Collection |

Key Advances in Cardiology

The Key Advances in Cardiology collection offers a unique series of specially commissioned ‘Year in Review’ articles that highlight the key discoveries made each year. In these articles, leading experts in the field describe their pick of the top 3–5 key advances of the year, outlining their clinical impact and implications for current and future research.

2018

Precision cardiology is a vision of a health-care approach that identifies the optimal course of care for each patient. Although precision cardiology is still in its nascent stage, new approaches and methodologies are being developed to achieve this goal and to overcome technical and implementation barriers. In 2018, several high-impact studies made progress in this direction.

Year in Review | | Nature Reviews Cardiology

More than 150 years after acetylsalicylic acid was synthesized by French chemist Charles Frédéric Gerhardt, aspirin is still one of the most prescribed medications worldwide. In 2018, several trials have suggested that the role of aspirin in the contemporary era might be less pre-eminent than in previous decades.

Year in Review | | Nature Reviews Cardiology

A number of papers published in 2018 have provided important information expected to influence clinical practice, particularly for the management of functional mitral regurgitation in patients with heart failure caused by ischaemic or non-ischaemic cardiomyopathy and for the treatment of severe aortic stenosis in patients at low surgical risk.

Year in Review | | Nature Reviews Cardiology

The VITAL trial showed that neither vitamin D nor fish oil supplementation significantly reduced the incidence of cardiovascular disease (CVD). Conversely, current evidence supports the benefits of multiple dietary patterns, especially the Mediterranean diet, in primary prevention of CVD. Health effects of low-carbohydrate diets depend on the food sources of macronutrients.

Year in Review | | Nature Reviews Cardiology

Considerable evidence supports a role for low-grade chronic inflammation in the atherothrombotic process, from plaque initiation to acute plaque rupture preceding myocardial infarction. Publications in 2018 revealed both the promise and challenges of targeting inflammation to treat atherosclerotic cardiovascular disease and highlighted the importance of understanding the mechanistic diversity of inflammatory pathways contributing to atherosclerosis.

Year in Review | | Nature Reviews Cardiology

2017

Important milestones in cardiac regenerative medicine that will define future research were reached in 2017: demonstration of adult cardiomyocyte renewal capacity, recognition of the importance of the extracellular matrix and the higher regenerative efficacy of repetitive dose protocols, and the publication of human data supporting paracrine effects of stem cell therapies and guidelines from TACTICS, the first international alliance on cardiac regenerative medicine.

Year in Review | | Nature Reviews Cardiology

In 2017, several high-impact studies in thrombosis were published. Refinements were made in the optimal therapy for patients with stable atherosclerosis or with atrial fibrillation undergoing percutaneous coronary intervention. Risk scores to determine duration of antiplatelet therapy were developed. The potential risk of subclinical valve leaflet thrombosis was identified.

Year in Review | | Nature Reviews Cardiology

In 2017, genetic research on cardiovascular disease (CVD) produced seemingly paradoxical findings. Thanks to the continuous upscaling of genotyping and sequencing data, researchers have discovered that whereas numerous genetic variants among the general population can increase CVD risk, an individual can tolerate most severe genetic alterations.

Year in Review | | Nature Reviews Cardiology

The past year provided strong evidence on the use of the instantaneous wave-free ratio to determine the severity of coronary artery disease, the improving outcomes of contemporary percutaneous coronary intervention, the increased risk of thrombosis with bioresorbable vascular scaffolds, and the benefits of a simple revascularization strategy in cardiogenic shock.

Year in Review | | Nature Reviews Cardiology

2016

In 2016, advances in atherosclerosis research were focused on the discovery and validation of new targets with genetic and mechanistic links to atherothrombotic heart disease. Novel targets include proteins involved in glycoprotein recognition and clearance, regulators of triglyceride-rich particle metabolism, inflammatory pathways that impair efferocytosis, and the gut microbiome.

Year in Review | | Nature Reviews Cardiology

Much of the progress in cardiovascular genetics in 2016 has been driven by next-generation sequencing studies, and the clinical utility of knowing an individual's genotype for predicting their risk of cardiovascular disease is gaining credibility, both for monogenic and polygenic disorders. Additionally, phenotype data are increasingly abundant, although databases linking genotype with clinically relevant phenotypes require optimization.

Year in Review | | Nature Reviews Cardiology

Clinical cardiac electrophysiology has evolved rapidly over the past 2 decades. Although the fast pace of technical and therapeutic advances has occasionally outpaced evidence supporting widespread effectiveness, the highlights of electrophysiology research in 2016 illustrate the emergence of robust evidence for implementation of several important therapies.

Year in Review | | Nature Reviews Cardiology