At the recent American Heart Association (AHA) meeting, several reported trial results will most likely inform practice in the coming years. These include RAFT, which found that CRT-D devices benefit less severe heart failure patients; GRAVITAS, which found that high doses of clopidogrel hold no benefit for low responders; and PARTNER quality-of-life trial, which found a significant positive quality of life for patients receiving transcatheter valve implants.

While the clinical data continue to add to clinicians’ understanding of cardiovascular disease and treatment, the practice environment continues to be challenging. Private practices are still aligning in one way or another with hospitals. Reimbursement is still a major issue affecting the ability of healthcare facilities and practices to adequately plan for the future. 

Hospitals and practices are still trying to effectively utilize electronic data collection, storage and retrieval in meaningful ways. In addition, everyone is bracing for the potential influx of some 40 million previously uninsured Americans into the healthcare system and what that means in terms of manpower, quality and the bottom line.

In our first Leadership Forum (page 4), thought leaders outline the key challenges for cardiovascular medicine as we move into 2011. While there are stark challenges that demand multi-society collaboration, as well as government advocacy outreach, there also are opportunities for those in cardiovascular medicine to once again rise above the fray and deliver excellent patient care. Dr. Douglas Packer, president of the Heart Rhythm Society, says that it is easy to get distracted by the “process” of medicine, but that “we have to continue to highlight our core mission and values.”

An opportunity for cardiologists, says Dr. Clyde Yancy, immediate past president of the AHA, is to embrace preventive medicine. That could be difficult because hovering over the future of cardiovascular medicine is the inescapable specter of uncertainty, notes Dr. Larry Dean, president of the Society for Cardiovascular Angiography and Interventions.

Taking the idea of uncertainty a bit poetically further, Dr. Jack Lewin, CEO of the American College of Cardiology, compares accountable care organizations to Bigfoot: “We think we know what they are, but nobody has really ever seen one.” The Bigfoot comparison could easily encompass many of the healthcare unknowns for 2011.

One thing is for certain, however: In terms of leadership, cardiovascular medicine is in good hands.