ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research
The American College of Cardiology presents select interviews and summaries covering the most interesting research areas in cardiology, drawn from the ACCEL library. Hosted by ACCEL Editor-in-Chief Alison L. Bailey, MD, FACC, FAACPVR, each episode highlights key findings and expert discussions. The podcast aims to keep clinicians informed about exciting cardiovascular research.
Episodes
Insights From the PVI-SHAM-AF
Catheter ablation is frequently performed to improve quality of life in patients with atrial fibrillation (AF). This randomized multicenter trial compared catheter ablation with a sham procedure to assess the true effect of the intervention on AF-related quality of life. In this episode, Clyde W. Yancy, MD, MACC and Rolf Wachter, MD discuss the results of "PVI-SHAM-AF: Pulmonary vein isolation
Impacts Of The FUND-HF Trial
The FUND-HF trial found that financial support provided soon after hospitalization is a practical strategy for improving medication adherence among economically vulnerable patients with heart failure and reduced ejection fraction. These results lay the groundwork for future trials designed to examine the durability of these benefits and their effects on health-related quality of life and clinica
Primordial Prevention of CVD in Young
The future of cardiovascular health depends on prevention that begins early in life. This episode reviews strategies for recognizing cardiovascular risk at an early stage and implementing interventions that can alter the trajectory of atherosclerotic cardiovascular disease before complications occur. In this interview, Allen J. Taylor, MD, FACC and Michael J. Blaha MD, MPH discuss Primordial
Umbrella: Cardioprotection During Treatment
Cardiovascular protection during cancer treatment is critical to help prevent complications such as heart failure. Patients should be educated on risk factors, symptom awareness, and heart-healthy behaviors. Oncologists should incorporate cardiovascular risk assessment and surveillance into treatment planning, while general cardiologists should understand the potential cardiotoxic effects of canc
No Murmur But Much Fervor: Nonobstructive HCM
Nonobstructive hypertrophic cardiomyopathy (HCM) represents one of the greatest areas of unmet need in HCM management. A key question is identifying the primary driver of symptoms in these patients, as many experience significant functional limitations despite the absence of left ventricular outflow tract obstruction. Understanding the rate and mechanisms of heart failure progression in nonobstru
Evolocumab In Patients Without Significant Atherosclerosis: Results From VESALIUS-CV
The VESALIUS-CV trial demonstrated that the PCSK9 inhibitor evolocumab significantly reduced the risk of a first major cardiovascular event in patients with diabetes who had no known significant atherosclerosis. These findings challenge current clinical practice, where PCSK9 inhibitors are typically reserved for secondary prevention in patients with prior heart attack or stroke. Importantly, the
Why Can't We Prove Revascularization Is Better Than Medical Therapy for SIHD?
Randomized trials in stable ischemic heart disease (SIHD) show revascularization does not reduce death or myocardial infarction versus guideline-directed medical therapy, with benefit limited to symptom relief. This likely reflects lesion–ischemia mismatch, unclear ischemia origin, effective modern medical therapy, and trial design constraints. As a result, a prognostic advantage is difficult to
Top Practice-Changing Advancements in Echocardiography Since ACC.25
ecent advancements in echocardiography since ACC.25 highlight a shift toward greater precision, efficiency, and consistency in cardiac imaging. Standardized echo reporting is now recognized as a key marker of quality care, improving communication and supporting more reliable clinical decisions, while artificial intelligence enhances imaging through automated measurements and diagnostic support. T
The Case For Medically Tailored Meals
The "Food is Medicine" approach is central to cardiovascular disease (CVD) prevention because diet directly shapes key risk factors, making nutrition a powerful, modifiable intervention. Medically tailored meals (MTMs) are fully prepared, condition-specific meals prescribed to meet the clinical needs of patients with chronic disease. Evidence shows that MTMs can improve health outcomes, enhance d
Managing Subclinical AFib Detected by Devices, Ambulatory Monitors and Wearables
The detection of subclinical, or "silent," atrial fibrillation (AFib) has increased substantially with the widespread use of implantable devices (e.g., pacemakers, defibrillators) and consumer wearables such as smartwatches. A key clinical question is the threshold of cumulative AFib burden—such as duration identified on device interrogation—at which anticoagulation should be considered. Addition
Cardiorenal Outcomes with Tirzepatide Compared with Dulaglutide in Patients with Diabetes and CVD
Is tirzepatide associated with a broader reduction in cardiorenal adverse outcomes compared with dulaglutide in patients with type 2 diabetes and cardiovascular disease (CVD? The SURPASS-CVOT, the first cardiovascular outcomes trial using an active incretin-based comparator, previously demonstrated that tirzepatide was noninferior to dulaglutide for major adverse cardiovascular events, including
Impact Of Ivabradine in Post-COVID POTS: The Recover-Autonomic Trial
The Recover-Autonomic Trial evaluates the impact of ivabradine on orthostatic intolerance, quality of life, and heart rate in patients with post-COVID postural orthostatic tachycardia syndrome (POTS). Recognizing that POTS disproportionately affects women, the study addresses a growing clinical need for targeted management strategies in this population. It examines ivabradine as part of a broader
Prehospital Heparin Administration In Patients With STEMI Undergoing Primary PCI
Prehospital heparin administration in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) offers a practical strategy to facilitate early restoration of blood flow in the infarct-related artery before hospital arrival. A key advantage of heparin over other agents studied for this purpose is its low cost, widespread availabil
Definitions and Treatment of Iron Deficiency in HF: Feel and Function or More?
