with advanced CKD
    • ISCHEMIA-CIAO (for patients who lack CTA evidence of obstructive CAD and cannot be randomized to ISCHEMIA main trial) Purpose is to investigate the association between changes in ischemia over one year and changes in angina over one year in participants excluded from the main ISCHEMIA study based on the absence of obstructive CAD.
  • Discovery trial - A Study Examining the Prevalence of TTR Mutations in Subjects Suspected of Having Cardiac Amyloidosis.
  • TAILOR-PCI- Prospective, randomized trial testing the hypothesis that after PCI, ticagrelor 90 mg bid is superior to clopidogrel 75 mg qd in reducing a composite endpoint of MACE in CYP2C19 reduced function allele patients
  • PRECISE: Prospective Randomized Trial of the Optimal Evaluation of Cardiac Symptoms and Revascularization (PRECISE). PRECISE will evaluate whether a precision evaluation strategy that combines contemporary risk stratification using the PROMISE Risk Tool with functional and anatomic non-invasive evaluation with cCTA with selective FFRct can improve outcomes over usual care in stable chest pain patients while safely deferring further testing in low-risk patients and reducing cost overall.

Heart failure

  • BMS-STANDUP: The purpose of this study is to evaluate the safety, tolerability, and efficacy of BMS-986231in subjects with heart failure (HF) and reduced systolic function (LVEF < 40%) who are admitted to the hospital with signs and symptoms of acute decompensated heart failure (ADHF). CLR325X2202: To determine the safety and tolerability of an 18-hour IV infusion of CLR325 in chronic stable heart failure patients.
  • GALACTIC : A Double-blind, Randomized, Placebo-controlled, Multicenter Study to Assess the Efficacy and Safety of Omecamtiv Mecarbil on Mortality and Morbidity in Subjects With Chronic Heart Failure With Reduced Ejection Fraction.
  • OBSERVE: Prospective, randomized (1:1), placebo-controlled, double blind, study of ivabradine (Corlanor®) begun at the time of discharge from the observation unit for a cohort of predominantly (but not exclusively) African American patients with acute heart failure (HF). The primary endpoint will be change in heart rate from discharge to 28 (+/-2) days.
  • AKROS: A Phase 2 Multicenter, Randomized, Double-blind, Placebo-controlled study to evaluate the efficacy and safety of JTT-251 Administered for 24 weeks in participants with Heart Failure with reduced ejection fraction.
  • GUIDE: CardioMEMS- Hemodynamic-guided management of heart failure
  • NTProBNP II: Vitros Immunodiagnostic Products NT-proBNP II assay sample collection protocol
  • PROCYRION REGISTRY: An observational study of patients with acute decompensated heart failure and kidney dysfunction
  • SOLOIST: A randomized, double-blind placebo-controlled, parallel-group, multicenter study to evaluate the effects of sotagliflozin on clinical outcomes in hemodynamically stable patients with type 2 diabetes post worsening heart failure.
  • TRANSFORM Torsemide comparison with Furosemide for management of heart failure.
  • SHORE: Surveillance heartcare outcomes registry
  • Medtronic Apogee Product Surveillance Registry
  • HVAD Post Approval Study in Destination Therapy: A multicenter post approval study providing continued evaluation and follow-up on patients who received a HVAD assist system for the treatment of advanced heart failure and destination (permanent) therapy.
  • METEORIC-HF: A Double-blind, Randomized, Placebo-controlled, Multicenter Study to Assess the Effect of Omecamtiv Mecarbil on Exercise Capacity in Subjects with Heart Failure with Reduced Ejection Fraction and Decreased Exercise Tolerance
  • MOMENTUM3- Multicenter Study of MAGLEV Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 Clinical Trial- Randomized trial assessing non-inferiority of HeartMate III vs. HeartMate II LVAD.

