Cardiac Wire’s Top Six Takeaways from AHA 2023

The AHA 2023 Scientific Sessions are officially complete. We hope you had a blast if you attended, and had a great weekend if you stayed home. We also hope you enjoy Cardiac Wire’s top-six takeaways from cardiology’s last big event of 2023:

  • SELECT Dominates – AHA 2023 kicked off with the full results from Novo Nordisk’s SELECT trial – and semaglutide’s ability to slash cardiovascular events was still what everyone was talking about as the Scientific Sessions wrapped up on Monday. Many attendees still aren’t totally comfortable with GLP-1s, but most would agree that these drugs are about to have a massive impact on cardiology.
  • A New Anticoagulation Factor – An impressive Late Breaker featuring Anthos Therapeutics’ Factor XI inhibitor abelacimab (see coverage in The Wire section) and a strong presence from Bayer and Janssen/Bristol Myers Squibb’s Factor XI research teams had many attendees considering a future where bleeding risks aren’t keeping millions of AFib and stroke patients from receiving anticoagulation meds. Depending on who you talk to, we could be headed towards a completely new anticoagulation standard of care.
  • Prevention & Detection – Boosted by GLP-1 obesity buzz and the fact that cardiovascular outcome trends have been headed in the wrong direction, AHA 2023 placed a greater focus on prevention. That preventative focus seems to be bringing an embrace of a wider range of risk factors and risk detection methods (well beyond blood pressure and LDL-C).
  • Treatment Evolution – That increased focus on detection might also be due in part to the incredible treatment evolution taking place, including for conditions that had no treatment options just a few years ago (e.g. ATTR-CM, obstructive HCM) and conditions that now have far more advanced treatment options (e.g. heart failure).
  • Implementation Science – We have the tools to detect and treat far more diseases, so why are so many people living undiagnosed, and why are so many diagnosed people not receiving proper treatment? That question repeatedly came up during AHA, suggesting that the impact of the latest treatment advances will depend on similar advances in implementation science.
  • Long-Term Solutions: A review of the most-discussed Late Breakers suggest that cardiology’s implementation science problems could be improved by embracing one-time (e.g. renal denervation, gene editing) or long-lasting therapies (e.g. zilebesiran, recaticimab). That said, there were still plenty of attendees who had major concerns about one-time therapies (especially gene editing), and many still aren’t sure that long-lasting therapies would solve our adherence problems.

The Takeaway

Cardiology faces its share of challenges, but AHA 2023 made it clear that plenty of solutions are on the horizon, and some of the smartest and most passionate people in medicine are ready to bring these solutions into patient care.

Check out the rest of today’s issue for details on the biggest trials from AHA 2023.

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