Iron deficiency (ID) is highly prevalent in patients with heart failure (HF) and is independently associated with poorer functional status, higher hospitalization rates, and increased mortality. ID in HF is typically defined by abnormal iron indices—most commonly low ferritin and/or low transferrin saturation—and is distinct from anemia, as it may be present even when hemoglobin levels are normal
Key Take-Home Messages From the 2025 Sports Cardiology Guidelines
There is increasing emphasis on shared decision-making when evaluating sports participation for competitive athletes with cardiovascular disease, reflecting a shift toward more individualized care. This approach recognizes that participation decisions should integrate clinical risk assessment with the athlete's values, goals, and informed preferences. Current guidelines aim to thoughtfully balanc
Insights From the CADENCE Trial
In the CADENCE proof-of-concept study, sotatercept demonstrated meaningful improvements in pulmonary vascular and cardiac hemodynamics in patients with combined pre‑ and post‑capillary pulmonary hypertension due to HFpEF (CpcPH‑HFpEF). Investigators selected a pulmonary vascular resistance threshold of ≥4 Wood units to enrich patients with a significant pre‑capillary component, where targeting pu
A Look At The ORBITA-CTO Trial
The ORBITA-CTO trial was a multicenter, randomized, double-blinded study that enrolled 50 patients with symptomatic single-vessel chronic total occlusion (CTO) and no bystander coronary disease. Participants were assigned to either CTO percutaneous coronary intervention (PCI) or a placebo procedure. The results demonstrated that PCI with angioplasty and stenting led to greater improvement in angi
THRIVE Food is Medicine Pilot Trial: Addressing Hypertension Through Produce Prescriptions
The American Heart Association–funded THRIVE Food is Medicine pilot trial demonstrated strong promise in addressing hypertension through produce prescriptions. Participants in the intervention arm with high adherence to the DASH diet experienced an average systolic blood pressure reduction of 13 mmHg, a clinically meaningful improvement. The program showed high acceptability and sustainability po
Inflammation in CVD: A 2025 ACC Scientific Statement
Inflammation has emerged as a critical contributor to the pathogenesis and clinical outcomes of cardiovascular disease (CVD), with growing evidence highlighting the prognostic relevance of residual inflammatory risk. Notably, residual inflammation measured by high-sensitivity C-reactive protein (hsCRP) remains a strong predictor of recurrent cardiovascular events, supporting the case for more uni
Lower LDL-C for Longer? Defining the Optimal Timing and Intensity of Rx
Should statin therapy be routinely initiated in middle‑aged adults with at least one atherosclerotic cardiovascular disease risk factor and LDL‑C levels above 100 mg/dL? Observational data consistently shows that lower LDL-C and non-HDL-C levels are associated with substantially reduced risks of atherosclerotic vascular disease. In the absence of randomized trial data in younger and middle-aged a
Keeping it Simple: Top 10 Things to Know About the 2026 Dyslipidemia Guideline
The 2026 ACC/AHA Dyslipidemia Guidelines highlight that Lp(a) confers a graded ASCVD risk, with levels around 125 nmol/L (50 mg/dL) indicating meaningful risk and ~250 nmol/L (100 mg/dL) identifying a substantially higher‑risk phenotype. Coronary artery calcium scoring and hsCRP are recommended selectively to refine risk assessment when traditional estimates are uncertain. Importantly, harmonizat
Heart and Liver Health: Interconnectedness of CV and Hepatic Risk
ardiac and hepatic function are closely interconnected, with deterioration in one organ often accelerating disease progression in the other. Emerging evidence, including data suggesting semaglutide may slow or halt liver fibrosis progression, highlights the need to rethink how we manage patients with overlapping heart and liver disease. By examining the heart–liver axis, clinicians can gain insig
