Cardiology Month in Review: May 2024

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Our cardiology month in review spotlights the top 5 storylines that defined cardiology during May 2024, including new HCM guidelines, news from ESA 2024, and the FLOW trial.

Coming on the heels of a historic Q1 and an April that featured the latest in advancements at the American College of Cardiology’s 2024 Annual Scientific Session, a lofty bar had been set for cardiology news and updates in May 2024.

Although it was without historic regulatory decisions or a flagship medical congress, May 2024 contained a bevy of news and information with the potential to aid in guiding care for a multitude of patient populations, including a new test for measuring Lp(a), new data from the European Atherosclerosis Society’s meeting, and news in the world of hypertrophic cardiomyopathy, including new guidelines and full data from SEQUOIA-HCM.

Guidelines and Regulatory Decisions:

New Cardiomyopathy Guidelines Endorse Cardiac Myosin Inhibitors, Expanded Role for Exercise

On May 08, 2024, the American College of cardiology and the American Heart Association released major updates to their guidance for management of hypertrophic cardiomyopathy. These new guidelines, which received endorsement from AMSSM, HRS, PACES, and SCMR, featured a more solidified stance on the role of exercise in management of HCM as well as an endorsement for cardiac myosin inhibitors for patients with symptomatic obstructive hypertrophic cardiomyopathy who do not get adequate symptom relief from first-line drug therapy.

FDA Grants Breakthrough Device Designation to Blood Test Measuring Lp(a)

On May 22, the US Food and Drug Administration granted Breakthrough Device Designation to the Tina-quant® lipoprotein Lp(a) RxDx assay for evaluating lipoprotein (a) in a person’s bloodstream, an emerging key marker for hereditary cardiovascular risk.

Announced by Roche, in collaboration with Amgen, the Tina-quant® Lp(a) assay is planned to be made available on the company’s installed base of more than 90,000 serum work area systems globally. Pending FDA approval, the Tina-quant® will be made available to assist in selecting patients who could benefit from an innovative Lp(a)-lowering therapy.

Conference Updates:

RNAi Therapies in Dyslipidemia

At the EAS 2024 meeting, lipidologists and cardiologists received the latest insight into the promise offered by RNA interference therapies, with new phase 2 data from clinical programs for plozasiran and zodasiran. Both RNAi therapies from Arrowhead Pharmaceuticals, the APOC3 inhibitor plozasiran was examined in the MUIR trial and the ANGPTL3 inhibitor zodasiran was examined in the ARCHES-2 trial.

SEQUOIA-HCM

Presented at Heart Failure 2024 and simultaneously published in the New England Journal of Medicine, results of the 24-week, phase 3 SEQUOIA-HCM trial suggest the cardiology community may soon witness the approval of a second cardiac myosin inhibitor for the treatment of symptomatic obstructive hypertrophic cardiomyopathy.

Results of the trial suggest use of aficamten was associated with significantly greater improvement in peak oxygen uptake and for all 10 secondary end points included in the trial relative to placebo therapy. The trial’s results less than a week after the American College of Cardiology and American Heart Association recommended use of cardiac myosin inhibitors in their 2024 update to HCM guidelines.

FLOW

The latest in semaglutide’s conquest to impact treatment algorithms in cardiometabolic disease, the FLOW trial captivated healthcare providers across a multitude of specialties with its presentation at the 61st European Renal Association Congress. A phase 3 trial comparing semaglutide against placebo therapy in patients with type 2 diabetes and chronic kidney disease, results demonstrated use of semaglutide was associated with a 24% relative risk reduction for the trial’s primary outcome of major kidney disease events compared to placebo therapy (Hazard Ratio [HR], 0.76; 95% Confidence Interval [CI], 0.66 to 0.88; P = .0003).

Further analysis indicated semaglutide use was associated with a 21% reduction in risk relative to placebo therapy (HR, 0.79; 95% CI, 0.66 to 0.94) for kidney-specific components of the primary outcome. Additionally, analysis of death from cardiovascular causes pointed to a 29% reduction in risk relative to placebo therapy (HR, 0.71; 95% CI, 0.56 to 0.89).