- 2020 had its share of innovative heart disease research, despite COVID-19 dominating the headlines.
- The American Heart Association recently released its summary of new findings.
- Studies evaluated different strategies using medication, surgery and prevention techniques to improve heart health.
[4 MIN READ]
Although COVID-19 dominated health headlines throughout most of 2020, it was not the only newsworthy event taking place in the healthcare arena. Despite the pandemic, science took some significant steps forward last year to help knock heart disease and stroke from their top positions on the list of deadliest diseases.
The American Heart Association recently released a summary of some of the most critical findings in 2020 for heart health. Our Providence heart and vascular caregivers weigh in on what that research means for you.
Sometimes less is more
Myocardial ischemia causes your coronary arteries to progressively narrow. The condition prevents your heart muscle from getting enough blood to function properly. It causes chest pain, tightness and burning and may feel like heartburn or indigestion. Opinions about best-practice treatment can vary and there’s some disagreement on when to start care. Two studies published in the New England Journal of Medicine shed some light on the issue.
As doctors, we tend to offer conservative approaches first - this includes medications, cardiac rehabilitation, lifestyle modification and smoking cessation. -- Dr. Waggoner
“There’s always been a debate about putting stents on patients with blocked arteries. As doctors, we tend to offer conservative approaches first - this includes medications, cardiac rehabilitation, lifestyle modification and smoking cessation. But often, patients want to start with a procedure to fix their symptoms quickly; the perception is that doing more is better,” says John Waggoner, MD, an interventional cardiologist with Providence.
The trial known as ISCHEMIA echoes Dr. Waggoner’s sentiments. Researchers studied more than 5,000 patients in 37 countries. Half received early, aggressive treatment that included coronary angiography, plus bypass surgery or some other form of coronary intervention to improve blood flow. The other half started with a medication-only approach. Results showed both groups had roughly the same risk of heart attack, hospitalization for chest pain, heart failure or death from cardiovascular causes.
A related trial, ISCHEMIA-CKD, looked at patients with chronic kidney disease, who often have cardiovascular disease as well. Its results were similar—finding little to no difference in the health outcomes between the two groups.
This trial sheds a brighter spotlight on what many cardiologists have long thought—a less invasive approach can help, even though it takes more time. A quick fix isn’t always better. -- Dr. Waggoner.
“During COVID-19, procedures were delayed. Many doctors turned to medically-managed care, which is a longer-term solution but tends to work very well. This trial sheds a brighter spotlight on what many cardiologists have long thought—a less invasive approach can help, even though it takes more time. A quick fix isn’t always better,” said Dr. Waggoner.
Active treatment for atrial fibrillation
Atrial fibrillation is a condition that causes your heart to beat irregularly. It can lead to blood clots, heart failure, stroke and other complications. Two studies from the New England Journal of Medicine indicate that if treatment begins shortly after diagnosis and returns the patient’s heartbeat to a normal rhythm, participants are less likely to have a stroke, be hospitalized from a heart attack or die from heart disease.
One study determined that early treatment including medication and ablation to remove a portion of heart tissue and restore regular rhythm can reduce the threat of future heart issues by 21%. Another found that cryoablation, or using extreme cold to freeze and destroy the area of your heart causing the irregular heartbeat, was more effective than medication in preventing future problems.
There is a benefit to rhythm control therapy and it’s s a game-changer in moderating the consequences of this condition. -- Dr. Waggoner
“This study shows that treatment for atrial fibrillation is becoming more aggressive. There is a benefit to rhythm control therapy and it’s s a game-changer in moderating the consequences of this condition,” said Dr. Waggoner.
Medication cuts cholesterol levels
Three studies published by the New England Journal of Medicine explore cutting-edge therapies to reduce cholesterol levels and lower heart disease risk.
In a pair of trials that looked at patients with high cholesterol levels, researchers found an innovative approach that used medication to switch targeted genes off and on. The results? Cholesterol levels dropped by half in most of the participants.
Another study showed promise with medication used to treat high cholesterol caused by genetics and not affected by lifestyle changes. Results from both studies indicate the remedy was highly effective in lowering the cholesterol levels of participants who received treatment.
Carotid stenosis is a plaque buildup that forms inside the arteries of your neck. The condition is a major risk factor for stroke. Several major studies last year investigated different treatment options, including medication and surgery, to determine if either reduced the chance of stroke.
ROADSTER 2 tested a minimally-invasive procedure called transcarotid artery revascularization (TCAR). The surgical treatment uses a balloon catheter to open your blood vessel and improve your brain's blood flow. After the procedure, less than 2% of patients in the study had a stroke or heart attack within 30 days.
Another study named THALES examined whether aspirin combined with another medication to reduce blood clotting might prevent future strokes in patients who had a stroke previously. Participants who took both drugs experienced a 17% lower risk of death or stroke within 30 days than those who did not.
Yet another study looked at whether lowering the recommended cholesterol level for patients who previously had a stroke prevented future issues. Patients who maintained a target LDL cholesterol (bad cholesterol) below 70 mg/dl had a 22% lower risk than patients with a target of 90 to 110 mg/dl.
Researchers everywhere understand the importance of accurate, evidence-based research to discover and fine-tune solutions that improve the quality of life of heart and stroke patients. And despite the health turmoil of 2020, their work continues to make a difference.
Has an advance in #HeartCare been a life-changer for you or someone you care about? Share your story with readers @providence.
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This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's advice.
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