Nauder Faraday, MD, , MPH, Professor of Adult Critical Care Medicine; Vice Chair, Faculty and Staff Development; Vice Chair, SOM Associate Professor Promotions Committee; Director, Perioperative Clinical and Translational Research; Director, Perioperative Hemostasis and Thrombosis Laboratory

Dr. Nauder Faraday is a professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. His areas of clinical expertise include cardiac anesthesia and surgical intensive care. He serves as director of Perioperative Genomic and Translational Research and director of the Perioperative Hemostasis and Thrombosis Research Laboratory and the Director of the Clinical Research Core for the Department of Anesthesiology and Critical Care Medicine.

After receiving his undergraduate degree from Columbia University, Dr. Faraday earned his medical degree from Mount Sinai School of Medicine. He completed an internship at the Hospital of St. Raphael at Yale University and a residency in anesthesiology at Johns Hopkins University School of Medicine. He performed fellowships in critical care medicine and cardiovascular anesthesiology, as well as two research fellowships, at Johns Hopkins. Recently, he earned a Master of Public Health degree from the Johns Hopkins Bloomberg School of Public Health. Dr. Faraday joined the Johns Hopkins faculty in 1993.

Since 2008, Dr. Faraday has worked to build a research program in perioperative genetic and molecular medicine. His goal is to identify molecular determinants of complications of surgery.

Dr. Nauder Faraday is a professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. His areas of clinical expertise include cardiac anesthesia and surgical intensive care. Dr. Faraday completed his residency in Anesthesiology in 1992, a fellowship in Critical Care Medicine in 1993, and a fellowship in Cardiac Anesthesiology in 1994—all at JHU. He is currently the Director of Perioperative Genomic Research and of the Perioperative Hemostasis and Thrombosis Laboratory at JHU. He serves as an ad hoc reviewer for a number of journals and is a member of the Society of Cardiovascular Anesthesiologists, the Society of Critical Care Medicine and the International Anesthesia Research Society, among others. He was recognized as a Marquis Who’s Who in Medicine and Healthcare in 2011.

He is funded by the NIH for investigation of the pharmacogenomics of antiplatelet agents for prevention of cardiovascular disease, for a genome-wide association study of platelet phenotypes, and for the study of the genotypic determinants of aspirin response in high-risk families; he also receives industrial sponsorship to investigate the safety and efficacy of rFVIIa in cardiac surgery.

In addition to these sponsored activities, Dr. Faraday conducts ongoing translational and clinical research programs in platelet biology and perioperative genomics. Translational projects use in vitro and vivo models to identify the mechanisms through which inflammation promotes platelet-mediated thrombosis. Dr. Faraday has assembled a multidisciplinary team that conducts a prospective cohort study to investigate the genetic basis for infectious and thrombotic outcomes after surgery. A summary of the goals of the preoperative genomic research program follows:

Infectious (wound, bloodstream, pulmonary) and vascular occlusive (myocardial infarction, venous thromboembolism) complications occur in as many as 20% of surgical patients and represent a significant source of preventable morbidity and mortality. Identification of patients at highest risk for these complications and alteration of medical therapy to mitigate their risk is an attractive approach toward improving patient safety and outcomes. Unfortunately, currently available risk-prediction tools that are based on medical history and surgical criteria have insufficient predictive power to guide medical decision making.

Dr. Faraday and his colleagues hypothesize that patient genetic factors account for a substantial proportion of the inter-individual variance in the development of postoperative complications and that the combination of genetic and clinical factors will improve the accuracy of risk models that are based on clinical criteria alone. The have designed a study to (a) identify genetic determinants of infectious and vascular occlusive complications in patients who undergo surgical procedures associated with a high incidence of infectious and vascular thrombotic complications, and (b) combine genetic and clinical information to develop risk-prediction tools that allow physicians to tailor therapy according to individual patient risk. To accomplish these goals, they are conducting a prospective observational study in 2500 “clean” surgical procedures, i.e., cardiac, vascular, spinal, and intracranial surgery. Cases of infectious and thrombotic complications will be identified from review of the medical records and interviews of patients and their physicians. Nasal colonization with Staphylococcus aureus is evaluated as an intermediate infectious outcome measure because of its high prevalence (~20%–30%) and strong relation to the subsequent development of wound, bloodstream, and pulmonary infection after these surgical procedures. Using the Illumina high-throughput platform, variants in ~150 candidate immunity- and hemostasis-related genes are identified from genomic DNA. Multivariable regression is used to determine the relationship between gene variants and each outcome measure. Clinical and genetic data are integrated to develop risk models for each outcome measure, and their predictive power as determined from receiver-operator characteristic analysis. The ultimate goal of Dr. Faraday’s research is to construct predictive tools that will allow targeted use of novel antimicrobial and antithrombotic strategies, which maximize benefit and minimize risk to individual patients.

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Professional Activities

  • American Society of Anesthesiologists
  • International Anesthesia Research Society
  • Society of Cardiovascular Anesthesiologists
  • Society of Critical Care Medicine
  • American Medical Association

Selected Publications

  1. Faraday N, Becker DM, Yanek YR, Herrera-Galeano JE, Segal JB, Moy TF, Bray PF, Becker LC. Relation between atherosclerosis risk factors and aspirin resistance in a primary prevention population. Am J Cardiol 98:774–9, 2006.
  2. Faraday N, Yanek LR, Mathias R, Herrera-Galeano JE, Vaidya D, Moy TF,  Fallin MD, Wilson AF, Bray PF, Becker LC, Becker DM.  Heritability of platelet responsiveness to aspirin in activation pathways directly and indirectly related to cyclooxygenase-1. Circulation 115:2490–6, 2007.
  3. Bray PF, Mathias RA, Faraday N, Yanek LR, Fallin MD, Herrera-Galeano JE, Wilson AF, Becker LC, Becker DM. Heritability of platelet function in families with premature coronary artery disease. J Thromb Haemost 5:1617–23, 2007.
  4. Bordeaux B, Yanek LR, Moy TF, White LW, Becker LC, Faraday N, Becker DM. Casual chocolate consumption and inhibition of platelet function. Prev Cardiol 10: 175–80, 2007.
  5. Faraday N, Becker DM, Becker LC. Pharmacogenomics of platelet responsiveness to aspirin. Pharmacogenomics 8:1413–25, 2007.
  6. Morrell CN, Sun H, Ikeda M, Beique JC, Swaim AM, Mason E, Martin TV, Thompson LE, Gozen O, Ampagoomian D, Sprengel R, Rothstein J, Faraday N, Huganir R, Lowenstein CJ. Glutamate mediates platelet activation through the AMPA receptor. J Exp Med 205:575–84, 2008

Laboratory Members/Key Associates

Lab Manager Angela McFillin, BS

Technicians Polly Robarts, BA

Faculty/Research Associates/Instructors Elizabeth White, RN Michelle Parish, RN Susan Townsend, RN

Fellows/Students Kate Schunke, PhD

Collaborators Craig Morrell, DVM, PhD Hui Zhang, PhD Ray Koehler, PhD Sylvain Dore, PhD Lewis Becker, MD Diane Becker, ScD Alan Shuldiner, MD Eliseo Guallar, MD, DrPH

Honors

Alpha Omega Alpha Honor Society

Association of University Anesthetists

Association of Cardiac Anesthesiologists