New research from the ACCORD Study Group offers insight into specific treatments that can reduce their risk of cardiovascular disease (CVD). The first study found that aggressive blood pressure control does not reduce CVD risk in people with type 2 diabetes at high risk for CVD. In a second study, a combination therapy with a statin plus a fibrate was no better at reducing risk than a statin alone in patients with type 2 diabetes at high risk for CVD. However, the combination lipid therapy may be successful in reducing CVD risk in those type 2 diabetes patients who had low HDL cholesterol and low triglycerides.

 

Transcatheter aortic valve implantation (TAVI) is an emerging alternative therapy to open-heart surgery in high-risk patients. Two new studies support the evidence that TAVI can improve symptoms and outcomes – including quality of life – even over the course of several years.

 

Significant new studies report chest compression only, or ‘Hands Only CPR’ for adults by bystander lay rescuers improves survival outcome. While the new procedure appears successful in adults, it is important to note that using conventional chest compressions with rescue breathing is still important for children stricken with sudden cardiac arrest.

 

For the first time in more than 20 years there are viable alternatives to the primary prevention of stroke for patients with atrial fibrillation (AF). Warfarin (Coumadin) has long been the standard anti-clotting drug used to reduce the risk of stroke for these patients. But it carries its own complications from bleeding, and managing the dose requires regular blood tests. Now, several new drugs have been found to work as well as warfarin – and are simpler for patients to take.

 

Many heart failure patients experience abnormal heart rhythms, known as arrhythmia. There are a number of devices available to treat arrhythmia, including implantable cardioverter difibrillators (ICDs) which can shock the heart beat back into a normal rhythm. New studies show that adding additional resynchronization pacing to ICD therapy can lead to improved outcomes in an expanded group of heart failure patients. In addition, new types of ICDs (defibrillators without leads, for example) can offer options that reduce some of the risks associated with traditional devices.

 

The Pediatric Heart Network’s randomized trial of Norwood shunt types in infants with single-ventricle lesions showed that the type of shunt used makes a difference in outcomes. Better transplantation-free survival at 12 months is a possibility with this new understanding of the better shunt choice for these patients.

 

7. Finding the right anti-clotting (anti-platelet) therapy

Selecting the right type of anti-clotting drug and the right dosage can be tricky, and risky. New research from the PLATO investigators has found that ticagrelor may improve outcomes and reduce adverse events better than the current standard, clopidogrel. The CURRENT-OASIS 7 Trial is exploring the optimal dosing of clopidogrel and aspirin in patient undergoing invasive surgery.

 

Findings from stem cell therapy have shown improved quality of life and survival in several early studies of patients with chronic heart failure and support the development of future cell-based therapeutics. A large animal study defined the basic mechanisms for heart muscle regeneration initiated by specific types of stem cells. The results demonstrated that these stem cells repair scarred myocardium through promotion of the generation of new heart muscle and blood vessel). A second study supported the notion that the heart has the capacity to regenerate large numbers of heart muscle cells several times during its lifetime.

 

New science examining lifestyle behaviors in adults and children, with particular emphasis on physical activity and consumption pattern, show that such conditions as obesity and hypertension are positively influenced by a change in diet with decreasing sodium levels. Results from the school setting suggest that the earlier one starts to adopt healthy behaviors the better the effect on health outcomes.

 

Racial and ethnic disparities have been found in the quality of care delivered to patients with cardiovascular disease and achieving equity and addressing disparities has implications for quality, cost, risk management, and community benefit. Eliminating these disparities is a top priority for the American Heart Association.