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Most Promising Therapies in Interventional Cardiology

  • New Therapies for Cardiovascular Disease (AA Bavry, Section Editor)
  • Published:
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Abstract

Purpose of Review

The last 40 years of clinical research in interventional cardiology were extraordinarily innovative. This article will review the most promising up and coming interventional cardiovascular therapies, with a primary focus on the treatment of coronary artery disease.

Recent Findings

From the first stent, to the first transcatheter aortic valve implantation (TAVI), and the left appendage closure technique, percutaneous interventions revolutionized the treatment of multiple diseases and dramatically improved the prognosis of many patients. While these advances have decreased the risk of mortality in some patients (such as ST-elevation myocardial infarction), 15% of acute coronary syndrome (ACS) patients still experience recurrent ischemic events within the first year, challenging us to develop new pharmaceutical targets and new devices.

Summary

The continued emergence of data supporting inflammation as a risk factor and pharmacologic target as well as data supporting the importance of cholesterol efflux have identified novel therapeutic targets that may play a major role in the improvement of prognosis of patients with coronary artery disease. In addition, novel medical devices are being developed to allow even earlier detection of acute cardiac events and to support high-risk percutaneous coronary interventions. Advances in computing and the ability to analyze large datasets will allow us to use artificial intelligence to augment the clinician patient experience, both in and out of the catheterization laboratory, with live procedural guidance as well as pre- and post-operative prognostication tools.

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Abbreviations

ACS:

Acute coronary syndrome

AMI:

Acute myocardial infarction

CABG:

Coronary artery bypass graft surgery

CAD:

Coronary artery disease

BMS:

Bare-metal stent

BVS:

Bioresorbable vascular scaffold

DAPT:

Dual anti-platelet therapy

DES:

Drug-eluting stent

HDL:

High-density lipoprotein

IVUS:

Intravascular Ultra sound

LDL:

Low-density lipoprotein

OCT:

Optical coherence tomography

OMT:

Optimal medical therapy

PCI:

Percutaneous coronary intervention

STEMI:

ST-elevation myocardial infarction

TAVI:

Transcatheter aortic valve implantation

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Authors and Affiliations

  1. PERFUSE Study Group, Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 930 Commonwealth Ave, Boston, MA, 02215, USA

    Mathieu Kerneis, Tarek Nafee, Megan K. Yee, Hassan A. Kazmi, Sudarshana Datta, M. Khurram Afzal, Mehrian Jafarizade, Sargun S. Walia, Iqra Qamar, Anmol Pitliya, Arzu Kalayci, Fahad Al Khalfan & C. Michael Gibson

  2. ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), Sorbonne Université - Univ Paris 06 (UPMC), Paris, France

    Mathieu Kerneis & Michel Zeitouni

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Correspondence to C. Michael Gibson.

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Conflict of Interest

Mathieu Kerneis has received research grant from Federation Francaise de Cardiologie and Institut Servier.

C. Michael Gibson reports grants from Angel Medical Corporation; grants and personal fees from Bayer Corp., CSL Behring, Janssen Pharmaceuticals, and Johnson & Johnson Corporation; personal fees from The Medicines Company, Boston Clinical Research Institute, Cardiovascular Research Foundation, Eli Lilly and Company, Gilead Sciences, Inc., Novo Nordisk, Web MD, UpToDate in Cardiovascular Medicine, Portola Pharmaceuticals, Amarin Pharma, Amgen, Boehringer Ingelheim, Chiesi, Merck & Co, Inc., PharmaMar, Sanofi, Somahlution, St. Francis Hospital, Verreseon Corporation, Boston Scientific, Duke Clinical Research Institute, Impact Bio, LTD, MedImmune, Medtelligence, Microport, PERT Consortium, and nference; and non-financial support from Baim Institute.

Tarek Nafee has received research grant support and consulting fees from Portola Pharmaceuticals Inc.

Megan K. Yee, Hassan A. Kazmi, Sudarshana Datta, Michel Zeitouni, M. Khurram Afzal, Mehriam Jafarizade, Sargun S. Walia, Iqra Qamar, Anmol Pitliya, Arzu Kalayci, and Fahad Al Khalfan declare that they have no conflict of interest.

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Kerneis, M., Nafee, T., Yee, M.K. et al. Most Promising Therapies in Interventional Cardiology. Curr Cardiol Rep 21, 26 (2019). https://doi.org/10.1007/s11886-019-1108-x

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