Tell us about the global trends that you see in CVD
Cardiovascular disease has risen to being the number one cause of mortality worldwide. It has been re-established as the number one killer in western world but in the past few years we have been witnessing a sharp increase also in developing countries such that in many places and in many countries in Africa and Asia cardiovascular disease are now similar to what happens in western world. It is for sure a huge problem from the public health point of view and measures need to be taken if we want to improve outcomes of patients and the population in general.
Major challenges in CVD
One of the major challenges that we are facing as doctors and policy makers is in dealing with cardiovascular disease in general is the accessibility to healthcare. This is particularly relevant for acute presentation of cardiovascular disease such as acute coronary syndrome that present dramatic symptoms which can have devastating consequences on the patients and subsequently on his or her family. One important challenge is accessibility to primary percutaneous coronary intervention which shall be shown to decrease the mortality in this setting. Other challenge that we face is assess ability to very complex interventions and catheter based interventions. This is also related to cost in this field of medicine so efforts shall be made in order to decrease costs and guarantee wider access to the vast majority of the population especially in developing countries to this therapies and treatment.How important is affordability and how are the policy makers fixing this vital issue?
In Italy there is a fixed reimbursement system in place. So for a given diagnoses that the patient receives, the hospital gets a fixed amount of money as reimbursement for the treatments that were provided for the patient. With the increasing mean population age in the country, it constitutes a challenge for the healthcare system because in the next few years more and more patients will age and more disease burden will be faced. So we as doctors and policy makers will need to find ways to guarantee this expensive treatment and therapies for the aging population that will grow over the next few years.
With the presence of various stents in the market, how do you select one and is the patient involved?
Worldwide in the past few years we have been witnessing huge growth in stent type availability. Traditionally we have had the global players mostly American and US based companies and stent manufacturers that have a huge share of the market but in the past 2-3 years also in Europe, we have been having access to new devices manufactured by countries from other countries in the world particularly China and India. In Italy currently we have been using stents from SMT – the Supraflex sirolimus-eluting stent with bio absorbable polymer and in certain regions of my country Supraflex now has the leading share of the market.
Your experience with Indian stents
My experience with Indian stents has been quite positive so far. Indian companies manufacture good quality products that are on par with tradition global leader products. My experience is quite positive and I look forward to newer filtration of the device by this company and other company to challenge well established leader in the market.