Clinical and preventive cardiology

  • iATTEND- NHLBI funded- The improving ATTENDance to Cardiac Rehabilitation (iATTEND) Trial- assessing the effect of an innovative approach to cardiac rehabilitation (CR) delivery on program attendance, one that combines center based only CR (CBCR) with remote CR (thus Hybrid CR, HYCR) and does so in a manner that is tailored to the individual needs of each patient; accomplished with the assistance of an easy-to-access telecommunications methodology (telemedicine). 
  • Henry Ford Heart Score Trial - Randomized Trial of Low-risk Chest Pain in the Emergency Department
  • Symptoms of ACS: substudy of the TRAPID-AMI study
  • REACTION-US Trial- Diagnostic Utility of a delta 1-hr rule-out AMI protocol using hs-cTnT
  • STOP-CP Trial- hs-CTnT to Optimize Chest Pain Risk Stratification
  • Siemens hs-cTnI Trial- Specimen Collection in the Emergency Department for the Assessment of Clinical Performance of Troponin Assays
  • HF-PROACTIVE (Prevention Using Exercise Rehabilitation to Offset Cardiac Toxicities Induced Via Chemotherapy)- Randomized, controlled trial with a target enrollment of 30 patients at risk for future heart failure using novel markers of early cardiac damage to determine if exercise training can improve these emerging markers as well as overall fitness and quality of life.
  • TACT2 (Trial to Assess Chelation Therapy)- Randomized, double blind controlled factorial clinical trial of edetate disodium-based chelation and high-dose oral vitamins and minerals to prevent recurrent cardiac events in diabetic patients with a prior myocardial infarction
  • CHALLENGE - NCIC CTG CO.21: A Phase III Study of the Impact of a Physical Activity Program on Disease-Free Survival in Patients with High Risk Stage II or Stage III Colon Cancer: A Randomized Controlled Trial
  • HFpEF - Novel cardiac rehabilitation in Heart Failure with Preserved Ejection Fraction. Comparison of standard training methods vs higher intensity aerobic interval and resistance training on fitness and quality of life in patients with HFpEF.
  • CTO-PCI – Evaluation of Exercise Capacity, as Measured by Peak Oxygen Uptake, Before and After Percutaneous Revascularization of Chronic Total Occlusion.

Recent or ongoing fellow clinical research topics/opportunities

  • Cardiac rehabilitation and chronic heart failure
  • Exercise training for heart failure and PVD
  • Exercise training in patients with ICDs
  • Exercise training in patient with heart failure and preserved ejection fraction
  • Association of clinical and demographic factors with cardiopulmonary performance in heart failure
  • Cardiorespiratory fitness in patients with left ventricular assist devices
  • Timing of referral to cardiac rehabilitation after cardiac events
  • Beta blockers in patients with heart failure with normal and reduced ejection fraction
  • Renal dysfunction in patients with heart failure
  • Valve repair during left ventricular assist device implantation
  • ICD settings and outcomes
  • Role of nonpharmacologic EP-based interventions in improving outcomes in patients hospitalized for heart failure
  • Arrhythmia and shock burden in different ICD populations
  • Surface ECG findings and predicting myocardial viability
  • Fragmented QRS studies
  • Cardiac biomarkers and outcomes in acute coronary syndrome
  • Cardiac biomarkers in the clinical decision unit setting
  • Cardiac biomarkers in hypertensive crisis
  • Cardiac biomarkers in patients undergoing cardiotoxic chemotherapy
  • Chest pain qualities in acute coronary syndrome
  • HEART score in the clinical setting
  • Beta blockers and outcomes in STEMI
  • Computer ECG read clinical correlations
  • LBBB and the diagnosis of myocardial infarction
  • 3D echocardiography and evaluation of cardiac function
  • Traditional versus accelerated protocols in echo stress testing
  • Assessing parameters to quantify the size and significance of pericardial effusions
  • Different imaging modalities in assessing left atrial appendage size/ morphology
  • Characteristics and outcomes of different nuclear pharmacologic stress drugs
  • Nuclear imaging and cardiac dyssynchrony
  • Traditional versus accelerated protocols in nuclear stress testing
  • Racial differences and outcomes in SPECT
  • Regadenoson PET outcomes
  • MIBG studies
  • Relationship of clinical/ imaging findings with coronary disease on coronary CT angiography
  • Demographic variables and coronary plaque composition and burden in CTA
  • Predictive value of coronary CT angiography on clinical outcomes
  • Cerebral protection during transcatheter aortic valve replacement
  • Epicardial fat in various transcatheter interventions
  • Optimal views in transcatheter therapies
  • Outcomes in PFO closure
  • Quantitative coronary angiography versus clinical interpretation
  • Radial versus femoral access in STEMI
  • Insulin resistance and atherosclerosis
  • Psoriasis and CAD
  • Yoga and cardiovascular outcomes
  • Omega-3 polyunsaturated fatty acids and ventricular arrhythmias
  • Atrial fibrillation and exercise training
  • Remote ischemic preconditioning
  • Use of fitness trackers in improving clinical outcomes for women
  • Research on transcaval SHD procedures and outcomes
  • Health care disparities research in the SHD population
  • Multiple SHD projects involving innovative procedures
  • Research on outcomes and approaches to pulmonary embolism treatment
  • Arrhythmias and sarcoidosis
  • Right heart failure and LVADs
  • Paradoxical low flow low gradient AS
  • Risk stratification for systolic heart failure with CPEX and clinical variables
  • Outcomes of primary and non-primary PCI at surgical and non-surgical sites
  • Outcomes of transcaval Impella 5.0 use in cardiogenic shock
  • Cardiogenic shock outcomes based on timing of admissions
  • LV dysfunction in patients on right sided mechanical support
  • Sex differences in MitraClip
  • Balloon expandable vs self expandable interventions in valve-in-valve procedures
  • Prosthesis mismtach in valve in valve and valve in ring mitral interventions
  • 3D Printing for PVL closure
  • Radial versus femoral in CTO interventions
  • Stroke risk in noncardiac surgery in patients with PFO
  • Upgrading mechanical circulatory support in worsening cardiogenic shock
  • Long term outcomes in the Detroit Cardiogenic Shock Initiative

