December 23rd, 2010

John Brush: 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. The PARTNER Trial demonstrated the efficacy of transcatheter aortic valve implantation for patients deemed too high risk for conventional cardiac surgery.  This intervention will be a game-changer for the treatment of patients with aortic stenosis, but raises mind-boggling questions about where and by whom the procedure should be performed, proper case-selection, cost-effectiveness, self-referral…the questions go on and on.

2. The Symplicity HTN-2 trial showed that catheter-based renal denervation safely and effectively reduces blood pressure. Imagine an effective once-and-for-all treatment for hypertension.

3. The DEFINE Trial showed phenomenal effects of a cholesteryl ester transfer protein (CETP) inhibitor, anacetrapib, on LDL and HDL levels. One can only hope that larger trials will show that this drug is safe and improves cardiac outcomes.

Predictions for 2010:

1. We will see meaningful payment reform that will fairly reimburse providers, properly align incentives, and finally create incentives to provide value in health care spending.

2. The American College of Cardiology will work with payers to develop a practical and scalable mechanism to implement at the point-of-care test ordering for imaging tests using the Appropriate Use Criteria.

3. Observational studies from prospective registries and administrative databases will demonstrate that interventional cardiologists, acting responsibly and professionally, perform the vast majority of coronary stent procedures appropriately. We will find that the alleged overuse of stents by the Maryland cardiologist is an aberration and that generalizing from this egregious case to create sweeping criticisms of the interventional cardiology community is unwarranted.

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