Beyond quality of life improvements: Dr. Khaldoon Alaswad on the challenges facing interventional cardiology

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As a field, interventional cardiology needs to prove its relevance beyond improving patients quality of life, according to Khaldoon Alaswad, MD, director of the cardiac catheterization lab at Detroit-based Henry Ford Health System.

Dr. Alaswad, who also directs the health system's Edith and Benson Ford Heart and Vascular Institute, recently joined Becker's Healthcare cardiology podcast to discuss the most pressing issues interventional cardiology is facing today. 

Here is an excerpt from the podcast. Click here to download the full episode. 

Question: What are some of the biggest issues you're seeing in interventional cardiology today?

Editor's note: This response was lightly edited for length and clarity. 

Dr. Khaldoon Alaswad: Interventional cardiology is a disruptive technology, and one of the most important issues now in interventional cardiology is where do we sit in the scheme of patient treatment? We understand that aggressive preventive cardiology or preventive measures, prevent a lot of cardiovascular events. We have a new clinical trial that shows revascularization, which is basically the crux of our profession with a stable ischemic heart disease patient … does not actually prolong their life or prevent heart attacks, but we were so happy to find that one of our missions — improving quality of life — was confirmed in a major clinical trial. 

Still, as an interventional cardiologist who thinks we need perfection, it was disappointing that we don't actually increase the longevity of life, and we do not prevent heart attacks, although we do improve the quality of life. 

So, I think we need to look into technological development, pharmacological development and skill development. Interventional cardiology is completely dependent on the skill of the operator, and in the development of all these things and a multidisciplinary approach, we need to get to the next stage where we actually provide more benefit than just improving the quality of life — an added benefit to other preventive cardiology measures like controlling the cholesterol, increasing exercise, decreasing weight, and all of these measures.

So, I think our challenge for the next few years is to prove that we are relevant, in terms of longevity and decreasing heart attacks. We know that in a patient with acute heart attacks, we are very relevant, but in 50 percent of patients with stable ischemic heart disease, we need to change that.

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