Addressing Cardiovascular-Kidney-Metabolic Syndrome Health
Cardiovascular-Kidney-Metabolic (CKM) syndrome encompasses a spectrum of interconnected cardiovascular, kidney, and metabolic conditions that progress through defined stages. A five-stage CKM treatment framework emphasizes timely identification of risk factors, structured and personalized risk discussions, and early, interdisciplinary intervention. By targeting obesity, diabetes, and chronic kidn
Sotatercept: New Therapies for PAH
Pulmonary arterial hypertension (PAH) remains a devastating, progressive disease with high morbidity and mortality despite advances in targeted therapies. Sotatercept, the most recent addition to the PAH treatment landscape, has demonstrated robust efficacy across multiple phase 3 randomized clinical trials. The HYPERION trial expands the evidence base by showing a favorable benefit–risk profile
Does Eliminating Coffee Avoid Fibrillation (DECAF) Trial
Caffeinated coffee may reduce the risk of atrial fibrillation through several proposed mechanisms, including improved autonomic balance, antioxidant effects, and enhanced vascular function. While observational data have hinted at these benefits, randomized trial evidence has been limited. Findings from the DECAF Trial further demonstrate that atrial fibrillation patients do not need to avoid caff
Evaluating the 2025 AHA/ACC High Blood Pressure Guideline
The 2025 High Blood Pressure Guideline introduces key updates to the 2017 recommendations, reflecting the evolving understanding of hypertension and its long‑term impact on patient health. This update emphasizes evidence‑based strategies for diagnosis and management, highlighting the importance of standardized guidelines in improving outcomes. Key takeaways include refined treatment thresholds, e
Cardiovascular-Kidney Therapies in CKD
Heart and kidney disease are closely linked, as individuals with chronic kidney disease (CKD) face a significantly higher risk of cardiovascular events and heart failure. Because this cardiometabolic connection is so strong, identifying high‑risk individuals early is essential to preventing progression of both conditions. A holistic approach—including guideline‑directed therapies that target bloo
Prasugrel Benefits Patients With Diabetes and Multivessel Disease Post-PCI: TUXEDO-2 Trial
The findings from the TUXEDO‑2 trial provide important clinical insights for managing high‑risk patients with diabetes and multivessel coronary disease undergoing stenting. By directly comparing ticagrelor and prasugrel within a dual antiplatelet therapy regimen, the trial helps clarify whether one agent offers superior protection in this complex population. These results may influence clinical d
The Power of Nutrition: GOFRESH Trial
The GOFRESH trial showed that providing DASH‑patterned groceries through a structured grocery‑ordering strategy meaningfully lowered systolic blood pressure and LDL cholesterol among Black families living in a Boston‑area food desert. These results highlight the powerful role of nutrition by showing that accessible, culturally relevant food‑as‑medicine strategies can deliver measurable cardiovascu
OCEAN Trial: Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation
The OCEAN Trial found that rivaroxaban did not significantly reduce the incidence of stroke, systemic embolism, or new covert embolic events compared with aspirin in patients at high risk for stroke who had undergone catheter ablation for atrial fibrillation (AFib) at least one year earlier. The central question—whether patients with a successful AFib ablation can safely discontinue anticoagulati
NOTIFY-PICTURE Trial: Real-Time Notification of AI-Derived Incidental CAC on Statin Initiation
