6. Hopeful new procedure for infants with congenital heart disease

The Pediatric Heart Network’s randomized trial of Norwood shunt types in infants with single-ventricle lesions showed that the type of shunt used makes a difference in outcomes. Better transplantation-free survival at 12 months is a possibility with this new understanding of the better shunt choice for these patients. This was the first large-scale randomized trial in congenital heart surgery, offering an approach that should provide answers to other questions in the future.

·  Pediatric Heart Network Investigators – New England Journal of Medicine, May 27, 2010; N Engl J Med; 362:1980-1992. http://www.nejm.org; Funding: National Heart, Lung, and Blood Institute.

7. Finding the right anti-clotting (anti-platelet) therapy

Selecting the right type of anti-clotting drug and the right dosage can be tricky, and risky. New research from the PLATO investigators has found that ticagrelor may improve outcomes and reduce adverse events better than the current standard, clopidogrel. The CURRENT-OASIS 7 Trial is exploring the optimal dosing of clopidogrel and aspirin in patient undergoing invasive surgery. These studies will help providers better understand the situations where new choices and dosages may improve results for the patient. 

·  PLATO Investigators – Lancet, Jan. 14, 2010; Lancet 2010;375:283-93. http://www.thelancet.com; Funding: AstraZeneca.

·  CURRENT-OASIS 7 Investigators – New England Journal of Medicine, Sept 2, 2010; N Engl J Med; 363:930-42;. http://www.nejm.org; Lancet, Sept. 1, 2010; Lancet 2010; 376:1233-43; http://www.thelancet.com; Funding: Sanofi-Aventis; Bristol-Myers Squibb

8. Basic science findings offer insight into future progress

Several studies this year brought the future of medicine closer to the present with new insight into emerging technologies. Findings from stem cell therapy have shown improved quality of life and survival in several early studies of patients with chronic heart failure and support the development of future cell-based therapeutics. A large animal study defined the basic mechanisms for heart muscle regeneration initiated by specific types of stem cells. The results demonstrated that these stem cells repair scarred myocardium through promotion of the generation of new heart muscle and blood vessel). A second study supported the notion that the heart has the capacity to regenerate large numbers of heart muscle cells several times during its lifetime. Being able to directly reprogram stem cells into working heart muscle is a big step toward use in therapeutic settings. The STaR-Heart Study showed that injecting the patient’s own bone marrow stem cells into the heart improved hemodynamics and long-term survival in the treatment of chronic heart failure

·  Hatzistergos, et al – Circulation Research, July 29, 2010; Circ Res.;107(7):913-22. http://circres.ahajournals.org; Funding: National Heart, Lung, and Blood Institute.

·  Kajstura et al – Circulation Research, June 3, 2010; Circ Res;107(2):305-15. http://circres.ahajournals.org; Funding: National Institutes of Health.

·  The STAR-heart study – European Journal of Heart Failure; doi:10.1093/eurjhf/hfq095; Funding: Cardiogenesis Corporation.