January 2012

Atrial fibrillation (AF) soaks up $26 billion per year, and that figure is set to rise. The estimated three million patients with AF in the U.S. likely will double in the next 25 years. Most physicians turn to warfarin as the drug of choice to prevent stroke in the AF population, but now that novel therapeutics like dabigatran and rivaroxaban are available in the U.S., will warfarin continue to own the anticoagulant market?

In this issue, we talk with cardiologists who are looking at the introduction of new pharmaceuticals that could prevent stroke in some atrial fibrillation patients. Drugs such as dabigatran (Pradaxa, Boehringer Ingelheim), rivaroxaban (Xarelto, Bayer/Johnson & Johnson) and potentially apixaban (Eliquis, Bristol-Myers Squibb) could offer a welcome alternative to warfarin in the anticoagulant market.

Stenting stenosis in the internal pudendal artery as a treatment for erectile dysfunction (ED) appears to be safe and effective, but more needs to be understood about disease prevalence and pelvic vasculature, cardiologists say. More immediate is leveraging ED to reduce cardiovascular risk factors.

While cardiothoracic surgery continues to have improved patient outcomes, practice management considerations, such as EMRs and hospital employment, often receive less attention. But, those tides may be turning.

The 60 percent decline in the death rate from cardiovascular disease that has occurred since the 1950s is the result of the development of new drugs and devices, improved medical imaging and new treatment strategies. Challenges now lie in sustaining and improving these gains cost effectively.

Approximately 30 percent of patients with an aortic aneurysm are considered too high risk for surgery yet unsuitable for existing endograft devices. Physicians are turning to extreme endovascular aneurysm repair and thoracic endovascular aneurysm repair to create solutions for these otherwise out-of-luck patients.

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