This year, the cardiometabolic health community has witnessed remarkable advancements. From breakthrough medications to innovative technologies, there is a lot for cardiometabolic clinicians professionals to celebrate. Let’s explore some key developments in 2024 that are offering hope to clinicians and patients.
Innovative Therapies and Medications for Cardiometabolic Clinicians
Lipid Management and Cardiovascular Therapies: Olezarsen, a new triglyceride-lowering agent, showcased impressive results in lowering triglyceride levels and reducing the incidence of pancreatitis in patients with elevated triglycerides. The PALISADE trial highlighted plozasiran’s efficacy in lowering triglycerides and apolipoprotein C3 (apoC3) levels, offering hope for patients with persistent chylomicronemia​. Another promising advancement is MK-0616, an oral PCSK9 inhibitor in Phase 3 trials, showing a significant reduction in LDL cholesterol, which provides a more convenient alternative to current injection-based therapies​.
Heart Failure Management: The FINEARTS-HF trial focused on the efficacy of finerenone, an aldosterone antagonist, in reducing heart failure hospitalizations and cardiovascular mortality among patients with preserved ejection fraction (HFpEF). These findings strengthen the case for broader utilization of finerenone in heart failure management​.
Diabetes and Obesity Care Advancements
New Technologies for Diabetes Management: The recent FDA approvals of various insulin delivery devices, including the Embecta patch pump for Type 2 diabetes, have expanded patient options. New developments in continuous glucose monitors (CGMs) have also been transformative. Eversense’s 365-day CGM and Medtronic’s Simplera Sync were among the major highlights, offering patients with diabetes more comfortable, longer-lasting monitoring options.
Tirzepatide’s Dual Benefits in Obesity: Recent studies on tirzepatide, a GLP-1 receptor agonist, revealed significant weight loss and improved outcomes in sleep apnea patients. The study found reductions in the apnea-hypopnea index (AHI), inflammation markers, and systolic blood pressure, making it a promising dual-purpose medication for managing obesity-related complications.
Lancet Commission on Obesity: The Lancet Diabetes & Endocrinology journal has accepted the Lancet Commission on Obesity’s report for publication, scheduled for early 2025, announced Robert H. Eckel, MD, FAHA, FACC at the 19th Annual CMHC. This report aims to redefine obesity as a chronic, systemic illness by establishing clear diagnostic and classification criteria for clinical and pre-clinical obesity, paving the way for enhanced treatment and recognition strategies.
Personalized Cardiometabolic Care
TRANSFORM Program for Coronary Artery Disease (CAD): The TRANSFORM program focuses on atherosclerosis-based care strategies rather than traditional risk-based approaches. This program seeks to enhance patient outcomes by intensifying treatment based on CAD stages, including novel lipid-lowering therapies and antithrombotic strategies. It is poised to change how clinicians approach cardiovascular risk stratification and therapy​.
New FDA-Approved Hypertension Treatments: The FDA’s approval of aprocitentan for hypertension marks a major step forward in treating patients who are not adequately controlled on other antihypertensive drugs. Aprocitentan’s unique mechanism targets endothelin receptors, providing an alternative pathway to lower blood pressure in resistant hypertension cases​.
Advancements in Cardiovascular Interventions and Clinical Guidelines
2024 ESC Guidelines for Chronic Coronary Syndromes: Updated guidelines from the European Society of Cardiology (ESC) emphasized shortened dual antiplatelet therapy (DAPT) durations and the potential for P2Y12 inhibitor monotherapy after percutaneous coronary intervention (PCI). These changes aim to reduce bleeding risks while maintaining ischemic protection, underscoring the importance of individualized therapy.
Clinical Trials for Stroke and Antithrombotic Therapy: The RAISE trial, focusing on reteplase versus alteplase for acute ischemic stroke, revealed promising outcomes for the use of reteplase. The trial highlights the importance of reevaluating and optimizing thrombolytic therapies for better patient outcomes. Additionally, the ongoing ORBITA-2 trial examines the use of percutaneous coronary intervention (PCI) for stable angina, offering valuable insights into procedural benefits and outcomes​.
Technological Innovations and Digital Health
AI-Enabled Cardiac Imaging: Advances in AI-enabled imaging and diagnostic tools are helping clinicians assess atherosclerotic burden and plaque characteristics with greater accuracy. This year, AI-powered whole-heart evaluation systems have been shown to improve the diagnosis of coronary artery disease (CAD) by providing comprehensive data on plaque morphology, lesion location, and remodeling.
Cuffless Blood Pressure Monitoring: AI-based cuffless blood pressure monitoring technologies are emerging as an alternative to traditional cuffs, especially in special populations or home monitoring scenarios. Although validation challenges remain, these devices could significantly improve hypertension management and patient compliance in the future​.
Takeaways for Cardiometabolic Clinicians
The past year has seen remarkable advances in the field of cardiometabolic health. Clinicians now have access to new medications, innovative technologies, and refined clinical guidelines that empower them to provide more personalized, effective care to their patients. As 2024 comes to a close, there is much for the cardiometabolic community to celebrate and look forward to in the coming year.
These breakthroughs reflect the dedication of researchers, healthcare professionals, and organizations committed to advancing cardiometabolic care and improving patient outcomes. Let’s acknowledge these achievements and continue pushing the boundaries of what is possible in cardiometabolic care.
