Author + information
- Received August 6, 2019
- Accepted August 20, 2019
- Published online October 7, 2019.
- Michael D. Shapiro, DO, MCRa,∗ (, )@DrMichaelShapir,
- David J. Maron, MDb,
- Pamela B. Morris, MDc,
- Mikhail Kosiborod, MDd,e,
- Pratik B. Sandesara, MDf,
- Salim S. Virani, MD, PhDg,
- Amit Khera, MD, MSch,
- Christie M. Ballantyne, MDi,
- Seth J. Baum, MDj,
- Laurence S. Sperling, MDk,
- Deepak L. Bhatt, MD, MPHl and
- Sergio Fazio, MD, PhDm
- aCenter for Preventive Cardiology, Section on Cardiovascular Medicine, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina
- bDepartment of Medicine and Cardiovascular Institute, Stanford University, Stanford, California
- cSeinsheimer Cardiovascular Health Program, The Medical University of South Carolina, Charleston, South Carolina
- dSaint Luke’s Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, Missouri
- eThe George Institute for Global Health, Sydney, New South Wales, Australia
- fDivision of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- gMichael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas
- hDivision of Cardiology, UT Southwestern Medical Center, Dallas, Texas
- iBaylor College of Medicine, Houston, Texas
- jCharles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
- kEmory Heart Disease Prevention Center, Emory University School of Medicine, Atlanta, Georgia
- lBrigham and Women’s Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts
- mCenter for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
- ↵∗Address for correspondence:
Dr. Michael D. Shapiro, Center for Preventive Cardiology, Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston-Salem, North Carolina 27106.
• The medical community must invest in cardiovascular disease prevention because past gains are threatened by increased rates of obesity and diabetes.
• An enormous opportunity exists to transition focus from intervention to prevention of cardiovascular disease.
• Given the array of dedicated skills necessary to manage cardiovascular risk, the specialty of “preventive cardiology” is emerging.
Although significant progress has been made to reduce the global burden of cardiovascular disease, efforts have focused primarily on treatment of manifest disease rather than on prevention of events. An enormous opportunity exists to transition focus from intervention to providing equal attention to prevention of cardiovascular disease. The nascent specialty of “preventive cardiology” is emerging from the background of long-established services such as lipid, diabetes, hypertension, and general cardiology clinics. It is incumbent on the cardiology community to invest in cardiovascular prevention because past gains are threatened with the rising tide of obesity and diabetes. Now is the time to establish a dedicated preventive cardiology subspecialty to train the clinicians of the future. This American College of Cardiology Council Perspective aims to define the need for preventive cardiology as a unique subspecialty, broaches controversies, provides a structure for future training and education, and identifies possible paths forward to professional certification.
The views expressed in this paper by the American College of Cardiology's (ACC's) Prevention Council do not necessarily reflect the views of the Journal of the American College of Cardiology nor the ACC.
Dr. Shapiro has served on an Advisory Board for Esperion; has been a consultant to Amarin; and has received institutional grant/research support from the National Institutes of Health (NIH), Akcea Therapeutics, Amarin, and the FH Foundation. Dr. Morris has been a consultant to and served on an Advisory Board for Akcea Therapeutics; and has received research funding from Esperion. Dr. Kosiborod has been a consultant to and served on Advisory Boards for Amarin, Amgen, Applied Therapeutics, AstraZeneca, Bayer, Boehringer Ingelheim, Eisai, GlaxoSmithKline, Glytec, Eli Lilly, Intarcia, Janssen, Merck (Diabetes), Novartis, Novo Nordisk, and Sanofi; and has received research support from AstraZeneca, and Boehringer Ingelheim. Dr. Virani has received research grants from the Department of Veterans Affairs and World Heart Federation; and has received honoraria from the American College of Cardiology as associate editor for Innovations, acc.org. Dr. Ballantyne has been a consultant to Abbott Diagnostics, Akcea Therapeutics, Amarin, Amgen, Arrowhead, AstraZeneca, Boehringer Ingelheim, Denka Seiken, Esperion, Intercept, Janssen, Matinas BioPharma, Merck, Novartis, Novo Nordisk, Regeneron, Roche Diagnostic, and Sanofi-Synthelabo; and has received institutional grant/research support from Abbott Diagnostic, Akcea Therapeutics, Amgen, Esperion, Novartis, Regeneron, Roche Diagnostic, Sanofi-Synthelabo, NIH, American Heart Association, and the American Diabetes Association. Dr. Baum has served on Advisory Boards for Sanofi, Regeneron, Amgen, Novartis, and Akcea Therapeutics; has been a consultant to Sanofi, Amgen, Regeneron, Novo Nordisk, and Akcea Therapeutics; and has received speaker honoraria from Amgen, Boehringer Ingelheim, Nordisk, and Akcea Therapeutics. Dr. Bhatt has served on the Advisory Boards of Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, PhaseBio, and Regado Biosciences; has served on the Boards of Directors of the Boston VA Research Institute, the Society of Cardiovascular Patient Care, and TobeSoft; has served as Chair of the American Heart Association Quality Oversight Committee; has served on Data Monitoring Committees for the Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott), Cleveland Clinic (including for the ExCEED trial, funded by Edwards Lifesciences), Duke Clinical Research Institute, Mayo Clinic, Mount Sinai School of Medicine (for the ENVISAGE trial, funded by Daiichi-Sankyo), and Population Health Research Institute; has received honoraria from the American College of Cardiology (senior associate editor, Clinical Trials and News, ACC.org, and vice chair of the ACC Accreditation Committee), Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute; RE-DUAL PCI clinical trial steering committee funded by Boehringer Ingelheim), Belvoir Publications (Editor-in-Chief, Harvard Heart Letter), Duke Clinical Research Institute (clinical trial steering committees, including for the PRONOUNCE trial, funded by Ferring Pharmaceuticals), HMP Global (Editor-in-Chief, Journal of Invasive Cardiology), Journal of the American College of Cardiology (guest editor; associate editor), Medtelligence/ReachMD (CME steering committees), Population Health Research Institute (for the COMPASS operations committee, publications committee, steering committee, and USA national coleader, funded by Bayer), Slack Publications (chief medical editor, Cardiology Today’s Intervention), Society of Cardiovascular Patient Care (secretary/treasurer), and WebMD (CME steering committees); has other relationships with Clinical Cardiology (deputy editor), NCDR-ACTION Registry Steering Committee (chair), and VA CART Research and Publications Committee (chair); has received research funding from Abbott, Afimmune, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Chiesi, CSL Behring, Eisai, Ethicon, Ferring Pharmaceuticals, Forest Laboratories, Idorsia, Ironwood, Ischemix, Lilly, Medtronic, PhaseBio, Pfizer, Regeneron, Roche, Sanofi, Synaptic, and The Medicines Company; has received royalties from Elsevier (editor, Cardiovascular Intervention: A Companion to Braunwald’s Heart Disease); has been a site coinvestigator for Biotronik, Boston Scientific, St. Jude Medical (now Abbott), and Svelte; has been a trustee for the American College of Cardiology; and has performed unfunded research for FlowCo, Fractyl, Merck, Novo Nordisk, PLx Pharma, and Takeda. Dr. Fazio has been a consultant to Amarin, Amgen, AstraZeneca, Esperion, and Novartis. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 6, 2019.
- Accepted August 20, 2019.
- 2019 American College of Cardiology Foundation
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