The 63rd annual meeting of the American College of Cardiology brought together leading experts in cardiovascular medicine. The result was a heady mix of promising new medications, old medications revisited, and links found between dietary conditions, unusual lifestyle factors and heart disease.
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1. New generation cholesterol lowering drug
PCSK9 inhibitors are the new potential game changers in cholesterol lowering medications. These trial drugs show promise in lowering LDL cholesterol long-term, without the sometimes-intolerable side effects associated with statins.
Steven Nissen, MD, Chairman of the Department of Cardiovascular Medicine at Cleveland Clinic, says he holds out hope for continued success with PCSK9 inhibitors. “For myself and other clinicians, statin intolerance is the bane of our existence,” he says. “These patients are very hard to treat, and knowing we have a therapy that could potentially be approved in the next few years that can lower LDL by more than 50 percent and be well tolerated without muscle-related side effects, is a very big deal.”
2. Good for gout, good for the heart (old medication, new use)
Effective in treating gout, colchicine is an old drug that reveals new uses; the CORP-2 Trial presented at the meeting shows that colchicine not only helps treat acute pericarditis — it also helps prevent multiple recurrences of the disease.
Allan L. Klein, MD, Director of the Center for the Diagnosis and Treatment of Pericardial Diseases at Cleveland Clinic, says the study “perhaps confirms its [colchicine’s] utility as first-line therapy for recurrent pericarditis.” It is used off-label in the U.S.
3. Blood test predicts heart attack before it happens
Scientists reviewed records at the Karolinska University Hospital in Sweden and identified a simple blood test that might accurately and quickly predict which emergency room patients presenting with chest pain will develop heart attacks.
This test may help clinicians determine who can safely be allowed to go home, reducing unnecessary hospitalizations and the length of time patients have to wait before being released from the ER.
Cardiologist Venu Menon, MD, Director of the Coronary Care Unit at Cleveland Clinic, says the new test could help clinicians speed up diagnoses. “Currently, it takes at least six hours…to make sure individuals are not having a myocardial infarction …Anything to decrease that time would be of significant value,” he says.
4. Out of this world heart health
It’s well known that spending time in outer space can alter bone structure, but a fascinating study conducted by NASA says microgravity also can affect your heart. Analysis of 12 astronauts’ hearts before and after stays at the International Space Station revealed a startling change — the hearts changed shape significantly, becoming more spherical by almost 10 percent.
Typical earthbound hearts are longer than wide, and researchers theorize the change might involve the strength and function of the heart as well.
Cardiologist James Thomas, MD, Lead Scientist for Ultrasound to NASA, says, “These findings confirm the need to counteract the changes that occur during long-term space travel, to invent ways to keep the heart in shape, literally and functionally.”
5. Celiac linked to cardiac risk
People with celiac disease experience painful gastrointestinal symptoms, including bloating and diarrhea when they eat gluten (a protein found in wheat, barley and rye). They also have increased risk for heart trouble, according to research presented at the annual meeting.
Out of a pool of more than 24 million patients, the small minority of those who had celiac disease (24,000 plus) had twice the risk of heart disease than non-celiac individuals.
Internist Rama Gajulapalli, MD, was co-investigator of the preliminary study. “People with celiac disease have some persistent low-grade inflammation in the gut that can spill immune mediators into the bloodstream, which can then accelerate the process of atherosclerosis and, in turn, coronary artery disease,” he says. “Our findings reinforce the idea that chronic inflammation, whether it’s from an infection or a disease, can have an adverse role in coronary artery disease and heart health in general.”