Interconnectivity of Cardiovascular Disease and Risks
Cardiovascular (CV) disease affects nearly 50 percent of adults in the United States and is the leading cause of death worldwide. Risk factors of heart disease include high blood pressure, high cholesterol, smoking, diabetes, unhealthy diet, excessive alcohol consumption and physical inactivity.[1][2]
There are many CV diseases that affect the heart in various ways and can progress into more serious CV events. For example, coronary artery disease (CAD), which is plaque buildup in the arteries, can lead to a heart attack if the plaque buildup constricts blood flow to the heart.[3]A previous heart attack can also lead to heart failure (HF) as lack of oxygen and nutrients can damage the heart’s muscle and may weaken the heart’s ability to pump blood.[4]
In addition to CAD and heart attacks, other medical conditions such as diabetes and high blood pressure can also impact and weaken the heart over time, which can increase the risk for HF.[5][6] Cardiomyopathy, a condition of the heart muscle, makes it difficult for the heart to deliver blood to the body, which can lead to HF if not monitored closely.[7]
Transthyretin amyloid cardiomyopathy (ATTR-CM) occurs when a protein called transthyretin (TTR) misfolds and builds up in the heart, nerves, and other organs. The misfolded proteins, called amyloid fibrils, cause damage to the heart the more they accumulate, restricting blood flow and potentially leading to HF.[8]
Underdiagnosed and potentially fatal, ATTR-CM can be hereditary, caused by a mutation in the TTR gene that is inherited, or wild-type, which develops with age and is not inherited.[8]
Factor Xa inhibitors (FXa), which are a class of a direct oral anticoagulants, are medications used for stroke prevention in atrial fibrillation and venous thromboembolism treatment and prevention.[9][10] While FXa inhibitors prevent unwanted clotting, they do increase the risk of uncontrolled and life-threatening bleeding.[10] Although the risk of major bleeding on FXa inhibitors is low at about 4-6% in national studies,[11][12] it is still important that patients openly communicate with their doctor and caregivers of this risk to discuss an action plan if they are hospitalized with an uncontrolled bleed.
Our commitment to CV diseases to better support patients
For over 40 years, AstraZeneca has been committed to protecting people with CV disease with the focus on eliminating CV risk, CV complications and HF.
We’ve invested in the research and development to help reduce the rate of CV death, heart attack, and stroke in patients with acute coronary syndrome (ACS). We’ve also supported patients with HF through investment in understanding how to reduce the risk of CV death and hospitalization, and continue to advance the science for patients across the HF spectrum.
We’re committed to expanding the science along the continuum of CV disease by supporting people with ATTR-CM as well as those at risk for FXa inhibitor-related uncontrolled bleeds. We look forward to continuously uncovering what science can do for these patients.
Resources for Patients
Along with our focus in medicine, we understand that a holistic approach to patient care, such as community connection and education, is a powerful tool in managing CV disease.
We continue to show up for people with CV disease and are proud of our longstanding expertise in this area, brought to life through our patient education program, Survivors Have Heart (SHH).
We first launched the program in 2017 with the help of Bob Harper—host of The Biggest Loser, best-selling author and heart attack survivor. Together with a small group of heart attack survivors, we started the conversation about how the emotional recovery after a heart attack can be just as difficult as the physical recovery, for both heart attack survivors and their caregivers. The program has grown exponentially in the years since its launch, offering a community and avenue for millions of patients to connect with each other and better manage their ongoing care.
Additionally, AstraZeneca established the Accelerate Change Together (ACT) on Heart Failure initiative to elevate HF as a priority and focus on enhancing prevention and diagnosis capabilities. We’ve collaborated with professional societies and patient advocacy groups on a number of HF programs to advance education and awareness for patients and healthcare professionals, including the Heart Failure Society of America’s (HFSA) Heart Failure Awareness 365 Initiative and Mended Hearts’ Welcome Home Program. Educational resources are available from our partners that provide information on risk factors, best practices, and treatment options to help support patients living with CV disease.
Our Promise
Building on our long-term legacy in CV disease, we continue to explore this space with a commitment to advancing the science, working to push policy change to increase access to innovative therapies and deepen our partnerships to increase awareness and understanding of CV disease among patients.
At AstraZeneca, we will continue to remain steadfast in our dedication to addressing CV patients’ unmet needs, raising awareness for CV diseases and health, and moving toward a future where CV disease is no longer a leading cause of death.
References
- American Heart Association. Cardiovascular diseases affect nearly half of American adults, statistics show. 2019. https://www.heart.org/en/news/2019/01/31/cardiovascular-diseases-affect-nearly-half-of-american-adults-statistics-show. Accessed January 24, 2023.
- Centers for Disease Control and Prevention. Heart Attack Symptoms, Risk, and Recovery. https://www.cdc.gov/heartdisease/heart_attack.htm. Accessed January 24, 2023.
- Centers for Disease Control and Prevention. Coronary Artery Disease (CAD). https://www.cdc.gov/heartdisease/coronary_ad.htm. Accessed January 24, 2023.
- American Heart Association. What Causes Heart Failure? https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure/causes-of-heart-failure. Accessed January 24, 2023.
- Centers for Disease Control and Prevention. Diabetes and Your Heart. https://www.cdc.gov/diabetes/library/features/diabetes-and-heart.html. Accessed January 24, 2023.
- Centers for Disease Control and Prevention. Heart Failure. https://www.cdc.gov/heartdisease/heart_failure.htm. Accessed February 6, 2023.
- Centers for Disease Control and Prevention. Cardiomyopathy. https://www.cdc.gov/heartdisease/cardiomyopathy.htm. Accessed January 24, 2023.
- Amyloidosis Research Consortium. Wild-Type Amyloidosis. https://arci.org/about-amyloidosis/wild-type-amyloidosis/. Accessed February 3, 2023.
- Milling TJ Jr, Clark CL, Feronti C, et al. Management of Factor Xa inhibitor-associated life-threatening major hemorrhage: A retrospective multi-center analysis. Am J Emerg Med. 2018;36(3):396-402. doi:10.1016/j.ajem.2017.08.042
- McCarty D, Robinson A. Factor Xa inhibitors: a novel therapeutic class for the treatment of nonvalvular atrial fibrillation. Ther Adv Cardiovasc Dis. 2016;10(1):37-49. doi:10.1177/1753944715605011
- Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365(10):883-891. doi:10.1056/NEJMoa1009638
- Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365(11):981-992. doi:10.1056/NEJMoa1107039