Volume 11 Issue 11, November 2014

The past decade has seen considerable advances in the treatment of acute coronary syndromes (ACS), particularly in the search for improved antithrombotic therapies. Despite these successes, however, renewed efforts are needed to improve long-term outcomes after ACS by reducing recurrent ischaemic events and lowering the risk of bleeding complications.

Cardiac rhythm disorders, or 'arrhythmias', are major sources of morbidity and mortality, and have been challenging to treat because classic pharmacological therapies are often ineffective and sometimes dangerous. In the past decade, groundbreaking developments have revolutionized the management of arrhythmias and prepared the groundwork for new advances in the future.

Since Wallace Brigden first used the term 'cardiomyopathy' in 1952, this group of diseases has continued to attract the interest of clinicians, researchers, and importantly, patients. The past decade has seen a substantial accumulation of knowledge relating to various cardiomyopathies, which has partially lifted the mystery surrounding this topic.

Over the past decade, we have witnessed the unparalleled success of statins to treat dyslipidaemia. Target identification by Mendelian randomization, human monoclonal antibodies, gene therapy, RNA-based targets, and atherogenic lipoproteins other than LDL cholesterol have fuelled intense development efforts that might bear fruit in the very near future.

In this Decade in Review article, I highlight the top 10 advances in heart failure (HF) over the past decade, including new pharmacological therapies and expanded indications for devices in HF with reduced ejection fraction. The poor progress in acute HF and HF with preserved ejection fraction is emphasised. Biomarkers and devices that help prevent, detect, and guide treatment represent the future of HF management.

Hypertension research in the past decade has been a mixture of hope and hype. In the absence of new drug developments, clinical intervention procedures such as renal nerve ablation and baroreflex activation therapy have dominated the research, but the results have not yet fulfilled the great expectations.

Clinical trials published during the past decade have had substantial effects on the treatment of peripheral vascular diseases. In this article, I discuss ten important trials that have influenced treatment for common vascular disorders, including peripheral artery disease, abdominal aortic aneurysm, renal artery disease, extracranial carotid artery disease, and venous thromboembolism.

Tremendous advances in the understanding and treatment of structural heart valve disease have been made in the past decade, including widespread utilization of minimally-invasive surgical procedures and the invention and evolution of numerous interventional techniques. These innovations will become the norm in therapy for valvular disease in the future.

The prevalence of atrial fibrillation (AF) is estimated to increase worldwide, mainly as a consequence of generalized population ageing. Even though the rise in AF prevalence is a global trend, data from Africa, Asia, and South America are limited and might underestimate the true frequency of AF. In this Review, the authors discuss the available epidemiological data on AF and highlight the widespread inadequacy of its treatment.

During stress or injury-induced cardiac remodelling, fibroblasts increase production of extracellular matrix proteins, which leads to fibrosis formation, and consequently, heart failure. In this Review, Thomas Thum describes the contribution of noncoding RNAs to this process, with a specific focus on microRNAs that might be used as future therapeutic targets or biomarkers for cardiac fibrosis.

To mark the 10^th anniversary of Nature Reviews Cardiology, five of our Advisory Board members were invited to consider a topic within cardiology about which we know too little. The key opinion leaders from around the globe also suggest ways in which future research could be targeted to address the deficits in our understanding, with the aim of preventing cardiovascular disease, improving patient care, and reducing morbidity and mortality.

The global epidemic of cardiovascular disease is being fuelled by the spread of a Western lifestyle characterized by a high prevalence of cardiovascular risk factors. In this Perspectives article, Valentin Fuster highlights 10 therapies and interventions that, in his opinion, will be most useful in combating cardiovascular disease and promoting cardiovascular health over the next decade.

November 2014 marks the 10th anniversary of Nature Reviews Cardiology, originally published under the titleNature Clinical Practice Cardiovascular Medicine. To celebrate this milestone, we have commissioned a collection of articles to summarize the major advances in cardiology over the past decade. These articles, together with a special infographic, provide an authoritative snapshot of cardiovascular medicine in 2014, and how the field might progress over the next 10 years.