Basic science research opportunities

  • Cardiac metabolism in heart failure
  • The mitochondria in heart failure
  • Beta-3 antagonists for the treatment of acute heart failure
  • Mitochondrial abnormalities in skeletal muscle: Role in exercise intolerance in patients with heart failure targeting peptides for the treatment of heart failure
  • The apelin signaling system in heart failure
  • Stem cell conditioned media for the treatment of heart failure
  • Animal models of cardiorenal syndrome
  • Abnormalities of contractility and relaxation in heart failure
  • Myocardial augmentation for the treatment of heart failure
  • Role of interstitial fibrosis in heart failure (HFpEF and HFrEF)
  • Cardiac contractility modulation for the treatment of heart failure 
  • Genomics, proteomics, and metabolomics in heart failure

Clinical registries

  • The FIT Project- The Henry Ford Exercise Testing Project- stress testing database
  • FIT-CPX- The Henry Ford Hospital Cardiopulmonary Exercise Testing Project
  • Henry Ford STEMI Registry
  • Henry Ford Genomic Registry
  • Henry Ford Liver and Renal Transplant Registry
  • Henry Ford Cardiomyopathy Registry
  • Henry Ford SPECT Registry
  • Henry Ford Coronary CTA database
  • Advanced cardiac imaging consortium Michigan CTA database
  • Henry Ford Cardiac MRI database
  • HF-Action- Exercise training in Heart Failure
  • Multicenter cardiac sarcoidosis registry
  • Retrospective HF and MI databases utilizing Corporate Data Store
  • National Cardiovascular Data Registry
  • Blue Cross Blue Shield of Michigan BMC2-PCI Registry - Percutaneous coronary intervention registry
  • STS/ACC TVT Registry - Transcatheter valve replacement and repair procedures
  • ACC LAAO Registry- covers Left Atrial Appendage Closure
  • TOPAS-TAVI- Transcatheter Aortic Valve Implantation in Patients with Low-Flow, Low Gradient Aortic Stenosis (Truly or Pseudo Severe Aortic Valve Stenosis). A Prospective Multicenter Registry.
  • PROGRESS CTO REGISTRY- Multi center Registry of Chronic total Occlusion Interventions
  • EAGLE Registry- Close Chested Epicardial Ligation of the Left Atrial Appendage in Atrial Fibrillation Patients Registry: A Multicenter Prospective Observational Cohort
  • SCORE- Electrophysiology St. Jude Medical Product Longevity and Performance Registry
  • IRAD registry - aortic dissection registry
  • Michigan Anticoagulation Quality Improvement Initiative
  • TRIUMPH registry- Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patient’s Health Status Registry
  • THEME Registry- enrolling patients who receive TandemLife devices
  • USPella Registry- enrolling patients who receive Impella devices
  • MITRAL Registry- mitral valve in valve, valve in ring, valve in MAC registry for transcatheter mitral valve implantation using Sapien valves in the mitral position
  • POMME-Registry
  • Amplatzer PFO Closure: Post-approval registry for Amplatzer PFO devices
  • NCDR: TVT and LAA-O in Structural heart
  • CVAD registry- Shock and Impella
  • INTERMACS- InterAgency Registry of Assisted Circ Support
  • IMACS: ISHLT Mechanically Assisted Circulatory Support Registry
  • MCSRN: Mechanical Circulatory Support Research Network 
  • Preventive Cardiology Outcomes (PRECO) database
  • OPTIMUM Trial: Outcomes of Percutaneous Revascularization for Management of Surgically Ineligible Patients with Multivessel of Left Main Coronary Artery Disease: A Prospective Registry.
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