Heart disease: advances and breakthroughs in 2023

Dr. Karol Watson, an attending physician, cardiologist and professor of medicine/cardiology at the David Geffen School of Medicine at the University of California, Los Angeles, says all of the big developments in cardiovascular health in 2023 will be in the prevention of lipids and hypertension management. He said there are measures in place.

Watson also is director of the UCLA Center for Women’s Cardiovascular Health, the UCLA-Barbra Streisand Women’s Heart Health Program, co-director of the UCLA Preventive Cardiology Program, and director of the UCLA Cardiovascular Disease Fellowship Program, she told Healthline. Ta. Her big goal is to “figure out how to get people to take their medications in the least invasive way possible.”

Previously, patients had to take a pill daily or an injection every two weeks, Watson said. Today, there are even more options.

“We now have data on injectables that people can do every six months. Now, the gap period is even longer. [between injections]. The whole idea is for him to be one and do what people find easy to do. And it works,” Watson explained. “The problem is, these products aren’t going to be cheap.”

Discovery of the drug direbesiran Indicated The possibility of lowering pressure with semi-annual injections was presented at the 2023 American Heart Association Scientific Sessions.

Watson added that these types of injections “make it easier for people to get the medicine they need.” She reiterated that big problems still exist.

“these [medications] It’s easy because you only need an injection once every six months,” she said. “But the prices aren’t cheap. That’s the problem.”

Mr. Wu looks back on 2023, scientific statement Contains an overview of cardiovascular, renal, and metabolic syndrome (CKM) by the American Heart Association. He said this is “an interrelationship with obesity, chronic kidney disease, diabetes and cardiovascular disease, which are associated with premature death and disability.”

He said pointing to this relationship specifically is one of the big cardiovascular headlines this year.

“This statement summarizes what is known about CKM syndrome and how to prevent and manage it. It highlights new ways to calculate risk for the syndrome and gaps in knowledge and needed research. We did,” Wu added. “Accompanying presidential recommendation It helps define CKM syndrome and provides guidance on its prevention and treatment in various clinical settings and communities. ”

Another big topic for 2023, Wu said, is research into endovascular thrombectomy, a minimally invasive surgical procedure to remove blood clots that cause strokes from arteries in the brain.

This procedure restores blood flow and prevents further brain damage or disability. This is the standard treatment for small or medium-sized strokes.

“Until now, it was unclear whether endovascular thrombectomy would also benefit patients with larger and more severe strokes, which account for up to a quarter of all strokes.

In a study of severe stroke patients in China and another trial of people in North America, Europe, Australia and New Zealand, researchers found that endovascular thrombectomy within 24 hours of a stroke is standard of care. “We found that it’s better than that,” Wu said.

The study showed that people who received the treatment experienced fewer signs of disability and were “more functionally independent for three months after treatment.”

he pointed to the third one study Among patients treated for severe stroke in Europe and Canada with similar outcomes.

“Those who underwent endovascular thrombectomy were more functionally independent than those who received only standard care. This study also found that patients who underwent thrombectomy were less likely to die. We also showed that,” Wu added.

What do these experts predict for next year? All three cited innovations in gene editing.

“We are beginning to see the era of gene editing,” Watson said.

she pointed the study New Zealand researchers have shown for the first time that gene editing technology can reduce low-density lipoprotein (LDL).

“What we’ve seen in this small proof-of-principle study, what we’ve seen in the first 10 patients, is that [we saw] “However, two out of 10 patients had very serious adverse events, one died and one had a heart attack, so questions about safety will always remain,” she added.

Even more encouraging, Watson and Wu said, is the FDA’s approval of a treatment for sickle cell disease that uses the same CRISPR gene editing technology.of approval According to NBC News, Kasugebi’s development is a major advance, making it the first drug to be approved in the United States using CRISPR.

Nissen pointed to the number of drugs in development to treat lipoprotein(a), or Lp(a), as a development that will continue to be at the forefront in the coming year. “This is a disease that is a risk factor for heart disease in 20% of the population, and so far we have not been able to treat it,” he said.

Currently, RNAi, or what is known as RNA interference, is being used to reduce Lp(a). Nissen said he and his team have published several papers on these new treatments, including one on a clinical trial of a drug called peracalcen, which he chaired. He said there was.

The study has enrolled 8,300 patients and is “now on track for completion,” he said.

“If successful, it will be the first time in history that we can treat this disease. Everyone is waiting for the results of the trial,” he said.

Additionally, beyond these innovations, Wu said he is excited about: FDA Modernization Act 2.0This opens the door to a new era that goes beyond mandatory animal testing and uses stem cells, organoids, artificial intelligence, machine learning, and computer models for drug discovery.