Part one of Progress in Cardiology was a sober look at the current lull in innovation. In part 2, as promised, I tell you what is right and optimistic about my field. There is a lot.
The post touches on the return of the basics. Basics in doctoring and basics in therapeutics are huge new developments in cardiology. Then, I talk about the less is more movement, which thankfully, pervades all aspects of cardiology.
Radial artery catheterization gets a nod, as does caution with combining drug therapy aggressively. Treating to surrogate markers is out. No longer do doctors worship at the altar of cholesterol values, rather, we treat patients based on risk. Here is an excerpt that I cut out of the final draft. It deals with the concept of surrogate markers:
On aside on surrogate markers: The problem is not with the concept of surrogates. but with the choice of the surrogate itself. Imagine if CV therapeutics targeted improving exercise time. For the young, use oneâ€™s 5K time; for the infirmed, use 6-min walk time. Implement exercise and weight loss interventions, and sure, use some drugs and procedures if you must.Then, measure functional capacity with a Timex. The fall in cardiovascular deaths and therapeutic misadventures from this sort of targeted therapy would be spectacular.
Other topics I addressed as optimistic were, mobile technology and the rise of the decision quality movement.
Cardiac MR, lessons from adult congenital patients, and of course, social media get honorable mentions.
The title of the link is: Progress in Cardiology, Part 2: Less Is More
I am heading to AHA13 this morning. Look forward to breaking news in Cardiology. There will be a lot more on the new CV treatment guidelines.