Cardiovascular disease (CVD) remains a major public health burden and financial concern. By 2030, the American Heart Association predicts that over 40 percent of the United States population will have some form of CVD (including hypertension, coronary heart disease, heart failure, stroke and other CV disorders). In parallel with this expansion of the patient pool, direct medical costs will significantly increase from almost $300 billion in 2010 to over $800 billion in 2030 (Heidenreich P, 2011). Given this worrying trend, it was reassuring to track several major developments in 2012 that could stem the rising tide of CVD.

AliveCor's novel heart monitor stands to be one of the most important diagnostic developments in CVD in recent history. Its sensor technology, operated using an iPhone, enables a fast, efficient and cost-effective approach for detecting and diagnosing cardiac disorders, such as atrial fibrillation (a common heart rhythm abnormality). Using a simple cover that attaches to an iPhone, users can quickly generate a high-quality ECG trace for recording, storing, and analysis by medical professionals. The device was approved by the FDA in December 2012 and its future looks remarkably promising. By increasing access to a cornerstone of cardiology medical practice, the ECG, AliveCor's device stands to revolutionize not only how CVD is diagnosed but, perhaps more importantly, when it is diagnosed. Prompt medical intervention driven by earlier diagnosis is a fundamental step towards optimizing cardiovascular outcomes.

Outside of the diagnostics field, 2012 witnessed countless pharmaceutical milestones for CVD. Eliquis was approved in Europe for stroke prevention in atrial fibrillation in November 2012. Part of a new cohort of advanced anticoagulants, Eliquis has a powerful value proposition on measures of efficacy and safety. With an FDA PDUFA date of March 2013, Eliquis is poised to enter the U.S. market and provide patients with another key therapeutic option to manage their stroke risk. Additionally, results from serelaxin's (developed by Novartis) Phase III RELAX-AHF trial and the continuation of the Phase IIb ATOMIC-AHF trial (investigating Cytokinetics/Amgen's omecamtiv mecarbil) provide new promise for the millions of patients with acute heart failure.

Collectively these advances, and many others in cardiovascular drug and device development in 2012, will ensure that the wider healthcare community remains on course to continue innovating the access and delivery of cardiac care in the future.

Matthew Killeen, Ph.D. is an Associate Consultant with the DRG Consulting group.

Heidenreich P et al. (2011). Forecasting the Future of Cardiovascular Disease in the United States: A Policy Statement from the American Heart Association. Circulation, 123(8):993-944.

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