The leading cause of death in the U.S. for both men and women is getting a makeover. Heart Disease treatment breakthroughs are reaching for and getting better outcomes.
There have been some very significant advances made in the past few years, and like a freight train, they’re moving quickly toward widespread availability.
After more than 10 years of failed efforts at developing new heart drugs, two important therapeutic breakthroughs have received FDA approval.
They are already changing the outcomes for the better and helping to change the practice of medicine to help patients who have not made good progress from existing therapies.
Here are the heart disease treatment breakthroughs:
1. A Better Drug for Heart Failure
Congestive Heart Failure is a common disorder involving the failure of the heart muscle to forcefully pump blood to the body’s tissues.
Common causes of heart failure include hypertension (high blood pressure), heart attacks or other diseases that weaken the heart muscle.
➡ Patients often have severe shortness of breath or fatigue that limits their ability to enjoy life.
This disorder is the number one reason for hospitalization among Medicare patients.
In a large clinical trial, a new drug, LCZ696, was used to treat heart failure, and it was highly effective.
➡ There was a substantial 20% reduction in death or repeat hospitalization compared with the best currently available therapies.
➡ LCZ696 was superior to Enalapril (also called Vasotec, Renitec, Enacard) and others, in reducing the risks of death and of hospitalization for heart failure.
Of course, although the benefits of a reducing the death rate are wonderful, reducing hospital readmissions can’t be underestimated.
Currently, 20% or more of patients hospitalized for heart failure are readmitted within 30 days. This is a significant burden for patients as well as to our already overburdened healthcare system.
➡ LCZ696 is now sold under the brand name Entresto (generic: Sacubitril/valsartan) as a combination drug for use in heart failure. It is proving to be a new, promising option for the 5.7 million Americans living with heart failure.
Different types of treatments are used to lower high LDL (bad cholesterol).
Statins are the most commonly prescribed treatment, but sometimes your cholesterol numbers are still too high and you may need additional help in lowering your LDL.
➡ If you’re on a diet, are taking the highest dose statin you can take, and you have plaque-related heart or blood vessel problems or inherited high cholesterol, but you’re still struggling to lower your LDL, it’s time for a different approach.
This new class of drugs has moved from discovery to the clinic more rapidly than any cardiovascular advancement in recent memory.
The single most important risk factor for developing coronary heart disease is an elevated level of “bad” cholesterol, also known as LDL.
➡ Up until recently, statins have been considered the best available drugs for lowering cholesterol, decreasing the risk of heart attack or stroke by 35%.
But although Statins have been available for more than 25 years and have been enormously successful at reducing the burden of heart disease, unfortunately, some patients cannot tolerate statins or can’t take large enough dosages to adequately reduce cholesterol levels.
➡ In other cases, LDL is very high due to an underlying genetic cause, and even the most powerful statins cannot reduce it to safe levels.
But now there are PSCK9 inhibitors which have been shown to reduce bad LDL by as much as 50-70% with very few if any, adverse effects.
➡ PSCK9’s are antibodies. They target and inactivate a specific protein in the liver, dramatically reducing the amount of harmful LDL cholesterol circulating in the bloodstream.
➡ Known by the generic names Alirocumab and Evolocumab, research has demonstrated that they are much more effective than statins at lowering LDL levels (even in patients already taking statins).
➡ Although these drugs are given by injection every two weeks or once a month, they are injected with very small needles that produce little or no pain. Patients can easily self-inject these drugs using an automated injector.
➡ This new class of drugs appears to be well tolerated even in patients who cannot take statins due to adverse effects.
In 2011, the FDA approved a new procedure to treat heart valve disease without a major surgical operation, known as TAVR (transcatheter aortic valve replacement).
This device is approved for patients who need an aortic valve replacement, but who are a too high risk for standard open-heart surgery.
When a patient is too ill to tolerate an open-chest procedure, such as older patients, this new approach is an important advance.
➡ For this procedure, a catheter (small hollow tube) is placed in the groin (femoral artery) and guided into the heart chambers using advanced imaging techniques.
➡ Through this catheter, a collapsed tissue heart valve is guided into position and placed directly inside the diseased aortic valve.
➡ Once the new valve is correctly placed, a balloon is inflated to deploy the valve, incredibly, without opening the patient’s chest.
TAVR is currently being performed at multiple hospitals in the United States.
Although heart disease remains the No. 1 cause of death in the United States, these treatment breakthroughs offer new hope to patients.
These long-awaited advances are already making a difference.
Special thanks to Steven Nissen, MD, Chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at Cleveland Clinic’s Sydell and Arnold Miller Family Heart & Vascular Institute. He has more than 35 years experience as a physician and is world-renowned for his work as a cardiologist, patient advocate, and researcher.