American College of Cardiology: Topics in the field of heart disease in 2015

Nearly 800,000 Americans die each year from cardiovascular disease. The head of the American College of Cardiology predicts that wearable technology, changes in cardiac stent applications, state legislation for energy drinks, expanded use of minimally invasive cardiac surgery, and the development of a new class of cholesterol-lowering drugs will be available in 2015. Become a hot topic in the field of cardiology.

Release date: 2015-01-07

Nearly 800,000 Americans die each year from cardiovascular disease. Among the top ten public health challenges announced by the US Centers for Disease Control and Prevention, cardiovascular disease is also on the list. The head of the American College of Cardiology predicts wearable technology, changes in cardiac stent applications, state legislation for energy drinks, expanded use of minimally invasive techniques for cardiac surgery, and development of a new class of cholesterol-lowering drugs Etc., will become a hot topic in the field of cardiology in 2015.

Wearable medical monitoring technology

As hardware and software continue to evolve and become more widely used, and medical professionals combine the data collected from such devices with outpatient information, wearable technologies that monitor personal health outside the physician's clinic will be People play a more important role in health care. In September 2014, Apple introduced an Apple Watch that measures heart rate, monitors exercise, and totals for the wearer. When used in conjunction with a new app, Apple Watch can aggregate data from several wearable devices and share it directly with the patient's physician. Microsoft's smart bracelet (Fitbit and Garmin) is already popular among consumers seeking to monitor their health more accurately. With the innovation of technology in this field, the application of such wearable devices will continue to grow.

Changes in cardiac stent applications

The debates and discussions in the medical community will continue with regard to the risks, benefits, and timing of performing a full revascularization after a heart attack. Complete revascularization is a method of placing a stent in multiple arteries of a patient to improve blood circulation after a heart attack. Two clinical trials, PRAMI in 2013 and CvLPRIT in 2014, showed that in the treatment of patients with heart attacks, if the doctor puts a stent in all of the blocked arteries, the patient's medical effect will be better. Based on previous research, the current guidelines recommend that the initial treatment be directed only to obstructed blood vessels that cause a heart attack. The Programme Development Committee will consider the latest research and related issues in complete revascularization.

Advice for athletes with heart problems

The long-awaited update on the qualifications of young athletes with heart problems will be completed as early as the first half of 2015. The report entitled "Eligibility and Disqualification of Athletes with Cardiovascular Abnormalities" is an update of the report of the 36th Bethesda Conference published in 2005. This document provides advice on allowing, temporarily or permanently canceling athletes with heart problems to participate in competitive sports. At the same time, the document will explore the use of stimulants and daily dietary supplements, diagnostic testing strategies, legal considerations, and other issues.

Expanded use of minimally invasive cardiac repair technology

Transcatheter aortic valve replacement is an alternative to traditional direct heart surgery. In the United States, the technology began in 2011 for patients who are not suitable for routine surgery and began to be used in high-risk patients in 2012. This technique can replace the original stenotic valve with a new valve inserted into the heart artery through the catheter, which is a life-threatening disease. For the mitral valve counterflow, a device for repairing heart valves, MitraClip, was approved for application in 2013. Currently, these new options for cardiac repair operations are only used in high-risk cases where there are problems such as physical weakness and are not suitable for surgery. The National Cardiovascular Data Registration System registers all patients who have undergone such surgery, and as this information is reviewed by regulatory agencies and physicians, minimally invasive treatments will be considered for more cases. At the same time, treatments for other types of heart disease will also appear.

The birth of a new anticoagulant

In early 2015, the US Food and Drug Administration (FDA) will decide whether to approve the use of Edoxaban. Once approved, Edushaban will become the fourth alternative to warfarin on the market. Warfarin, which is used to help patients with atrial fibrillation to prevent cerebral infarction, has been used for decades. Although it can effectively prevent cerebral infarction, it has a large side effect and requires close monitoring to maintain a safe and effective dose. An FDA advisory panel presented recommendations for the approval of edusaban in October. Atrial fibrillation is the most common type of arrhythmia, affecting more than 2.5 million people in the United States, and this number will continue to grow as the population ages.

PCSK9 inhibitor

There will be new cholesterol-lowering drugs in the market. PCSK9 inhibitors are a class of drugs that reduce "bad" cholesterol (low-density lipoprotein) and are particularly useful in patients with high levels of blood cholesterol that are ineffective in other treatments. In August 2014, biopharmaceutical company Amgen (AMGEN) sent its new cholesterol-lowering drug evolocumab to the FDA for approval. Sanofi/Regeneration also announced plans to seek a priority review of its drug, alirocumab. This means that the FDA will make the decision to approve the drug in the summer of 2015. At the same time, with the competition of various pharmaceutical companies, the results of PCSK9 inhibitor related research will continue to emerge.

Adjusting diet and increasing exercise are not just about prevention

The cardiovascular disease research team will focus its attention on emphasizing lifestyle control to reduce cardiovascular disease and expand to treat such diseases that have already occurred. Studies have shown that comprehensive, exercise-based cardiovascular repair can reduce mortality in patients after myocardial infarction. Dietary control and physical exercise can prevent and adjuvant treatment of many identified risk factors for atherosclerosis, including hypertension, insulin resistance, glucose intolerance, elevated triglycerides, and obesity. Exercise and weight loss combine to reduce the content of low-density lipoprotein (LDL) or cholesterol.

Team health

As the concept of team health continues to heat up, US state legislatures may also begin to consider issues such as training qualifications, claims, and patient safety. More and more heart disease and other professional teams are beginning to adopt a medical care model that doctors lead the team. This approach is designed to promote teamwork and leverage the unique skills, knowledge and training of team members.

Energy drink

The abuse of energy drinks by children and school-level athletes is becoming more and more serious, and state legislatures may issue relevant legal provisions. The Accident and Emergency Department of various medical institutions reported that more and more young people came to see a doctor, expressing symptoms such as arrhythmia or rapid heart rate, anxiety or insomnia. The existing research results are not enough to assess the long-term damage caused by long-term drinking energy drinks, but many people in the medical field believe that the increase in the number of children after drinking energy drinks indicates that public policy should make changes aimed at reducing youth consumption. . In recent years, several states in the United States have introduced bills, especially for the sale and marketing of children. As these bills enter the legislative process, they will also receive attention.

Source: Shell Network

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