What exactly is incidental coronary artery calcification, and what does it mean when artificial intelligence identifies these calcifications? Incidental coronary artery calcification refers to calcium deposits in the coronary arteries that are detected on imaging studies performed for unrelated reasons. AI now enables clinicians to repurpose routine clinical images to efficiently and scalably ass
VESALIUS-CV Trial: Effect of Evolocumab in Patients at CV Risk without Prior MI or Stroke
The VESALIUS‑CV trial demonstrated that adding the PCSK9 inhibitor evolocumab to optimized lipid‑lowering therapy significantly reduced the risk of first major cardiovascular events by 25% in high‑risk adults without prior heart attack or stroke and cut the risk of first heart attack by 36%. These results confirm that intensive LDL‑C lowering with evolocumab provides meaningful primary‑prevention
ACCEL Lite: Hypertension Treatment Trials in the Elderly for Brain Health
Is the evidence convincing that intensive antihypertensive therapy protects brain function and helps prevent dementia? Research increasingly shows that high mid‑life blood pressure is a strong predictor of later cognitive decline. Emerging data further indicate that intensive blood‑pressure lowering can reduce the risk of cognitive impairment and dementia while remaining safe for many older adult
ACCEL Lite: SURPASS-CVOT: Effect of Tirzepatide Versus Dulaglutide on MACE
In patients with Type 2 diabetes and established atherosclerotic cardiovascular disease (ASCVD), tirzepatide was non‑inferior to dulaglutide for major cardiovascular events while providing superior kidney protection, lower all‑cause mortality, and greater reductions in HbA1c and body weight. Compared with dulaglutide, a GLP‑1 receptor agonist, tirzepatide demonstrated broader metabolic and clinic
CAUGHT-CAD: Combining Coronary Calcium Score with Treatment on Plaque Progression in Familial CAD
Coronary artery calcium (CAC) scoring provides important prognostic value, particularly for individuals at intermediate risk for coronary artery disease (CAD) or those with a family history of the condition. Incorporating computed tomography calcium scoring into a structured disease‑management program may help prevent the progression of coronary plaque, although this strategy has not yet been eva
AI-Enabled Nationwide Opportunistic Screening of Non-Contrast Chest CT for Death and CV Outcomes
AI technology transforms routine chest computed tomography (CT) scans by precisely quantifying—rather than simply detecting—key cardiovascular imaging risk factors such as heart calcification, aorta calcification, and fat around the heart. By shifting from binary "yes or no" findings to actual measurement, clinicians can more accurately identify high‑risk patients and intervene earlier to help pr
ACCEL Lite: Should There Be a Reappraisal of Surgical Threshold in Patients with AA Dilation?
Ascending aortopathy (AA) is typically asymptomatic and often diagnosed incidentally, with surgical aortic replacement recommended once aneurysmal thresholds are reached. Emerging evidence suggests that indexing aortic size to patient height may more accurately identify individuals who could benefit from earlier intervention. For AA patients who do not currently meet guideline-based criteria for
Top Takeaways from 2025: Preventive Cardiology with C. Noel Bairey Merz, MD, MACC
In this interview, C. Noel Bairey Merz MD, MACC and Alison L. Bailey, MD FACC, discuss the Top Preventive Cardiology Takeaways from 2025 including trials clopidogrel versus aspirin, the benefit of vaccines, statin use in pregnancy, and more. Suggested Materials: Valgimigli M, Choi KH, Giacoppo D, et al. Clopidogrel versus aspirin for secondary prevention of coronary artery disease: a syst
Top Takeaways from 2025: EP with DJ Lakkireddy, MBBS, FACC
In this interview, DJ Lakkireddy, MBBS, FACC and Alison L. Bailey, MD FACC, discuss the Top Electrophysiology Takeaways from 2025 including trials CLOSURE-AF, ALONE-AF, NEMESIS-PFA, and more. Suggested Materials: 1. Verma A, Birnie DH, Jiang C, et al. Antithrombotic Therapy after Successful Catheter Ablation for Atrial Fibrillation. N Engl J Med. Published online November 8, 2025. doi:10.1
