Dr Dipti Itchhaporia on Health Equity, Clinical Trials, and Emerging Therapies at ESC

After moderating an emerging science session on acute ST-elevation myocardial infarction (STEMI) care at the 2024 European Society of Cardiology Congress, Dipti Itchhaporia, MD, MACC, FAHA, FESC, discussed the growing inclusivity in clinical trials through innovative digital tools and addressed the impact of GLP-1 therapies on cardiovascular treatment—highlighting both their benefits and the challenges related to access and affordability.

Itchhaporia is the chair of the Health Equity Task Force and the immediate past president of the American College of Cardiology (ACC). As she spearheaded the ACC's Health Equity Task Force during her vice presidency, she brought together a diverse group of experts to develop actionable strategies aimed at ensuring equitable cardiovascular care for all patients.

This transcript has been lightly edited for clarity.

Transcript

Can you share a bit about the ESC Congress session you just finished?

I was moderating an emerging science session on acute STEMI care, and so that was very interesting to talk about: what should you do in a patient with STEMI and shock? I think there are a lot of questions that have been answered, but a lot that still remain unanswered. There was also talk about imaging therapies in these patients and, also about intracoronary cooling in patients who are having STEMIs. So, that data is not out, but it's interesting to hear what people are doing and the research that's coming out in this area.

The need for more inclusivity in clinical trials has been a topic of conversation. How is this being addressed?

I think the clinical research space is a place where we are making some progress. And I think there's a recognition that we do need diversity in the patient population if we're going to serve these patients. You know, can you take data from a caucasian male and apply it to a Hispanic female? Probably not. And so we've always known that, but how to overcome that? I think that we have started to try to reach the patients using digital tools to try to enroll them, using the smartphone, using telehealth visits, all of that. So we're making it a little bit easier.

There is actually a lot of innovation in the research space. In fact, I have a Radcliffe [Cardiology] review coming out right now with Michael Gibson talking specifically about this issue. So, I do think that we are starting to do a better job of enrolling these patients than we have in the past. Do we have a lot of work to do still? Absolutely; and again, being able to get to those communities, reach those communities, and being able to facilitate enrollment easier will make this a lot, a lot better.

How is the emergence of GLP-1 therapies impacting the treatment landscape for cardiologists?

So we know that GLP-1s have shown cardiovascular benefits in diabetic patients, and it's certainly also helpful in patients with obesity in terms of weight loss, and then that translates into cardiovascular benefits. We know that, in general, cardiovascular disease is increasing because of the risk factors, and 2 common risk factors are obesity and diabetes. So if we can target those patients, then we can say that we're going to help in terms of their cardiovascular outcomes.

But we also know 2 things; one—these drugs can be expensive, so that could be a barrier. The other thing is that now that there is utilization for obese patients, our diabetic patients are not having as much access to it because the supplies are not there. I think there's equity issues on both sides there, right? Because I think both sets need it. The question is, can they get it because of the supply, and can they afford to get it? So I think that's a health equity issue.