Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
In 2013, clinical trials in heart failure focused on drugs and devices that might improve treatment of symptomatic patients beyond standard therapy. None achieved this aim. Therefore, future efforts should emphasize increased adherence to current, evidence-based therapy, and trials might better address efforts to prevent, rather than treat, heart failure.
The new ACC/AHA guidelines on treatment of blood cholesterol focus on intensity of statin therapy rather than target levels of lipids. Early studies show substantial reductions in LDL-cholesterol level with antibodies against PCSK9. MicroRNA silencing and gene-repair techniques to treat dyslipidaemia are promising strategies under development.
Patients with chronic coronary artery disease can develop angina that is refractory to standard medical treatment. Henry and colleagues review the novel treatment strategies being developed for those individuals who are not suitable candidates for traditional revascularization, including pharmacological metabolic modulation, therapeutic angiogenesis, neuromodulation, and other invasive and noninvasive techniques.
Adherence to medication is a prerequisite for treatment to be effective, but fewer than half of patients are adherent to long-term therapies for cardiovascular diseases, such as antihypertensive drugs and statins. In this Perspectives article, Tajouri and colleagues propose that multifaceted, individually tailored strategies that harness incentives schemes and modern technology are required to improve both adherence to medication and patient health.
Chelation therapy with ethylenediamine tetra acetic acid is increasingly being used in patients with cardiovascular disease, without definitive evidence for its efficacy. In this Perspectives article, Sidhu et al. discuss data from major studies of chelation therapy in this field, with particular emphasis on TACT. They opine that the findings from this trial are not robust and do not marshal evidence in support of the potential clinical use of chelation therapy for cardiovascular disease.
Endovascular aneurysm repair has become the standard of care in many hospitals for patients with abdominal aortic aneurysms (AAAs) who have anatomy deemed suitable for the procedure. In this Review, Dominique Buck and colleagues discuss evidence-based practice and evaluate promising new strategies for endovascular repair of AAAs. The role of imaging in the management of AAAs is also highlighted.
Ventricular tachyarrhythmias are a leading cause of sudden cardiac death (SCD). In this Review, Bezzina et al. discuss the genetics of SCD, and how gene discovery programmes will contribute to the identification of novel genes involved in SCD in the coming years.