Multimodality Imaging in Inflammatory Cardiomyopathy
Multimodality imaging plays a pivotal role in evaluating inflammatory cardiomyopathy, particularly when cardiac sarcoidosis (CS) is suspected. Symptoms of CS include unexplained high-grade AV block, ventricular arrhythmias, reduced left ventricular function, or regional wall thinning without coronary disease. The best evaluation combines cardiac magnetic resonance imaging (MRI) for structural and
Top Takeaways from 2025: Clinical Cardiology with Allen J. Taylor, MD, FACC
In this interview, Allen J. Taylor, MD, FACC and Alison L. Bailey, MD FACC, discuss the Top Clinical Cardiology Takeaways from 2025 including trials SCOT-HEART 2, ALONE-AF, Launch-HTN, and more. Suggested Materials: 1. Kim D, Shim J, Choi EK, et al. Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation: The ALONE-AF Randomized Clinical Trial. JAMA. 2
Top Takeaways from 2025: Interventional Cardiology with Deepak Bhatt, MD, MPH, MBA, FACC
In this interview, Deepak Bhatt, MD, MPH, FACC and Alison L. Bailey, MD FACC, discuss the Top Interventional Cardiology Takeaways from 2025 including DanGer Shock trial, revascularization in STEMI, aspirin withdrawal after PCI, and more. Suggested Materials: 1. Møller JE, Beske RP, Engstrøm T, et al. Long-Term Outcomes of the DanGer Shock Trial. N Engl J Med. 2025;393(10):1037-1038. do
PANTHER-P2Y12 Inhibitor or Aspirin moNoTHERapy as Secondary Prevention in Patients with CAD
he PANTHER study indicates that clopidogrel provides superior protection against major cardiovascular events compared to aspirin in patients with coronary artery disease, without increasing bleeding risk. This supports its use in individuals at higher risk of gastrointestinal complications, reinforcing current clinical preferences. Overall, these results could inform long-term treatment strategie
ACCEL Lite: Top Takeaways from 2025: HF with Clyde Yancy MD, MSc, MACC
In this interview, Clyde Yancy MD, MSc, MACC and Alison L. Bailey, MD FACC, discuss the Top Heart Failure Takeaways from 2025 including trials SUMMIT and BaxHTN, the ACC/AHA Blood Pressure Guidelines, and more. Suggested Materials: 1. Jones DW, Ferdinand KC, Taler SJ, et al. 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM Guideline for the Prevention, Detection, Evaluation,
ACCEL Lite: Top Takeaways from 2025: CV Imaging with Amit R. Patel, MD, FACC
In this interview, Amit R. Patel, MD, FACC and Alison L. Bailey, MD FACC, discuss the Top Cardiovascular Imaging Takeaways from 2025 including myocardial fibroblast activation, photon-counting detector CT, the newly published ACC/AHA CT Advanced Training Statement, and more. Suggested Materials: 1. Nijveldt R, Maeng M, Beijnink CWH, et al. Immediate or Deferred Nonculprit-Lesion PCI in Myoc
C-Reactive Protein and CV Risk in the General Population
Inflammation is a key contributor to cardiovascular disease (CVD), influencing both its onset and progression. High-sensitivity C-reactive protein (hsCRP) serves as a reliable biomarker for detecting systemic inflammation and assessing cardiovascular risk. Recognizing the role of inflammation helps refine risk stratification and guide preventive strategies in the general population. In this
ALONE-AF: Discontinuing Long-Term Oral Anticoagulation After Successful AFib Ablation
The ALONE-AF study examined outcomes in atrial fibrillation (AF) patients who remained free of recurrence following catheter ablation. Researchers found that discontinuing oral anticoagulation (OAC) was associated with a lower risk of stroke, systemic embolism, or major bleeding compared to continued OAC. These findings, presented at the ESC Congress 2025, suggest that stopping OAC may offer a sa
How Does Imaging Guide Management in Patients with Obesity?
