The American College of Cardiology’s 67th Annual Scientific Session & Expo
The annual meeting of the American College of Cardiology was held from March 10 to 12 in Orlando, Fla., and attracted more than 20,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in cardiology. The conference highlighted recent advances in the treatment, management, and prevention of cardiovascular diseases, with presentations focusing on novel drugs and surgical approaches to improve the quality of care for patients.
In one study, Karlee Hoffman, D.O., of the Allegheny Health Network in Pittsburgh, and colleagues found that preeclampsia during pregnancy appears to be associated with hypertension, hyperlipidemia, and diabetes within five years after delivery.
“This is one of the first studies to follow preeclampsia patients after their delivery and show that within five years these women have higher rates of hypertension, hyperlipidemia, and diabetes when compared to women without preeclampsia. It reiterates the point that these women need follow-up with a physician after a diagnosis of preeclampsia,” Hoffman said. “Women diagnosed with preeclampsia should be educated on their long-term cardiovascular risk. They should follow-up with an ob-gyn, primary care physician, or cardiologist and be closely monitored. They should be educated about aggressive lifestyle modifications. It’s a highly motivated patient population and we can have an impact on their overall long-term cardiovascular risk by modifying the associated risk factors. It has to be a multidisciplinary approach with our ob-gyn colleagues to capture these patients.”
In another study, Carolyn Larsen, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues found that only a minority of breast cancer and lymphoma patients and survivors develop heart failure, but those who received chemotherapy with an anthracycline are at increased risk. The investigators also found that older age and diabetes increase the risk of heart failure in cancer patients and survivors.
“Breast cancer and lymphoma patients and survivors who were treated with chemotherapy and/or radiation therapy were about three times more likely to have developed heart failure five years after cancer diagnosis than matched controls. At 10 and 20 years after cancer diagnosis they were still nearly twice as likely to have been diagnosed with heart failure compared with matched controls,” Larsen said. “Ten years after cancer diagnosis, around one in 20 breast cancer and lymphoma patients and survivors in our study had been diagnosed with heart failure.”
The investigators found that age, chemotherapy with an anthracycline (doxorubicin isotoxic dose greater than 300 mg/m²), and diabetes mellitus were independent risk factors for heart failure in breast cancer and lymphoma patients and survivors.
“Our retrospective, observational study did not explore interventions to reduce the risk of heart failure. However, we believe that given the increased risk of heart failure in cancer patients and survivors it is imperative that they have regular follow-up with a physician to screen for and modify cardiovascular risk factors such as diabetes, hypertension, smoking, hyperlipidemia, obesity, and sedentary lifestyle,” Larsen said. “It is also important for physicians to assess for early signs or symptoms of heart failure in their patients who have received potentially cardiotoxic drugs such as anthracyclines.”
Khaldoun Tarakji, M.D., of the Cleveland Clinic, and colleagues found that the Kardia Band, the first health care wearable accessory approved by the U.S. Food and Drug Administration for the smartwatch, and its automatic algorithm can detect atrial fibrillation with strong specificity.
“By placing your thumb of one hand on the electrode of the band on the opposite wrist, you can record a rhythm strip,” Tarakji said. “The system is paired with an app with an algorithm that provides automatic interpretation to detect atrial fibrillation.”
In this study, the investigators assessed the accuracy of the automated algorithm in detecting atrial fibrillation.
“In order to do this, we set the standard high and we compared the Kardia Band recording and its automated algorithm to a 12-lead electrocardiogram (ECG) interpreted by an independent blinded electrophysiologist. We enrolled 100 patients with atrial fibrillation who presented to our electrophysiology lab for an electively scheduled cardioversion procedure. A 12-lead ECG was done before and after the cardioversion along with Kardia Band recording done at the same time,” Tarakji said. “When able to provide a diagnosis, the Kardia Band detected atrial fibrillation with 93 percent sensitivity and 84 percent specificity. When we compared the physician interpretation of the same Kardia Band recording blinded to the automatic interpretation, the sensitivity of detecting atrial fibrillation was 99 percent. Even among the recordings that were unclassified by the algorithm for different reasons, whether due to short recording or slow heart rate, the physician was able to provide an interpretation.”
AliveCor, the company that makes the Kardia Band, provided smartwatches for the study.
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