Celebrating Heart Month with Dr. Norman Lepor
At LACMA, we want to recognize February as Heart Month and one of our cardiologists – Norman Lepor, MD, FACC, FAHA, FSCAI. Dr. Lepor is much loved by his patients for his attentive, personal care. He serves as Southern California Governor of the American College of Cardiology – California Chapter and is the immediate past President. He’s also been an active LACMA member for years. We really appreciate your support!
We asked Dr. Lepor what’s new and exciting in cardiology. Here’s what he shared:
These are exciting times in the field of cardiovascular medicine. We are translating device and pharmacologic innovations to enhance the care of our patients. Who would have thought ten years ago that the most common valvular conditions, aortic stenosis and mitral regurgitation can be treated effectively and non-surgically in the cardiac catheterization laboratory with transcutaneous aortic valve replacement (TAVR) or a mitral valve clip? Treatment of thoracic and abdominal aortic aneurysms are treated in collaboration with our surgical colleagues using percutaneous techniques allowing for improved outcomes and more rapid recovery compared to what was conventional surgical procedures. Cardiologists can now revascularize patients with critical lower limb ischemia avoiding in many cases save a foot and leg from an incredibly disabling amputation.
Pharmaceutical innovations have also led to improvements in patient outcomes. Warfarin, or how we often refer to it as “rat poison”, has in many cases been replaced by drugs known as novel oral anticoagulants (NOAC’s) to prevent strokes in patients with atrial fibrillation and treat and prevent deep venous thrombosis and pulmonary emboli. A new class of cholesterol reducing drugs known as PCSK9 inhibitors can lower LDL (bad) cholesterol by 60-70% either as stand alone or added to statin therapy have given new hope for patients with a particular genetic defects and other leaving them with very high cholesterol levels or those who do not tolerate statins due to myalgias who are at high and very high risk for cardiovascular complications to hopefully prevent heart attacks and stroke. There is hope that the PCSK9 inhibitors and statins together can almost put atherosclerosis into the “deep freeze”. A new class of drugs for the treatment of heart failure, angiotensin receptor/neprolysin inhibitors, have been shown to significantly reduce cardiovascular mortality from this deadly disease which many physicians do not realize has a risk worse then many cancers. We now have a new class of diabetic drugs, SGLT-2 inhibitors, one of which has finally shown the ability to reduce all cause and cardiovascular mortalty.
Wow, all these innovations have done nothing short of revolutionize the care of our patients. As the immediate past president of the California Chapter of the American College of Cardiology, one of my main goals was to develop programs that would increase awareness of these innovations among cardiologists and our primary care colleagues to help insure access to our patients and appropriate utilization.
I am proud of the level of collaboration between the California Chapter of the American College of Cardiology (CA ACC) and LACMA under the direction of CEO Gustavo Friederichsen. I’m looking forward to further work with Gustavo and Dr.William Averill as we cross pollinate our efforts for educating our colleagues and perhaps even more importantly, join forces in advocating for our patients and our profession here locally in Los Angeles and statewide in Sacramento.
A recent example of this collaborative effort was the promotion of the 1st annual CA ACC Technology Fair held in Downtown Los Angeles among LACMA members. Stay tuned for an announcements regarding future technology fairs and other important educational initiatives. The pace of change and increasing complexity of health care delivery in the United States and here in Los Angeles have led to much angst among our patients and physicians providing their care. It is up to physician leaders such as those at LACMA and CA ACC to push our way and have a “being seated at the table” where decisions are made and where we can have impact versus “being on the menu.”