Forty-six years after he graduated from the Temple University School of Medicine, renowned vascular specialist Dr. Mark Creager still approaches each day with the enthusiasm of a student.
"I wake up in the morning and look forward to the day's opportunities. I love what I do," said Creager, director of the Heart and Vascular Center at Dartmouth Hitchcock Medical Center and a professor of medicine and surgery at Dartmouth College's Geisel School of Medicine.
"Whatever you do, you should have a passion for it," he said. "But you've got to be skilled at it also."
Or, in Creager's case, exceptional.
His distinguished career includes pioneering the Heart and Vascular Center at Dartmouth in 2015, leading vascular initiatives at Brigham and Women's Hospital for 31 years prior and advancing medical understanding of atherosclerotic vascular disease through research.
As an American Heart Association volunteer for over three decades – including a term as president in 2015-16 – he transformed the research enterprise and embedded peripheral vascular diseases into its construct.
For his work, Creager is the recipient of the AHA's highest volunteer honor, the Gold Heart Award, which will be presented during a virtual event on Oct. 27.
"There are so many great things about the AHA, and there are so many great leaders who contribute – each in our own way – to make a difference," he said. "I love medicine. I love the patient care involved in cardiology. I love serving through science."
Son of the City of Brotherly Love
The principle of combining passion with purpose was instilled in Creager early during his upbringing in Philadelphia. His dad was a contract procurement officer with the U.S. Army Signal Corps, and his mother worked as an analyst for the IRS. Neither had a college degree, but both taught their three children the value of a good education.
Creager, the eldest, excelled in science and math and knew in high school that he wanted to be a physician. Industrious by nature, he worked at his grandfather's men's clothing store in north Philadelphia.
That store would become a recurring motif in the narrative of Creager's life.
As an infant, he lived with his family in an apartment above the store. After his family moved, he returned as a teen to work just as his interest in medicine was awakening. And after he earned an undergraduate degree from Albright College in Reading, Pennsylvania, he came back to attend medical school at Temple a couple of miles away.
Creager said he developed a passion for cardiology by his fourth year in medical school.
That passion prompted him to do an extra rotation in cardiology at the Deborah Heart and Lung Center in Browns Mills, New Jersey, in the mid-1970s when advances in cardiology diagnosis and treatment were emerging rapidly. "Still, a lot relied on your innate skills for evaluating patients and figuring out how to manage their care," he said.
Onward and upward
By the time he graduated from medical school, Creager's education had been confined to Philadelphia or close to it. So, when the time came to do his residency, he set his sights 300 miles northeast to Boston. There, he landed at University Hospital – predecessor to Boston University Medical Center – and Boston City Hospital next door.
"That's where things really happened related to my career and my work with the American Heart Association," he said.
During the final stretch of his residency, program director Dr. Jay Coffman invited him to spend the year supporting his research on understanding how a digitalis-like drug affected peripheral vascular function.
"My role was to measure heart and blood vessel function in patients who had heart attacks," he said. "That was my very first research."
That opportunity led to another as a cardiology fellow under chief of cardiology Dr. Thomas J. Ryan, a former AHA president who led one of the first clinical trials comparing medication to heart surgery in patients with coronary artery disease.
Creager and his colleagues studied captopril – the first oral ACE inhibitor – to assess its effects on the heart and blood flow in patients with heart failure. This cemented his interest in clinical research and set the stage for his academic career.
For the next phase of his career, Creager accepted a combined faculty position working for Ryan and Coffman.
Both men shepherded Creager, with Coffman becoming "the most important mentor" he's ever had, for demonstrating through example the priority of the patient, and for teaching him about vascular disease, research and scientific writing.
"Jay became a role model for me," he said. "Everything I do, even today, I think about him."
Path to the AHA presidency
Coffman and Ryan inspired Creager's service to the American Heart Association – a tradition that runs deep at the hospital. It produced four AHA presidents including Ryan, Dr. David Faxon, Dr. Alice Jacobs and Creager.
After his fellowship there, Creager stayed on staff for another five years before moving to Brigham and Women's Hospital – colloquially known as The Brigham – to help launch a division of vascular medicine.
"Dr. Eugene Braunwald was chairman of the department of medicine," he said proudly of the man now known as the father of modern cardiology. "Braunwald appointed Dr. Victor Dzau to start the division of vascular medicine, and Victor recruited me."
Working alongside Creager was Dr. Joseph Loscalzo, who later became chairman of the department of medicine. Soon thereafter Creager also worked with Dr. Gary Gibbons, who is now director of the National Heart, Lung, and Blood Institute. Ultimately, the vascular and cardiology divisions merged, becoming the cardiovascular division.
In 1992, Creager became medical director of The Brigham's vascular center. There, he relished his opportunity to mentor others, including Drs. Joshua Beckman and Heather Gornik, who went on to lead their own programs and grow vascular medicine as a subspecialty.
Fast forward to 2005, when AHA leadership formed an interdisciplinary working group on peripheral vascular disease and reached out to Creager to chair the group.
"It was my first leadership position in the American Heart Association, though I had been active in many other committees of the organization all along," he said.
After serving as founding chair of the Peripheral Vascular Disease Inter-Disciplinary Working Group (now the Council on Peripheral Vascular Disease), he went on to chair the Atherosclerotic Peripheral Vascular Disease Symposium II in 2008 and the National Research Committee in 2011-13.
"Then, we decided it was time to take a look at the AHA's research portfolio and see if we could make it more relevant to our strategic plan and impact goals," he said.
Creager co-chaired the 2012 AHA Research Summit, held to define future strategies and goals. A key outcome was the bold vision known as the 12 Essential Elements for Research, which ensures the AHA remains at the forefront of global change, emphasizes collaborative and team research, accelerates discovery and drives groundbreaking research. The first of the 12 elements is to develop innovative models that integrate AHA research values and fund highly meritorious research.
Creager's transformative leadership of the AHA's research enterprise made him a natural choice for president.
He took office on July 1, 2015, with an ambitious to-do list that included ensuring the AHA's interaction with scientists, clinicians and health care professionals hit the proverbial mark. That included a broad scope of work: continuing to have premier scientific meetings and journals; improving the quality of patient care; and promoting healthy schools, workplaces and communities.
In a moment of serendipity, his presidential address coincided with announcement of the AHA's One Brave Idea Science Innovation Center in Boston to revolutionize coronary heart disease detection.
Reflecting on his presidency, Creager said among his great honors was working with other inspiring AHA science leaders – including Drs. Mariell Jessup, Elliott Antman and Steven Houser – and serving with AHA volunteers who are pillars in business, such as former board chairmen Bernie Dennis and Alvin Royse.
Creager notes the organization is "always evolving to address cardiovascular disease and brain disease. The programs that have been put into place are profoundly innovative and often transformative."
He remains passionate about the promise of medical research during the COVID-19 pandemic.
"I am optimistic that we will have a vaccine to reduce contagion, and targeted therapies to address the downstream effects of the coronavirus, including the severe inflammatory and thrombotic response causing complications in the lungs, heart and brain," he said.
"With the breadth of research being performed to tackle this virus, including that funded by the AHA, I am hopeful."