December 22nd, 2010
Deepak Bhatt: Looking Back at 2010 and Ahead to 2011
To celebrate the holiday season, CardioExchange asked several of our contributors to choose the 3 most important cardiology-related events of the past year and to make 3 predictions for 2011.
Looking back at 2010:
1. PARTNER: Transcatheter aortic valve implantation significantly improved symptoms and reduced mortality in patients with severe aortic stenosis who were not candidates for surgery. The treatment of valvular heart disease is forever changed.
2. RAFT: CRT when added to an ICD reduced heart failure hospitalizations and reduced mortality in an easily identified group of patients with heart failure.
We can indeed identify patients in whom device therapy is highly effective.
3. DEFINE: The increases in HDL and reductions in LDL were quite impressive, with no apparent off-target toxicities. If the clinical outcome trial looks as good, anacetrapib will be a major breakthrough in cardiovascular medicine.
Predictions for 2011:
1. Increased focus on health care costs, which will nevertheless continue to increase. De facto rationing will start to emerge (though it will not be called that).
2. Increased scrutiny of appropriateness of cardiology procedures and cardiac imaging. Will paradoxically lead to many cases of inappropriate underutilization of these technologies.
3. Further consolidation among cardiology practices and hospitals. Solo cardiology practice will continue to disappear and more cardiologists will become employees of hospitals; costs will rise, not fall.