Imaging is a powerful tool in managing obesity, helping clinicians visualize fat distribution and detect complications like fatty liver disease or heart issues. Advanced techniques like magnetic resonance imaging (MRI) and computed tomography (CT) scans guide personalized treatment plans and monitor progress over time. Despite challenges with equipment limitations, innovations like artificial int
TACSI Trial: Dual or Single Antiplatelet Therapy After CABG in Patients With ACS
In the TACSI trial, researchers evaluated ticagrelor plus aspirin versus aspirin alone in about 2,200 patients who underwent coronary artery bypass grafting (CABG) for acute coronary syndrome (ACS). At 12 months, dual antiplatelet therapy (DAPT) did not reduce major adverse cardiac events compared to aspirin alone. However, it was associated with a higher risk of major bleeding. These findings do
VICTORION-Difference: Inclisiran-Based Strategy vs. Standard of Care
Current clinical challenges in lipid control include achieving and maintaining target LDL-cholesterol levels in patients at high risk for atherosclerotic cardiovascular disease, especially those who do not respond adequately to standard therapies. The VICTORION-Difference trial demonstrated that an inclisiran-based treatment strategy significantly outperformed usual care in helping patients reach
Aortopathies: What A Cardiologist Needs to Know
What if your genes could predict a life-threatening condition before symptoms ever appear? Explore how medical science uncovered the genetic roots of thoracic aortic aneurysm—and why that discovery changed everything. From famous historical figures to modern patients, the implications are profound: understanding the exact genetic mutation can guide treatment and safeguard entire families. In
PhysioSync-HF: Conduction System vs. Biventricular Pacing in Cardiac Resynchronization in HFrEF
Can a newer, more targeted pacing method revolutionize heart failure treatment? The PhysioSync-HF trial investigates conduction system pacing as a potentially more effective and affordable alternative to traditional cardiac resynchronization therapy. Explore the surprising differences between this study and prior research and hear firsthand what it was like to lead a nationwide, publicly funded c
DAPT-SHOCK-AMI Trial: Cangrelor in Cardiogenic Shock
The DAPT SHOCK AMI trial is the first major study to evaluate antiplatelet therapy specifically in patients with cardiogenic shock (CS) following acute myocardial infarction (AMI). It compares initial treatment strategies using cangrelor versus crushed ticagrelor. Early and potent platelet inhibition is critical for restoring microvascular reperfusion in this high-risk population. Previous random
ODYSSEY-HCM: Mavacamten in nHCM
The ODYSSEY-HCM trial found that mavacamten did not significantly improve exercise capacity or patient-reported outcomes in individuals with symptomatic nonobstructive hypertrophic cardiomyopathy. Safety concerns emerged, including more frequent reductions in ejection fraction and treatment interruptions among those receiving mavacamten. The trial's limited diversity and short duration raise ques
DAN-RSV: RSVpreF Vaccine for Preventing Cardiorespiratory Hospitalizations
The DAN-RSV trial is one of the largest individually randomized studies ever conducted, enrolling over 131,000 participants aged 60 and older to evaluate the effectiveness of the RSVpreF vaccine. Using a pragmatic design with electronic consent and national health registry data, the trial successfully met its primary objective of reducing RSV-related respiratory tract disease hospitalizations. It
The Role of Prevention During and After Reproduction
Adverse pregnancy outcomes (APOs), affecting up to 20% of pregnancies, serve as early indicators of a woman's future cardiovascular risk and should be treated as critical markers in preventive care. Pregnancy offers a unique opportunity—a "window"—to identify and address cardiovascular vulnerabilities, making routine screening for heart health essential at every clinical encounter. Long-term moni
The Role of Imaging in Cardiovascular Prevention
Cohort studies have provided robust data on cardiovascular risk factors, forming the basis for predictive models like the Pooled Cohort Equations and PREVENT. Clinical trials confirm that treating these risk factors effectively reduces cardiovascular events. Over the past 50 years, age-adjusted mortality from acute myocardial infarction has dropped by 89%, reflecting major progress. To advance fu
Improving Cardiovascular Clinical Competencies Menopausal Transition
The menopause transition marks a pivotal period of cardiometabolic change that significantly elevates cardiovascular (CV) risk in women. Despite its clinical importance, this phase remains underrecognized in CV risk assessment, contributing to a profound knowledge gap. Enhancing clinician education and fostering multidisciplinary collaboration are essential to delivering individualized care that
Behind the 2025 ACC/AHA Acute Coronary Syndrome Guideline
