Feature | December 24, 2013

American College of Cardiology Previews Top Cardiology Stories of 2014

acc pharmaceuticals renal denervation heart valve repair antiplatelet therapy
December 24, 2013 — Clinical trials for a promising new class of cholesterol-lowering medications, a long-awaited repair of the Medicare formula for paying physicians, the Affordable Care Act, new technology and the implementation of new prevention guidelines are among the top developments in cardiology anticipated for 2014.
 
Leaders from the American College of Cardiology (ACC) identified the following issues to watch for in the new year:
 
Affordable Care Act’s Individual Mandate for Health Insurance Coverage
The new health plan takes effect Jan. 1. The medical community, including cardiology, will be watching and working to adjust as payment models change and more patients have access to medical care. Some heart disease patients may see a cardiologist for the first time as they get access to care through plans established because of the Affordable Care Act.
 
Sustainable Growth Rate Permanent Fix
Congress seems closer than ever to passing a fix to the flawed formula for calculating physician pay under Medicare enacted almost two decades ago. The Senate Finance and House Ways and Means committees passed a permanent sustainable growth rate (SGR) fix Dec. 12, but the House and Senate only passed a three-month patch to avoid a 20 percent Medicare payment cut on Jan. 1. The full Congress is expected to vote on and pass legislation to permanently repeal the SGR in 2014, before that patch expires. A permanent repeal would be good news for Medicare patients, as many physicians would be unable to continue to see Medicare patients if payments for physicians were cut so dramatically. It would also stop the almost annual exercise of Congress approving a last-minute patch.
 
Development of PCSK9 Inhibitors
Multiple trials are in progress for this anticipated new class of drugs that dramatically decrease LDL cholesterol, known as “bad” cholesterol. PSCK9 inhibitors mimic a gene found in people with naturally low LDL. The drug interferes with the destruction of the LDL receptor. The new class could have a big impact on the treatment of patients not able to tolerate statin medications or those with very high LDL who have not responded to other treatments.
 
Implementation of New American College of Cardiology/American Heart Association Prevention Guidelines
Guidelines for obesity, lifestyle management to reduce cardiovascular risk, cholesterol management and risk assessment were released in November based on systematic reviews of evidence initiated by the National Heart, Lung and Blood Institute (NHLBI). The guidelines will continue to be discussed and debated, and education programs will be developed to help physicians incorporate them into daily practice. The ACC and AHA, with support from NHLBI, will also start work on a guideline for the management of hypertension.
 
Rollout of Mitral Valve Clip
In October 2013, the U.S. Food and Drug Administration (FDA) approved a transcatheter procedure for treatment of prohibitive risk patients with severe degenerative mitral regurgitation, a heart disorder in which the mitral valve does not close properly when the heart pumps blood. This procedure offers a chance for treatment for these patients. An experienced heart team composed of an interventional cardiologist, cardiac surgeon and others will dictate use of this procedure. The ACC and the Society of Thoracic Surgeons (STS) will also add a mitral module to the National Cardiovascular Data Registry TVT Registry and begin reporting data in 2014.
 
Expanded Use of Novel Oral Anticoagulants in Patients With Atrial Fibrillation or Venous Thromboembolic Disease
These new medications began to get traction in the market in 2013 but still lagged behind warfarin, which was the only anticoagulant on the market for decades. Recent trial results have shown these new medications, which cost more per dose, improve outcomes compared to warfarin and do not require extensive monitoring or dietary/medication restrictions.
 
Results of Dual Antiplatelet Therapy Study (DAPT)
Results of this phase IV study are expected to be released in 2014 and may impact the duration of such treatment following coronary stenting across a wide spectrum of patients. Researchers are evaluating 12 months versus 30 months as the optimal duration of therapy in these patients.
 
Potential New Therapy for Refractory Hypertension
The results of a phase III trial of renal denervation for hypertension are expected in early 2014 and could eventually lead to FDA approval for a renal denervation device. With this procedure, a catheter is inserted into the renal artery to deliver radiofrequency pulses to reduce nerve signaling and lower blood pressure. If successful, it may be an alternative treatment for patients with refractory hypertension — those patients whose blood pressure remains elevated after treatment with three medications including a diuretic.
 
Continued Growth of Cardio-Oncology
This cardiology subspecialty is focused on the cardiovascular manifestations of cancer and complications of its treatment. It is offered at select hospitals across the country to help cancer patients maintain their heart health during and after treatment. Look for it to expand rapidly to more hospitals across the country.
 
For more information: www.cardiosource.org

Related Content

Edwards Intuity aortic valve, surgical aortic valve replacement, PinnacleHealth, first U.S. implants
News | Heart Valve Technology| August 26, 2016
This week, PinnacleHealth, Harrisburg, Pa., became the first hospital in the country to implant the Edwards Intuity...
nanoparticles, blood clotting, internal bleeding, American Chemical Society study, Erin B. Lavik

Nanoparticles (green) help form clots in an injured liver. The researchers added color to the scanning electron microscopy image after it was taken. Image courtesy of Erin Lavik, Ph.D.

News | Hemostasis Management| August 24, 2016
August 24, 2016 — Whether severe trauma occurs on the battlefield or the highway, saving lives often comes down to...
Technavio report, renal denervation devices, 2015
News | Renal Denervation| August 23, 2016
August 23, 2016 — Technavio analysts forecast the global...
TAILOR-PCI study, antiplatelet medication, genotype, NHLBI grant
News | Antiplatelet and Anticoagulation Therapies| August 18, 2016
Researchers at the Peter Munk Cardiac Centre, Toronto, and at Mayo Clinic are leading the Tailored Antiplatelet Therapy...
Sapien III, Sapien 3, PARTNER III, FDA approval, expanded indication, intermediate risk patients

The Sapien 3 valve has a skirt of fabric at its base that has significantly reduced issues of paravalvular leak, which was an issue with the first generation Sapien device. 

Feature | Heart Valve Technology| August 18, 2016 | Dave Fornell
August 18, 2016 — The U.S.
warfarin, long-term stability, atrial fibrillation, DCRI study, Sean Pokorney
News | Antiplatelet and Anticoagulation Therapies| August 16, 2016
August 16, 2016 — Warfarin prescribed to prevent strokes in...
Sponsored Content | Videos | Heart Valve Technology| August 15, 2016
The Edwards Lifesciences Intuity Elite surgical aortic valve uses a balloon expandable skirt technology taken from th
Edwards Lifesciences, FDA approval, Intuity Elite valve

The Edwards Intuity Elite valve system uses a balloon expandable skirt to anchor the valve rather than traditional sutures.

Technology | Heart Valve Technology| August 15, 2016
August 15, 2016 – Edwards Lifesciences announced the U.S.
mitraclip, mitraclip reimbursement
News | Heart Valve Technology| August 05, 2016
August 5, 2016 — The Centers for Medicare and Medicaid Services (CMS) has reassigned MitraClip transcatheter mitral v
Absorb, bioresorbable stent, FDA approval, FDA approves, FDA clears, most popular content, most popular stories, DAIC

The FDA clearance of the first bioresorbable stent, the Abbott Absorb, the first week of July has been the most popular story so far for all of 2016. It is the first fully dissolving stent approved for the U.S. market and many experts say this technology could be a paradigm shift in coronary and peripheral therapies in the coming years as the technology improves. 

Feature | August 05, 2016 | Dave Fornell
 
Overlay Init