The modern progression in science and technology has lead to miraculous assisting powers to medicine and healing benefits to the patients. This article will discuss recent advancements in cardiology treatments, from the discovery of new medical drugs to technology used during cardiac interventions.

Dapagliflozin provides significant benefits to heart failure patients:

Heart failure is characterized by progressive heart dysfunction and shortness of breath. 

 More than 3% of Canadian adults (age over 40) develop heart failure. It is the second most common cause of death in Canada

Recently, the FDA has approved Dapagliflozin (Farxiga)tablets for heart failure patients. It is a sodium-glucose co-transporter 2 (SGLT2) inhibitor, given to those patients with reduced ejection fraction, having class II-IV heart failure. Dapagliflozin is especially beneficial for patients with low ejection fraction.

According to Norman Stockbridge, director of cardiology and nephrology in FDA centre research, this new therapeutic addition for cardiology treatments of heart failure patients is going to markedly enhance the ejection fraction, patient survival rates and reducing hospital admissions.

Not only this, but Dapagliflozin is also FDA approved for diabetes type II patients to regulate their blood sugar levels and protect against cardiovascular diseases.  We can expect further expansion of indications as it is currently being tested in many different patient groups including kidney disease.

Subcutaneous & transvenous implantable cardioverter defibrillators:

A subcutaneous implant of a cardioverter-defibrillator(S-ICDs) is inserted to monitor arrhythmias and heart rate irregularities. It has a built-in ability to produce electric shocks as soon as it detects arrhythmias to regulate the normal rhythm.

 Subcutaneous cardioverter defibrillator(S-ICDs) can now substitute for traditional transvenous ones (TV-ICDs). One study compared the efficacy and complications of subcutaneous and transvenous cardioverter-defibrillators. The study deduced that both devices are efficient and safe, but TV-ICDs can cause more complications compared with S-ICDs.

Single or double antiplatelet treatment for transcatheter aortic valve implantation(TAVI):

In October 2020, a study investigated whether single or double antiplatelet cardiology treatments could be beneficial for patients with TAVI.  An important question particularly for those with elevated bleeding risk. The results were remarkable, consuming one antiplatelet therapy can provide similar thrombotic results and reduce bleeding risk to taking two.

The latest addition of two non-statin drugs for hypercholesteremia:

High cholesterol is the root cause of heart diseases, especially in people with comorbidity. Statins are the most studied and widely used drugs in medical practice to reduce high cholesterol levels. Recently, the FDA has approved two non-statin medications, namely Nexletol and Nexlizet, that appear promising in lowering high blood cholesterol levels. With other new compounds like inclisiran on the horizon this is a truly exciting space to watch.

Modified &advance treatment of Coronary artery disease (CAD):

Coronary artery disease is the most common heart disease, that cause more than 30% of deaths every year worldwide. Nevertheless, the highest death toll due to CAD is noted in western countries, which has risen to nearly 50%.

The good news is, the latest treatment options are now available to treat coronary artery disease more effectively than ever. The type of therapeutic interventions following CAD depends upon the intensity, extent and clinical picture of the coronary disease, where it is treated via medicines alone or combined with surgery. As a result of the collaboration between biotechnology and tissue engineering, advance treatment options have now introduced stem cells, robotic surgery and nanotechnology that warrant promising effects to manage CAD more effectively. Stem cell research is focused on regenerating cardiac tissues, whereas nanotechnology aims at drug delivery on the micro-level and modified stent and its coating for percutaneous coronary treatment.

Robotic machines in Cath labs:

The use of robots in the cath lab is not new. There has been extensive debate on if their outcomes would justify their cost in a medical setup. Nevertheless, their use in higher radiation areas can be quite beneficial. A physician could instruct the robot that would perform the cardiac procures, which would keep the physician out of radiation and lessen his discomfort of wearing heavy lead jackets.

Ticagrelor and aspirin combination for CABG patients:

Ticagrelor is an antiplatelet drug ( P2Y12 inhibitor)that reduces platelets adherence abilities, preventing blood clot formation. In routine cardiology practice, both aspirin and ticagrelor are prescribed to the patients undergoing CABGcardiac bypass surgery)to avoid stenosis of the saphenous graft(SVG).

As per a recent clinical trial, analyzing the efficiency of aspirin and ticagrelor or only aspirin in acute MI concluded that the chances of stenosis of SVG were the same in both cases. Therefore, only aspirin could be enough for the CABG patient to prevent potential SVG stenosis.

Effects of long term use of Beta-blocker for acute MI patients:

In routine practice, it is advised to use long term beta-blockers for acute MI patients to improve their survival rates. However, long-term means for how long? This has been debated for many years.

A recent clinical trial has concluded that patients using beta-blocker for one year showed good survival rates. However, continuing beta-blocker for more extended periods(up to three years)showed no extra benefits. 

Latest technology assisting in cardiology treatments:

The top technologies that are in use in cardiac treatments include:

  • Artificial intelligence supported automatic calculating ejection fraction for point of care ultrasound system(POCUS). These machines themselves analyze an anatomical position and automatically name its segments. Also, it takes optimized echo views and calculates measurements before a cardiac physician starts a clinical investigation. Not only this, artificial intelligence is used to monitor arrhythmias in patients via wearable devices and send alert through Smartphone notifications if it suspects arrhythmias.
  • Transcatheter aortic valve replacement (TAVR); is another new addition to advance cardiac interventions. Following 2019, the FDA has approved the replacement of the aortic valve via a transcatheter, especially for those who may have health risk following surgery. As per reports, aortic valve replacement by TAVR is even better than conventional surgical replacement of the aortic valve. It is assumed that TAVR will become the most commonly performed procedure by 2025.
  • Virtual reality(VR) and Augmented reality (AR); The modern cardiac practice is using Virtual reality technology for providing physician and patients a myriad of benefits including,
  • To trained the medical staff and trainee cardiologist to teach them about cardiac intervention via 3D models.
  • To pre-plan the operative strategies by virtually getting into the patient and plan the operative approach.

As per reports, upcoming advance options by VR will allow physicians to voice control the virtual field without leaving the sterile surgical environment.