Perhaps the most famous quote from famed cardiologist and editor, William C. Roberts, MD, who passed away last week.

Cardiology Pharmaceuticals

NYU’s Atherosclerosis Inflammation Discovery

NYU researchers discovered that AstraZeneca’s saracatinib – an investigational drug originally developed to treat cancer – could slow atherosclerosis progression by addressing inflammation that we know contributes to ASCVD and haven’t figured out how to treat.

The researchers’ path towards discovering saracatinib’s atherosclerosis benefits started with analyzing blood samples from 34 statin-takers with ASCVD and from 24 healthy controls – confirming that plasma from people with atherosclerosis had higher inflammatory signals. 

To find a potential treatment, they used the blood samples to identify which genes are involved in atherosclerosis inflammation, and then searched a pharmaceutical database to find an existing drug that might suppress the genetic processes that create that inflammation.

Their search brought them to saracatinib, which they found had a major impact on inflammation and plaque when they applied the cancer drug to…

• Human blood and tissue samples — reduced inflammation signaling by over 90%
• Rabbits — reduced plaque-based inflammation by 97%
• Mice — reduced cells linked to plaque inflammation by 80%

Those results were strong enough for the authors to conclude that saracatinib has the potential to address inflammation in patients who are already taking lipid-lowering drugs, while proposing new phase 2 trials to test this theory.

Future saracatinib studies might be part of a new wave of research into CVD inflammation, noting that cardio-immunology startup Bitterroot Bio just emerged with a similar mission to address the unsolved aspects of cardiovascular disease inflammation.

The Takeaway

Even though we know that inflammation contributes to ASCVD in ways that are independent from dyslipidemia and high cholesterol, lipid-lowering therapy remains the only pharmacologic option for ASCVD risk reduction, leaving atherosclerosis inflammation untreated. Saracatinib might not prove to be the solution to this problem, but the recent surge in CVD inflammation research and funding suggests that we could be getting closer to a solution.

Reducing ECG Background Noise

Monebo’s Kinitec Rhythms ECG Algorithm separates true ECG signals from background noise, leading to more accurate diagnoses and improved operator efficiency. See for yourself how the algorithm measured up to a gold standard.

PIA’s Post-Processing Solution

Advanced cardiac imaging often calls for a time-consuming post-processing step, requiring costly software, hardware, and training. See how PIA provides this post-processing at lower cost, improved consistency, and greater efficiency.

User Experience and Cardiovascular Imaging Transformation

Check out this Change Healthcare video discussing the importance of user experience in the adoption of structured reporting, and how it can lead to improvements in imaging speed, quality, and cardiologist workflow. 

The Wire

• CCTA Before LAAC: When interventional cardiologists use CCTA scans to plan echo-guided percutaneous left atrial appendage closure (LAAC) procedures, patients have significantly better outcomes. That’s the takeaway from a recent JACC study that compared 219 LACC procedures, including 92 where ICs had access to CCTAs for planning. After adjusting for confounders, CCTA planning was associated with far higher success rates following the procedure (93.5% vs. 81.1%) and at 45 days (83.7% vs 72.4%).

• Atherectomy False Claims Settlement: A Fayetteville, North Carolina cardiologist and his practice will pay over $5M to settle false Medicare and Medicaid claims allegations regarding unnecessary atherectomy procedures. Dr. Hari Saini reportedly “systematically overstated the stenosis percentage” to encourage patients to undergo atherectomy, a lucrative outpatient procedure that physicians across the country have apparently gravitated towards in recent years.

• Mavacamten’s FDA Label Update: The FDA granted an updated prescribing label to Bristol Myers Squibb’s mavacamten (Camzyos) hypertrophic cardiomyopathy medication, now showing that mavacamten reduces patients’ need for septal reduction therapy (SRT), an invasive surgery that was previously the only effective HCM treatment. The label update is based on BMS’ Phase 3 VALOR-HCM trial, which found that 82% of mavacamten users were no longer eligible for SRT at 16 weeks and decided not to undergo the procedure.

