A Look Forward to 2012 « CardioExchange

January 3rd, 2012

A Look Forward to 2012

CardioExchange Editors, Staff

CardioExchange invited contributors and members to offer predictions for 2012. Several of these folks also offered predictions for last year and helped assess the most important developments in cardiology in 2011.

What are your predictions for the year? Where have our Nostradamus’ gone wrong?

Steven E Nissen, MD 1. In a 5:4 vote, the U.S. Supreme Court will overturn portions of the Affordable Care Act. 2. Publication of the new BP and lipid Guidelines (JNC 8 and ATP IV) 3. Under FDA pressure, the manufacturer of dronedarone will withdraw the drug from the market.

Richard A. Lange, MD, MBA and L. David Hillis, MD 1. FDA-approved TAVR indications will be expanded to include patients at high risk for surgical valve replacement 2. Reducing “door-in, door-out” time will be a major focus for improving outcomes in STEMI patients who present to a facility without PCI capabilities 3. Sadly, the list of interventionalists cited (and indicted) for inappropriate use of PCI will grow

Deepak L. Bhatt, MD, MPH 1. Proceduralists will move from the top of the pyramid to the bottom 2. Appropriateness of cardiovascular procedures (stents, ICDs, imaging, etc.) will continue to receive greater scrutiny and patients who really need these types of procedures will not get them 3. The highest-risk patients will find it more challenging to receive aggressive care, and potentially, any care

James De Lemos, MD 1. Generic clopidogrel and atorvastatin will disrupt the marketplace. 2. Lack of reversibility will doom dabigatran 3. Cardiologists will be injured in stampede to get percutaneous aortic valves

John Mandrola, MD 1. The FDA will approve apixaban and the convincing data from ARISTOTLE will rapidly accelerate the somewhat sluggish acceptance of non-warfarin anticoagulants for the prevention of stroke in AF 2. Pills, even polypills, will not trump exercise, diet, good sleep, and altruism as the most effective means to prevent and treat heart disease 3. The increased scrutiny of coronary stents will actually help highlight the message of the Courage trial: that optimal medical (and lifestyle) therapy treats the disease of atherosclerosis better than squishing blockages

John Ryan, MD 1. Cost-effectiveness studies of novel anticoagulants 2. With the introduction of TAVI into clinical settings, multidisciplinary cardiovascular teams (CT surgeons, cardiologists, vascular surgeons) will grow dramatically. 3. The field of cardio-oncology will see significant growth, with guidelines directing when to image cancer survivors for cardiac sequelae.