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America’s CVD Problem | BAC & CAC Screening
October 28, 2024
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Together with
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“Magic pills, magic shots, and magic procedures will have no impact on this problem. Only a wholesale change in culture of health in USA will move the needle.”
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Johns Hopkins cardiologist Joseph Marine, MD.
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It’s well known that heart disease is the U.S.’s top cause of death, and our rising CVD rates have been widely covered, but a look back on some of the biggest stories of 2024 suggests that cardiovascular disease is about to become a much bigger problem.
- Heart Disease in 2050 – The AHA warned of massive heart disease increases by 2050, spanning CVD (+60%), diabetes (+100%), obesity (+70%), hypertension (+44%), heart failure (+66%), and stroke (+100%). Add all that up and the cost of treating adult CVD and stroke patients will increase by 195% to $1.85 trillion, representing 4.6% of US GDP.
- America Has CKM Syndrome – The vast majority of Americans are at risk of developing cardiovascular-kidney-metabolic (CKM) syndrome. A JAMA analysis of 11k adults revealed that only 10.6% had no CKM syndrome risk factors, while 26% were at Stage 1 (overweight, prediabetes), 49% were Stage 2 (hypertension, diabetes, CKD), 5% had Stage 3 (kidney disease or high CVD risks), and 9% were Stage 4 (heart disease, with or without kidney disease).
- U.S. Hypertension Problems: Another JAMA study highlighted the U.S.’s massive hypertension diagnosis and treatment problems. A survey of 7.3k U.S. adults (4k with hypertension) revealed that 79% of participants with hypertension didn’t have their BP under control, and 57.6% didn’t even know they had the disease. Meanwhile, only 30% of the participants who were actually aware of their hypertension had their BP under control.
- AFib Wakeup Call – A JACC study suggested that atrial fibrillation is far more prevalent than many thought. Analysis of 29M Californian’s records revealed that a whopping 2M (6.8%) of them had been diagnosed with AFib, with rates increased dramatically during the study period (4.49% in 2005-2009 >>> 6.82% in 2015-2019). If applied across the U.S., at least 10.55M Americans are currently diagnosed with AFib, representing 4.48% the U.S. adult population.
The Takeaway
These truly frightening statistics suggest that the U.S. is due for a wave of new CVD cases unless we make some major changes to how we live and deliver care. And we better get working on both fast, considering that another 2024 study revealed that 46.3% of U.S. counties don’t have a single cardiologist.
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The Benefits of Outsourced Post-Processing
Using an outsourced cardiac image post-processing solution doesn’t have to mean sacrificing control of the results. Discover how PIA’s customizable post-processing workflow can help you get the most out of your images.
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Measuring True Cardiac Risk
How can AI help physicians “see” beyond conventional lipid profiles? Tune in to this on-demand webinar showcasing how Cleerly’s AI-QCT solution complements conventional approaches to evaluating heart disease risk factors, and improves coronary artery disease diagnosis and heart attack risk assessments.
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- Real World BAC Screening: Using AI to assess mammograms for breast arterial calcifications and identify women with greater CVD risks has been widely covered in medical journals, and a NPR story reveals that it’s now expanding in clinical settings. Some imaging centers are now asking women whether they would also like their mammograms checked for CVD risks (often for a OoP fee), although experts cited in the story largely voiced concerns about follow-up and that the absence of BAC doesn’t mean a patient doesn’t have high heart risks.
- Okami’s Occlusion Financing: Okami Medical closed $32.5M in financing to accelerate the development and commercialization of its catheter-based technologies for peripheral vascular occlusion, including its LOBO Vascular Occlusion System and the SENDERO Microcatheter. The LOBO provides physicians with a single-device solution for the occlusion of a wide range of peripheral arterial targets without the need for multiple embolic devices, while the SENDERO supports smooth delivery and tracking of interventional devices in tight blood vessels.
- Siemens’ Solid CAC Scoring: Siemens Healthineers’ AI-based CAC scoring solution matched up well against radiologists’ manual CAC scoring results in a new study out of Sweden. Among 4.6k people without symptoms or coronary artery disease, the Siemens CAC scoring solution achieved 91% accuracy and “almost perfect” agreement (kappa = 0.913) with expert radiologists’ CAC scores.
- The HF-Cancer Link: It turns out that heart failure and cancer share several pathways that cause and exacerbate both diseases, highlighting a need for more coordination between cardiology and oncology. That’s from a new HFSA statement, which particularly emphasized how cardiomyopathy can be caused by common cancer drugs. The discovery opens the door to more research on permissive cardiotoxicity and whether cancer treatments’ benefits justify their HF risks.
