American Heart Top Heart Advances of the year 2017


Dr KK Aggarwal    09 February 2018

Dr KK Aggarwal

President Heart Care Foundation of India


  1. The new guidelines, published in the journal Stroke, say the clot-removal treatment window may be increased from six hours to up to 24 hours for specific patients who have clots in large vessels in the brain. The guidelines also increase the number of patients who will have access to a clot-dissolving drug proven to lower the chances for disability.
  2. A study in Nature suggests genome editing could be used to correct disease-causing mutations in the heart muscle of human embryos. Researchers focused on the MYBPC3 gene – which provides instructions for making a protein found in heart muscle cells and causes a form of inherited hypertrophic cardiomyopathy – and used new approaches to allow safe and accurate correction of the abnormal gene.
  3.  In children, "normal" blood pressure varies based on gender, age and height. So for years, doctors had to refer to sets of charts to calculate whether a childs blood pressure was normal or high. Last August, the American Academy of Pediatrics simplified the process by issuing updated guidelines for diagnosing, evaluating and treating children and adolescents with high blood pressure. The guidelines, published in Pediatrics, provide a short, easy-to-understand table that uses a childs age and gender to determine whether blood pressure is elevated or not.
  4.  The AHA and American College of Cardiology released new guidelines for adults last November that redefined what should be classified as high blood pressure, also known as hypertension. Experts looking at the newest data defined hypertension as a reading of 130 (for the top, or systolic, number) or 80 (for the bottom, or diastolic, number). In the past, hypertension was defined as 140/90.
  5.  Lifestyle changes alone, without the need for medication, are recommended for the majority of Americans with newly diagnosed high blood pressure, according to the guidelines.
  6. A study, in the Journal of the American Heart Association, found that 16- and 17-year-olds in the rural U.S. Southeast whose families suffered a financial downturn after the recession showed higher rates of metabolic syndrome, a cluster of disorders that may include abdominal obesity, high blood pressure, high blood sugar and high cholesterol.
  7. The study, in Circulation: Cardiovascular Quality and Outcomes, studied food deserts in metro Atlanta and found people who live there have higher rates of cardiovascular risk factors such as oxidative stress, inflammation and arterial stiffness. These associations are mostly due to low income of the area and its residents rather than proximity to a grocery store.
  8. A study in The New England Journal of Medicine found that the new injectable cholesterol-lowering drug evolocumab can reduce heart attacks and strokes among high-risk patients. The FOURIER study – paid for by Amgen, which makes and sells the PCSK9 inhibitor evolocumab showed that the drug cut the risk of having a heart attack, stroke or dying from a cardiovascular cause by 20 percent when added to intensive statin therapy. It lowered "bad" LDL cholesterol by about 60 percent, to a median of 30.
  9. A large international study in Circulation showed lower rates of death and heart failure for diabetes patients treated with the SGLT2 inhibitors canagliflozin, dapagliflozin or empagliflozin, compared with other glucose-lowering drugs. The CVD-REAL study – paid for by AstraZeneca, which markets dapagliflozin looked at more than 300,000 patients with Type 2 diabetes in the U.S., the U.K., Denmark, Norway and Sweden.
  10.  According to a study in The Lancet, combining low doses of the blood thinner rivaroxaban and aspirin is more effective than aspirin alone in preventing cardiovascular deaths, heart attacks, strokes and major amputations for people with peripheral artery disease, or PAD.
  11. The CANTOS study published in The New England Journal of Medicine looked at more than 10,000 high-risk patients who previously had heart attacks and found that canakinumab, a monoclonal antibody that targets interleukin-1 beta and blocks inflammation, significantly lowered their rate of having or dying from a heart attack, stroke or other cardiovascular cause.
  12. The SURTAVI study in The New England Journal of Medicine looked at severe aortic stenosis patients at intermediate risk for complications from surgery and found TAVR to be a viable alternative for them as well.

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