The 2025 ACC/AHA Acute Coronary Syndrome guideline is the first major update since 2013, incorporating a decade of new evidence and clinical insights. The writing committee stayed on track and on time, reaching consensus on key recommendations, including checklist-based Class I and II interventions before discharge. They thoughtfully addressed legacy practices and controversial studies to ensure
Top Takeaways From the 2025 ACC/AHA Acute Coronary Syndrome Guideline
The 2025 ACC/AHA Acute Coronary Syndrome (ACS) Guideline clarifies diagnostic distinctions using electrocardiogram changes, troponin levels, and imaging tools such as coronary CT angiography and echocardiography in the emergency setting. Updates in lipid-lowering strategies and antiplatelet therapy reflect a more personalized approach to risk reduction and long-term care. These recommendations ai
Risk vs. Benefit in Chronic Total Occlusion Revascularization
Chronic Total Occlusion Percutaneous Coronary Intervention (CTO PCI) is a procedure used to open coronary arteries that have been completely blocked for an extended period. It offers benefits like reduced angina and improved quality of life but carries risks such as vessel injury, heart attack, and procedural failure. Before considering CTO PCI, physicians typically optimize patients on anti-angi
LAAO vs. DOAC for Stroke Prevention in AFib
While blood thinners like warfarin and direct oral anticoagulants (DOACs) remain the standard for stroke prophylaxis, left atrial appendage occlusion (LAAO) devices offer a non-pharmacologic alternative for patients at high bleeding risk. Recent trials have shown that LAAO can be as effective as anticoagulants in preventing stroke and may be a viable option, especially for patients who cannot tol
Why Are They Still Dyspneic? Post PE Syndrome Workup and Management
Persistent symptoms after an acute pulmonary embolism (PE) may indicate post-pulmonary embolism syndrome (PPES), a condition affecting up to 50% of patients. The most important consideration in managing PPES is to carefully evaluate and differentiate it from other potential causes of ongoing shortness of breath, particularly chronic thromboembolic pulmonary hypertension (CTEPH), which requires ta
Palliative Care Across the Spectrum of Biological Age in Heart Failure
Palliative care supports heart failure patients by guiding complex medical decisions, managing symptoms, and enhancing quality of life. Despite being a guideline-recommended therapy, it remains underused—referrals are 45% lower for heart failure patients than for cancer patients with similar prognoses. Collaboration between cardiology and palliative care teams ensures that patients and caregivers
ACCEL Lite: Hypertension Diagnosis and Management: Renal Denervation and Newer Agents on the Horizon
Recent clinical trials demonstrate that intensive blood pressure lowering—targeting systolic levels below 120 mm Hg—can significantly reduce cardiovascular events and mortality, even among older adults, individuals with diabetes, and those with chronic kidney disease. This challenges the long-standing belief that looser blood pressure targets are safer for older patients, showing instead that wit
What's the Best Time to Revascularize the Non-culprit Lesions in MVD
Rapid emergency medical services transport to a percutaneous coronary intervention (PCI)-capable hospital is critical for timely intervention and management of life-threatening arrhythmias in ST-elevation myocardial infarction patients. Upon emergency room arrival, immediate transfer to the cath lab is essential to restore perfusion and improve both short- and long-term cardiovascular outcomes, a
Putting it All Together: Cardiogenic Shock Management in 2025
Cardiogenic shock remains a critical, time-sensitive emergency with a high mortality rate. However, recent advances—particularly multidisciplinary, team-based strategies—have shown promise in improving patient outcomes. With the release of the 2025 ACC Concise Clinical Guidance on Cardiogenic Shock, clinicians now have access to a streamlined, evidence-informed roadmap for early recognition, rap
Hemodynamic Assessment for Diagnosis and Treatment Selection in HFpEF
Heart failure arises when the heart is unable to pump or fill with blood effectively. In the cardiac catheterization lab, we have the unique ability to directly measure the physiological abnormalities underlying this condition, making it the gold standard for diagnosing heart failure. While not every patient requires heart catheterization, it is often essential for those with heart failure with p
Primary Results From the SOUL Randomized Trial
The SOUL trial demonstrated that in patients with type 2 diabetes (T2DM) and established atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD), or both, treatment with oral semaglutide significantly reduced the risk of major adverse cardiovascular events (MACE) compared to placebo—without an increase in serious adverse events. These findings position oral semaglutide as a c
Clopidogrel Versus Aspirin For Long-term Maintenance Monotherapy In Patients With High Ischemic Risk After PCI
