Most Promising Therapies in Interventional Cardiology
Purpose of Review
The last 40 years of clinical research in interventional cardiology were extraordinarily innovative. This article will review the most promising up and coming interventional cardiovascular therapies, with a primary focus on the treatment of coronary artery disease.
From the first stent, to the first transcatheter aortic valve implantation (TAVI), and the left appendage closure technique, percutaneous interventions revolutionized the treatment of multiple diseases and dramatically improved the prognosis of many patients. While these advances have decreased the risk of mortality in some patients (such as ST-elevation myocardial infarction), 15% of acute coronary syndrome (ACS) patients still experience recurrent ischemic events within the first year, challenging us to develop new pharmaceutical targets and new devices.
The continued emergence of data supporting inflammation as a risk factor and pharmacologic target as well as data supporting the importance of cholesterol efflux have identified novel therapeutic targets that may play a major role in the improvement of prognosis of patients with coronary artery disease. In addition, novel medical devices are being developed to allow even earlier detection of acute cardiac events and to support high-risk percutaneous coronary interventions. Advances in computing and the ability to analyze large datasets will allow us to use artificial intelligence to augment the clinician patient experience, both in and out of the catheterization laboratory, with live procedural guidance as well as pre- and post-operative prognostication tools.
KeywordsPercutaneous coronary intervention Implantable device Acute coronary syndrome Coronary artery disease
Acute coronary syndrome
Acute myocardial infarction
Coronary artery bypass graft surgery
Coronary artery disease
Bioresorbable vascular scaffold
Dual anti-platelet therapy
Intravascular Ultra sound
Optical coherence tomography
Optimal medical therapy
Percutaneous coronary intervention
ST-elevation myocardial infarction
Transcatheter aortic valve implantation
Compliance with Ethical Standards
Conflict of Interest
Mathieu Kerneis has received research grant from Federation Francaise de Cardiologie and Institut Servier.
C. Michael Gibson reports grants from Angel Medical Corporation; grants and personal fees from Bayer Corp., CSL Behring, Janssen Pharmaceuticals, and Johnson & Johnson Corporation; personal fees from The Medicines Company, Boston Clinical Research Institute, Cardiovascular Research Foundation, Eli Lilly and Company, Gilead Sciences, Inc., Novo Nordisk, Web MD, UpToDate in Cardiovascular Medicine, Portola Pharmaceuticals, Amarin Pharma, Amgen, Boehringer Ingelheim, Chiesi, Merck & Co, Inc., PharmaMar, Sanofi, Somahlution, St. Francis Hospital, Verreseon Corporation, Boston Scientific, Duke Clinical Research Institute, Impact Bio, LTD, MedImmune, Medtelligence, Microport, PERT Consortium, and nference; and non-financial support from Baim Institute.
Tarek Nafee has received research grant support and consulting fees from Portola Pharmaceuticals Inc.
Megan K. Yee, Hassan A. Kazmi, Sudarshana Datta, Michel Zeitouni, M. Khurram Afzal, Mehriam Jafarizade, Sargun S. Walia, Iqra Qamar, Anmol Pitliya, Arzu Kalayci, and Fahad Al Khalfan declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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