Biomarkers developments and prevention strategies
proCardio 2024 began with a focus on basic science research in cardiac disorders and biomarkers, highlighting the hot topics of new biomarkers, sex differences impacting circulating levels of protein biomarkers, as well as strategies to identify patients with no standard modifiable risk factors.
The following session on Prevention explored the potential of anti-obesity medications for cardiovascular disease (CVD) prevention, prevention in the general population, and gaps in the early identification of heart failure and associated implications. Another highlight from this session was the shift of Lp(a) from purely diagnostic use to a potential therapy target in the near future.
Advancements in diagnostics: Integration of AI, diagnostic algorithms, and Point-of-Care Testing
The session on Diagnosis covered novel and gold standard diagnostic and management approaches. The importance of early diagnosis of heart failure specifically in primary care was discussed, emphasising current limitations in implementation and future potential of NT-proBNP as a diagnostic marker in this setting. The role of innovative algorithms, such as CoDE-HF, for heart failure diagnosis was also highlighted. Additionally, the effectiveness and importance of rapid diagnostic protocols, particularly the ESC 0/1 hour rule-in/out algorithm, for diagnosis of acute myocardial infarction were explored. Moreover, a future outlook on the PRECISE-MI study analysing the effects of implementation of the ESC 0/1h algorithm in hospitals not using the algorithm yet was presented. The integration of artificial intelligence in decision-making processes for cardiovascular diseases was another significant focus, demonstrating the capabilities of models like Cardio Explorer® in enhancing diagnostic accuracy. The future of point-of-care testing was discussed, with a particular interest in the development and potential impact of point-of-care devices for high-sensitivity cardiac troponin measurement in emergency departments.
Therapeutic advancements and newest innovations in cardiometabolic care
The Therapy session opened with a discussion on novel treatment strategies aimed at addressing the burden of hypertension. This was followed by an exploration of the future role of obesity drugs in managing heart failure, particularly within the context of the STEP-HFpEF trial. The importance of serial NT-proBNP measurements for the clinical evaluation and management of chronic heart failure was also emphasised. The session concluded with insights into the cardiorenal axis, highlighting the interconnected complexities between cardiac and renal functions.
proCardio also featured a roundtable session on innovation, which examined the questions of the future of cardio metabolic care, what practical steps can be made towards empowering patients to achieve value-driven care and reduced hospitalizations, and how can implementation roadblocks be overcome? This discussion was a great leeway into the next session, focussing on Implementation.
Bridging the gap between guidelines and clinical practice: Implementation & Policy
A common theme that was present throughout the discussions at proCardio was the importance of implementation. Guidelines recommendations and new scientific and diagnostic advancements are often not immediately adapted in everyday clinical practice. Specifically, four topics were discussed considering the implementation of: digital tools for chest pain patient triage, STRONG-HF protocol in clinical practice, NT-proBNP based screening for heart failure prevention and lastly diagnosis of perioperative myocardial infarction after non-cardiac surgery.
For the first time proCardio hosted a panel discussion on “cardiovascular disease policy developments in the European Union and the Asia-Pacific region“ with a panel consisting of cardiologists and policy experts. Firstly, the significance of shaping policy for cardiovascular diseases (CVD) to address mortality, economic impact, and drive necessary innovations was highlighted, specifically noting that current national action plans are often inadequate. It was emphasised that there is a need for clear goals, collaborative efforts between public and private sectors, and addressing economic challenges to enhance healthcare equity. Lastly, the importance of advocacy, strong relationships between health societies and government bodies, and the inclusion of policy officers to bridge gaps between clinicians and legislators was underscored.
Exploring Hot Topics and Unmet Needs in Cardiovascular Health
The proCardio program closed with a session dedicated to Hot topics and unmet medical needs. Firstly, amyloidosis and its impact on heart failure was discussed together with promising novel treatments like gene silencing and CRISPR-Cas9. Challenges in diagnosing and managing hypertrophic cardiomyopathy (HCM) were highlighted, emphasising the need for better standardisation and more trials to understand patient variability. Lastly, there was a focus on the importance of early recognition and treatment of diabetic cardiomyopathy and the epidemiological overlap of cardiovascular, kidney, and metabolic disorders, advocating for interdisciplinary models of care.