The unrelenting growth of diabetes around the world is prompting cardiologists to rethink how they treat and manage a challenging patient population, even as an emerging class of cardio-protective diabetes drugs is setting the stage for transformation.
When third-grader Ava Rao was diagnosed with type 1 diabetes, it changed life for her whole family. Now a high school freshman, Ava and her dad, cardiologist Sunil V. Rao, MD, share their perspectives on the disease and hopes for the future.
As Cardiovascular Business enters its second decade, our team has been pondering what the magazine’s pre-teen and teen years will be like. Are we looking at dignified maturity or awkward adolescence?
Ask cardiologists to name the big advances of the past decade, and many point to transcatheter aortic valve replacement (TAVR) and other breakthroughs that are allowing cardiologists to treat structural heart disease with minimally invasive procedures. Looking ahead, some believe that even bigger, broader changes are coming.
The recently reported CANTOS trial represents an enormously important development in cardiovascular medicine. For the first time, an anti-inflammatory drug (canakinumab) given by injection every three months has been shown to reduce morbidity and mortality. Trial entry criteria required a hsCRP level >2 mg/L and stable coronary heart disease. The 150-mg dose reduced the risk of nonfatal myocardial infarction, stroke and cardiovascular death by 15 percent with no effect on lipids. These benefits were observed in patients already treated with the best available therapies, including high-dose statins and antiplatelet drugs. The importance of these findings extends far beyond the CANTOS trial. Now that we know that treating inflammation can reduce cardiovascular morbidity and mortality, the search for other anti-inflammatory regimens can proceed with the high likelihood of successful clinical trials.
This has been such an exciting time in cardiology—although the lens we use is often cloudy. Why? Because the pace of change is truly unparalleled. From massive changes in the physician fee schedule resulting in a rapid migration to employment to a total transformation in cardiovascular care delivery models, our practices are not what they were a decade ago. Cardiovascular service lines, dyad leadership and payment for quality and patient outcomes were unheard of in 2007. Yet I find our world invigorating and inspiring. We have successfully reduced mortality related to cardiac events!
With physicians and administrators ever more focused on high-quality medicine and the financial bottom line, what trends and strategies are shaping the future of the cardiovascular service line? Let’s take a look at the future forecast through the expert eyes of Brian Contos, an executive director of The Advisory Board Company. Is your program poised to take advantage of changing market dynamics such as outpatient care, reimbursement and payment policies? And what about implantables, MACRA patient-focused care and interventional procedures like Protected PCI?