Next Friday, November 17, the 6th Cardiovascular Update Conference will take place, and Dr. Rodriguez Rodrigo, head of the Department of Cardiology (Teaching) at HM Hospitales, will give us a preview of the main points.
With regard to heart failure, what new developments will be addressed at the conference?
- Heart failure will be considered a multidisciplinary disease that requires coordinated action by the specialty of cardiology with experts who deal with different clinical aspects of this disease and who are internists and family physicians, nephrologists, endocrinologists, nutritionists and rehabilitation physicians.
- Treatments for heart failure will be reviewed, ranging from changes in lifestyle habits and the use of salt in meals to drug indications, dosage recommendations and application times according to the Clinical Guides and guidelines, thus improving patients’ adherence to treatment.
- To emphasize cardiac rehabilitation as a method of improving the quality of life of patients.
- The value of atrial fibrillation ablation in patients with left ventricular dysfunction.
- The approach to patients with heart failure with intermediate and preserved ventricular ejection fraction.
- Analysis of the role of new biomarkers in the management of heart failure.
- Analysis of the role of the most modern imaging techniques, such as cardiac resonance imaging, in the risk stratification of patients with heart failure and therapeutic implications.
- The role of the Heart Failure Units in the follow-up of patients after discharge, as well as the role of telemedicine programs.
The multiple comorbidities or pathologies associated with heart failure, such as anemia or the efficacy of treatment with ferric carboxymaltose or vitamin D, ischemic heart disease, COPD and bronchial asthma, cachectic states with appropriate nutritional management, neoplastic disease, depression, diabetes, erectile dysfunction, gout, dyslipidemia, hypertension, renal failure, prostatic hypertrophy and sleep apnea will also be addressed.
What are the latest developments in cardiovascular risk and prevention?
- Early detection of subclinical cardiovascular disease, through 3D ultrasound of the carotid arteries and coronary CT angiography.
- The categorization of cardiovascular risk in populations exposed to family history and specific pathologies such as diabetes mellitus, arterial hypertension, familial hypercholesterolemia or neoplastic diseases. Also the application of preventive measures, especially those based on lifestyle changes.
- The cardiovascular risk to which a woman is exposed after menopause.
What about secondary prevention of acute coronary syndrome?
- Patient adherence to the main therapeutic groups used in secondary prevention after an acute coronary syndrome is currently a cardiological challenge. This is due to patients’ abandonment of treatment, which leads to increased mortality. Increased adherence is achieved through patient communication and motivation techniques, cardiac rehabilitation programs, and the use of the polypill, a pill with established therapeutic components in secondary prevention. These components are an angiotensin-converting enzyme inhibitor (ramipril), acetylsalicylic acid (adiro) and a statin (atorvastatin), allowing the treatment to have a greater effect. Several studies support the efficacy of popypill in reducing morbidity and mortality in these patients after acute coronary syndrome.
- The use of new drugs (antiPCSK9 antibodies) to achieve ambitious therapeutic targets set in the Clinical Guidelines to lower LDL to levels below 70 mg/dL, which is essential to avoid new cardiovascular events in patients after an acute coronary syndrome.
- The role of the new oral anticoagulants (NACOS) in chronic ischemic heart disease, which have been shown to significantly reduce cardiovascular events and stroke.
Cardio-Oncology Units, why are they necessary?
These new units have been created because of the need for cardiological monitoring of people with neoplastic disease and who are treated with specific drugs that can silently damage the heart. Thus, it allows the prevention of cardiovascular disease due to secondary toxic damage -allowing dose adjustment-, withdrawal of the drug or substitution of another medication in the event of the appearance of signs of cardiac involvement.
Clinical follow-up is supported by complementary diagnostic imaging techniques, such as echocardiography with the use of specific techniques for assessing left ventricular function.
With this objective in mind, Hospital Madrid Sanchinarro has a pioneering Cardio-oncology unit in Spain, associated with our Clara Campal Comprehensive Oncology Center (CIOCC) and made up of oncologists and clinical cardiologists who are experts in imaging techniques. Numerous clinical trials and studies are being carried out in this unit to analyze their efficacy and optimize results.
It is necessary to insist on the importance of this sixth edition of the Cardiovascular Update Day organized by the Integral Center for Cardiovascular Diseases (CIEC) of the HM Hospitales Group, as it encompasses the most relevant cardiological issues that have occurred throughout the year, allowing an update on the diagnostic, preventive and therapeutic aspects of cardiovascular disease.
The scientific meeting is completed with presentation and discussion of complex clinical cases with a moderating table of speakers and audience, which allows scientific interaction among all participants of the day.