- Sensory Issues and CVD: Older adults with trouble seeing, hearing, or both may face a higher risk of stroke or heart attack. A China-based AHA study examined 11K participants aged 45+ without a history of CVD, including 2,100 who developed cardiovascular conditions over a seven year follow-up. Participants with vision or hearing loss were more likely to develop CVD (24% & 20%), while those with both conditions had a 35% increased risk compared to those without sensory issues.
- TAVR Mortality Surveillance: Though TAVR outcomes in the U.S. have improved substantially since 2011, surveillance of these trends has broadly dropped off since 2019. A national analysis of TAVR outcomes found that risk-adjusted 30-day mortality increased modestly from January 2019 to March 2022 (from OR 0.98 to OR 1.09). However, no site-level, patient-related, or process-related factors could explain these findings, implying follow-up studies are necessary to keep a finger on the pulse of TAVR outcomes.
- EchoPrime: A Cedars-Sinai led research team announced EchoPrime, the first echocardiography AI model capable of evaluating and interpreting a full transthoracic echocardiogram. The model was trained on 10X the data of existing echo AI models, including 12M videos of 275k echofirst studies from 108k patients. It also uses an “Anatomic Attention” model to rank different echo videos for identifying the most relevant views and producing the most accurate holistic interpretation for a study.
- Best and Worst MI Mortality: CMS revealed that NYU Langone had the lowest 30-day heart attack mortality rate in the U.S. (7.7%), while Cedars-Sinai and Mayo Clinic Rochester tied for second (8.6%). The highest mortality rates were at Midland Memorial (17.6%), Princeton Baptist Birmingham (17.5%), and Ochsner Lafayette (17.3%). Though the differences seem stark, it’s worth noting that the top hospitals were wealthy research institutions and the bottom hospitals were regional centers treating poorer populations.
- HF and Cognitive Function: The cognitive impacts of HFpEF may be worse than previously thought, with even modest impairment of brain function leading to poorer outcomes. A prespecified substudy of the PARAGON-HF trial analyzed cognitive function using the Mini-Mental State Examination (MMSE) in roughly 2,900 patients and found those with borderline and impaired cognitive scores were 27% and 58% more likely to experience HF hospitalization or cardiovascular death.
- Americans Lack CVD Knowledge: In an emerging challenge for cardiac health providers, 29% of Americans have never heard of peripheral artery disease (PAD) and 85% said they are unsure what vascular surgeons do. This data comes from the Society of Vascular Surgery’s latest survey as part of its three-year patient education campaign – Highway to Health, which aims to improve the general public’s understanding of PAD, vascular surgery, the risks of tobacco use, and more.
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Bringing AI Into Echo Workflows
Cardiovascular AI solutions are still far more commonly found in cardiology journal papers than in actual clinical workflows, but that’s changing fast and there’s a lot to learn from AI early adopters. Tune into the latest Cardiac Wire Show with Mount Sinai’s Jeffrey Bander, MD and Us2.ai’s Seth Koeppel to see how they launched and expanded their echo AI partnership, and learn how to “adopt echo AI the right way.”
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Addressing Coronary Artery Disease
Learn how the AGENT™ Drug-Coated Balloon provides a new treatment option for in-stent restenosis in the U.S. Rx Only. (Sponsored by Boston Scientific)
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Identify and Treat Cardiovascular Disease
Complex care pathways make getting patients to the next step a challenge. See how Tempus Next, an AI enabled care pathway platform, helps providers identify and reduce under treatment in cardiovascular disease by adding an intelligent layer onto their routinely generated EHR data.
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- Innovating AFib Care: The first manifestation of AFib is often stroke, but many hospitals aren’t set up to coordinate these patients’ post-stroke care. See how UCSD is leveraging Viz.ai’s Viz Connect solution to simplify neuro and EP collaboration in this HRX 2024 interview.
- Experience the future of learning: Medtronic Academy 2.0 is here! Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!
- Single-Database Simplification: Ready to simplify your cardiovascular imaging data? See how one cardiovascular group used Optum’s single-database system to combine data, get rid of dictation systems, make registry submissions easier, and improve reporting compliance.
- Connecting the ECG Monitoring Ecosystem: There’s so much that goes into building the solutions that providers use each week, and that’s definitely true for ECG monitoring. In this Cardiac Wire Show interview with Flipside Media’s president Brad Ummer, we get an insider’s view of what it takes to develop an ECG monitoring solution, including Flipside’s partnership with Monebo Technologies.
- It’s Time to See The Full Picture: See how HeartFlow ONE is transforming precision heart care as the first all-in-one CCTA pathway, combining FFRCT, stenosis, and plaque analysis in a single workflow.
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