Progress in the fight against heart disease and stroke came on many fronts during 2014, from novel drugs and procedures to improvements and newfound benefits from existing treatments. In the December 2014 Harvard Heart Letter, Editor in Chief Dr. Deepak L. Bhatt selected 10 of the most important advances.
New drugs cut cholesterol levels by half. A new class of drugs, given by injection just once or twice a month, can slash harmful LDL cholesterol levels by about 50%. Studies are under way to see if any of these experimental agents, called PCSK9 inhibitors, prevent heart attacks or improve heart disease survival.
Replacing aortic valves without surgery. Transcatheter aortic valve replacement (TAVR) offers a way to fix a stiff, narrowed aortic valve without open-heart surgery. It delivers the new valve through a thin tube called a catheter that is threaded into an artery in the groin and gently maneuvered into the heart. People who underwent TAVR had a higher one-year survival rate than people who had surgery to replace the valve. Currently, TAVR is approved for people considered too sick or high risk for valve replacement surgery.
Renal denervation loses luster. What had been a promising experimental treatment for stubbornly high blood pressure failed an important test. Renal denervation zaps nerve endings in arteries leading to the kidneys. This makes the arteries unable to stimulate the kidneys, which can change how the kidneys regulate blood pressure. But the technique proved no more effective than a sham procedure for lowering blood pressure.
Wireless sensors for severe heart failure. A new device helps doctors keep tabs on people with serious heart failure by measuring pressure in the pulmonary artery, which transports blood from the heart to the lungs. The CardioMEMS HF System is implanted in the pulmonary artery. From there it wirelessly sends data to a doctor, who can then adjust the person's treatment as needed—often without an office visit. The goal is to prevent hospitalization for flare-ups of heart failure symptoms.
Other advances include newly affirmed cardiovascular benefits from weight loss surgery and the use of continuous positive airway pressure for sleep apnea; a new medication that helps prevent blood clots in people who've had a heart attack; advances in the treatment and prevention of stroke; and a possible new drug for heart failure.
Read the full-length article: "Top 10 cardiovascular advances of 2014"