• The Toll of Rising Drug Costs: A new survey (N=2k) revealed that 20% of older adults in the U.S. have stopped medications due to cost, while others forgo basic needs (8.5%) or go into debt (4.8%) to afford medications. Meanwhile, a JAMA study (N=80k) found that patients with type 2 diabetes and CVD were far less likely to begin their SGLT2 inhibitor or GLP-1 treatments if their out-of-pocket costs were in the highest quartile (-20% & -13% vs. lowest quartile).

• Us2.ai Integrates with Core Sound: Us2.ai has integrated its echo AI offerings with Core Sound Imaging’s Studycast Integration Program. Launched earlier this month, the program brings software developers into Studycast, Core Sound’s environment that gives healthcare providers access to AI algorithms and other image analysis tools. Studycast users can now route selected echo images to Us2.ai, producing a full echo report and incorporating the analysis into their reports.

• Redefining SAVR Risk: Cleveland Clinic researchers found that SAVR is far safer than risk models suggest, particularly at high-volume centers and with low-risk patients. The researchers compared outcomes from 3,493 SAVRs (2005-2017) against Society of Thoracic Surgeons (STS) model predictions, finding far lower mortality rates than STS predicted (0.43% vs. 1.6%). Major morbidity or mortality rates steadily declined (2006 = 8.6%, 2011 = 6.7%, 2016 = 5.2%), even though the STS model predicted a 12% rate for each year.

• Medical Malpractice Lawsuits: An AMA study found that 34% of physicians have been sued for medical malpractice during their career. A majority of general surgeons and OB-GYNs have faced a malpractice suit (59% & 62.4%), far outpacing cardiologists (17.3% under aged 55yrs, 49.7% over 55yrs).

• Sensydia’s NIH Grant: A month after adding $8M in venture funding (total raised $17.8M), non-invasive cardiac monitoring startup Sensydia landed a $3M NIH grant to support the development and clinical testing of AI algorithms used in its Cardiac Performance System (CPS) platform. Sensydia’s CPS platform combines biosensors and AI to produce multiple hemodynamic measurements and support heart failure management, allowing cardiac performance assessments to be performed “anywhere” ranging from the OR to home care settings.

• Preeclampsia Genetic Risk Factors: Researchers in Finland uncovered new insights into how genetic factors can increase women’s risk of developing hypertensive pregnancy disorders like preeclampsia. The researchers analyzed genome variations in 32k women, identifying 13 novel points in the genome that may play a role in preeclampsia. Seven of those genes were already associated with blood pressure, while the remaining genes are linked to other aspects of pregnancy.

• US Healthcare Expenditures to Hit $7.2T: CMS predicts that a surge in Medicare spending will push US healthcare expenditures to $7.2 trillion by 2031, up from $4.3 trillion last year. The projections anticipate that the combination of an aging population and federal policy changes will grow Medicare costs by 7.5% annually between 2022 and 2031, outpacing GDP’s expected 4.6% annual growth. 

• The Psychological Impact of ICDs: Implantable cardioverter defibrillators (ICDs) extend patients’ lives, but also come with significantly increased rates of mood disorders. EP Europace analysis of 109 studies (N=39,954 ICD patients) showed that ICD patients have far higher rates of anxiety, depression and PTSD at one year after insertion than the general population (23% vs. 13%, 15% vs. 7%, 12% vs. 1-2%), suggesting that psychological assessments and therapy should be integrated into routine ICD patient care.

Cleerly Brings the Confidence to Compete

Pro triathlete Timothy O’Donnell recently spoke on the Rich Roll Podcast about surviving a heart attack mid-race and how getting a Cleerly analysis gave him confidence to compete again. Once he confirmed his heart was ready, he returned to racing and went on to win an Ironman at the age of 42.

Automating Echo Amyloidosis Assessments

The University College London National Amyloidosis Centre is the world’s largest cardiac amyloidosis care provider, making their echo assessments both crucial and high-labor. See how UCL researchers used Us2.ai’s AI echo software to accurately analyze echos from 1,200 patients with ATTR Amyloidosis in 24 hours, without requiring human interaction.

The First Step to Coronary Artery Disease Diagnosis

HeartFlow’s new RoadMap Analysis solution allows CT readers to accurately, efficiently, and consistently identify stenoses in the coronary arteries. See how RoadMap Analysis’ visual and quantitative insights into the narrowing of all major coronary arteries helps readers evaluate coronary CT angiograms before determining the need for an FFRCT.