Top cardiovascular issues to be tackled in 2015

Chuck Bednar for redOrbit.com – Your Universe Online
Wearable technology to monitor a person’s health, the expanded use of minimally invasive heart repair procedures and eligibility recommendations for athletes with cardiovascular maladies top the American College of Cardiology’s (ACC) list of issues expected to be addressed in 2015.
The list, which was compiled by leaders from the organization and released on Friday, also includes possible changes to stenting practices, a decision from the US Food and Drug Administration (FDA) on whether or not to improve a new novel coagulant, and legislation to address the use and abuse of energy drinks among children and scholastic athletes.
The ACC said that it expected wearable health-related technology such as the Apple Watch and the Fitbit to “play an increasing role in health care” as they become more sophisticated and more widely used. It noted that it expected data from these devices, which can measure pulse read and monitor exercise habits, to become increasing incorporated by doctors during appointments.
In addition, the group expects that the debate regarding the risks and benefits of complete revascularization after a heart attack, which could involve the practice of inserting stents in more than one artery, will continue during the new year. Recent clinical trials have indicated that patients perform better when a cardiologists inserted stents to open all blocked arteries found when treating patients for heart attacks. Current guidelines recommended treating only the blockage associated to the heart attack, but the new findings may cause those to be re-evaluated.
Another issue expected to be revisited is recommendations regarding sports participation for young athletes dealing with heart issues, and the ACC believes these suggestions could be updated during the first half of 2015. Likewise, the expanded use transcatheter aortic valve replacement, an alternative to open heart surgery that has been available in the US for some inoperable patients since 2011 and for high-risk patients since 2012, will likely be addressed.
“The procedure involves inserting a new valve into the heart using a catheter inserted into an artery to replace a heart valve that has narrowed – a life-threatening condition called aortic stenosis,” the organization explained. “A similar procedure was approved in 2013 for the MitraClip, a device designed to repair a leaky heart valve, a condition called mitral valve regurgitation. So far, these new heart repair options are only available for high risk patients, including those considered too frail for surgery.”
Patients receiving those treatments have been followed in a national data registry, and the information is being reviewed by regulators and physicians, which could lead the minimally-invasive procedures to be considered for use in a greater number of patients. Additional devices for repairing other heart conditions are expected to follow, the ACC said.
During the year ahead, the FDA will likely decide whether or not to approve the anticoagulant edoxaban. If it receives federal approval, it will become the fourth drug to hit the market as an alternative to warfarin, a medication that is effective for preventing strokes by comes with harsh side effects. An FDA advisory panel recommended in October that the drug be approved.
In addition, companies are expected to continue pushing the FDA for approval of their respective PCSK9 inhibitors, an experimental class of medications that have proven effective in lowering levels of low-density lipoprotein (LDL). They have proven especially effective in patients with unusually high blood cholesterol levels that don’t respond to other treatments, the ACC said.
“Amgen filed for Food and Drug Administration (FDA) approval of its PCSK9 inhibitor, evolocumab, in August, and Sanofi/Regeneron announced plans to seek priority review of its drug, alirocumab,” the group said. “This means the first FDA decision on this new class could come as early as summer of 2015. Meanwhile, results of research related to PCSK9 inhibitors will continue to be released as drug makers vie to make their drug the first available to patients with a genetic disposition to extremely high ‘bad’ cholesterol.”
The ACC also expects state lawmakers to pursue new legislation designed to address the increasing number of emergency room visits from young people complaining of irregular and increased heart rate, acute anxiety and sleep deprivation believed to be linked to the consumption of energy drinks.
“Currently available research is inadequate to assess the long-term damage energy drinks may cause, but many in the medical community believe that the increased number of children who visit their offices and emergency rooms after consuming energy drinks merits changes in public policy aimed at reducing consumption by minors,” the ACC said. “Bills introduced in several states in recent years, especially addressing sales and marketing to children, are likely get attention as they move through the legislative process.”
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