The SMART-CHOICE 3 trial demonstrated that clopidogrel monotherapy is more effective than aspirin monotherapy in reducing the risk of major adverse cardiac and cerebrovascular events in high-risk patients who completed standard dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI). Despite concerns that more potent antiplatelet agents may increase bleeding risk, the
Dapagliflozin in Patients Undergoing Transcatheter Aortic Valve Implantation
The DapaTAVI trial, conducted across 39 centers in Spain, is the first study to evaluate the use of sodium-glucose co-transporter-2 (SGLT-2) inhibitors, specifically dapagliflozin, in patients with heart failure undergoing transcatheter aortic valve implantation (TAVI). The trial found that patients who received dapagliflozin (10 mg daily) within 14 days of hospital discharge after TAVI experien
PRAGUE-25 Trial: Catheter Ablation Versus Antiarrhythmic Drugs With Risk Factor Modification for Treatment of AF
The PRAGUE-25 study evaluated the effectiveness of two treatment strategies in patients with both atrial fibrillation (AF) and obesity: catheter ablation versus lifestyle modification (including weight loss and increased physical activity) combined with antiarrhythmic drug therapy. While motivated patients who adhered to lifestyle changes experienced a reduction in AF episodes, the study found t
Lifetime Benefit by Control of Modifiable Risk Factors
A Global Cardiovascular Risk Consortium study of nearly 2 million people worldwide found that avoiding five modifiable risk factors—hypertension, hyperlipidemia, abnormal weight, diabetes, and smoking—by age 50 added over a decade of life expectancy for both sexes. Midlife control of systolic blood pressure and smoking yielded the greatest global gains. In this interview, Drs. Roger S. Blument
ZENITH Phase 3 Trial: Sotatercept in Pulmonary Arterial Hypertension With High Mortality Risk
The ZENITH trial evaluated sotatercept, an activin signaling inhibitor, in patients with advanced pulmonary arterial hypertension (PAH) at high risk of death. Sotatercept met its primary endpoint—time to first morbidity or mortality event—prompting an independent data monitoring committee to recommend early trial termination and offer the drug to all participants. In this interview, Drs. All
Cardiac Arrest During Long-Distance Running Races: 2010-2023
The "Cardiac Arrest During Long-Distance Running Races: 2010–2023" study analyzed the incidence and outcomes of sudden cardiac arrests (SCAs) occurring during marathons and half-marathons in the United States. Known as the RACER2 study, it serves as a follow-up to the original RACER1 study, which covered the years 2000–2009. In this episode, Drs. Jonathan H. Kim and Aaron L. Baggish discusse
WARRIOR Trial: Outcomes to Reduce Events in Non-Obstructive Coronary Artery Disease
Funded by the Congressionally Directed Medical Research Programs (CDMRP) of the Department of Defense, the WARRIOR (Women's IschemiA TRial to Reduce events In non-ObstRuctive CAD) Trial addresses the urgent need for evidence-based care in a growing population of patients—particularly women—experiencing ischemia without obstructive coronary artery disease (INOCA). This clinical strategy t
STRIDE Trial: Effects of Semaglutide in Patients With Peripheral Artery Disease
Patients with peripheral artery disease (PAD) often experience significant walking difficulties, and there are limited therapies available to improve their mobility. Investigation made through the STRIDE (Effects of Semaglutide on Functional Capacity in Patients With Type 2 Diabetes and Peripheral Arterial Disease) trial focused on semaglutide, a drug known for promoting weight loss, reducing inf
Evolut Low-Risk Trial: 5-year Data Outcomes
Transcatheter aortic valve replacement (TAVR) has emerged as the preferred treatment for aortic stenosis. However, there is a lack of long-term outcome data for low-risk patients. The 5-year results from the Evolut Low-Risk randomized trial address this gap, offering compelling evidence with no significant negative signals regarding TAVR's clinical outcomes and valve performance. In this episo
FRESH-UP Study: Liberal Fluid Intake Versus Fluid Restriction in Chronic Heart Failure
Fluid restriction is often recommended for heart failure (HF) patients to prevent congestion, but its benefits and safety are unclear. The FRESH-UP study is the first to show that strict fluid restriction does not improve health status for chronic, symptomatic HF patients and may increase thirst distress without reducing mortality, hospitalization, acute kidney injury, or medication needs. In
Chronic Thromboembolic Pulmonary Hypertension (CTEPH): Procedures or Pills?
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare and potentially fatal form of elevated blood pressure in the lungs. CTEPH treatment overall is a very complex clinical assessment and medical decision. Treatment options may include pulmonary thromboendarterectomy (PTE) surgery, balloon pulmonary angioplasty (BPA), or medical therapy. In this interview, Drs. Shashank Sinha a
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