ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research

In this interview, Deepak L Bhatt, MD, MPH, MBA, FACC, and Alison L. Bailey, MD FACC, discuss the Top Interventional Takeaways from 2024. Dr. Bhatt discusses the CLEAR SYNERGY, DanGer Shock, EARLY TAVR trials and more.   Jolly SS, d’Entremont MA, Lee SF, et al., for the CLEAR Investigators. Colchicine in Acute Myocardial Infarction. N Engl J Med 2024;Nov 17:[Epub ahead of print].  Møller JE, Engstrøm T, Jensen LO, et al., on behalf of the DanGer Shock Investigators. Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock. N Engl J Med 2024;390:1382-93.  Généreux P, Schwartz A, Oldemeyer JB, et al., for the EARLY TAVR Trial Investigators. Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis. N Engl J Med 2024;Oct 28:[Epub ahead of print].  Erriquez A, Campo G, Guiducci V, et al. QFR for the Revascularization of Nonculprit Vessels in MI Patients: Insights From the FIRE Trial. JACC Cardiovasc Interv 2024;17:1425-36.  Généreux P, Banovic M, Kang K-H, et al. Aortic valve replacement vs clinical surveillance in asymptomatic severe aortic stenosis: a systematic review and meta-analysis. J Am Coll Cardiol 2024;Nov 26:[ePub ahead of print].    Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL 

In this interview, Thomas H. Marwick, MD, PhD, FACC, and Alison L. Bailey, MD FACC, discuss the Top Takeaways from 2024 in Cardiovascular (CV) Imaging. Dr. Marwick discusses the SCOT-HEART trial, patient-echo reports augmented by AI, tricuspid valve regurgitation, and more.    Dahl JS, Julakanti R, Ali M, Scott CS, Padang R, Pellikka PA. Cardiac damage in early aortic stenosis: is the valve to blame? JACC Cardiovasc Imaging 2024;17:1031-1040.   Kolossvary M, Lin A, Kwiecinski J, et al. Coronary plaque radiomic phenotypes predict fatal or nonfatal myocardial infarction: analysis of the SCOT-HEART trial. JACC Cardiovasc Imaging 2024;Oct 30:[ePub ahead of print].   Naser JA, Harada T, Tada A, et al. Prevalence, incidence, and outcomes of diastolic dysfunction in isolated tricuspid regurgitation: perhaps not really "isolated"? JACC Cardiovasc Imaging 2024;Jul 24:[ePub ahead of print].   Spartera M, Stracquadanio A, Pessoa-Amorim G et al. Reduced left atrial rotational flow is independently associated with embolic brain infarcts. JACC Cardiovasc Imaging 2023;16:1149-59.  Martin JA, Hill T, Saric M, et al. Evaluating patient-oriented echocardiogram reports augmented by artificial intelligence. JACC Cardiovasc Imaging 2024;17:1381-83.  Sayed A, Al-Mallah M. Geographic proximity to cardiac positron emission tomography facilities across the United States. JACC Cardiovasc Imaging 2024;Aug 18:[ePub ahead of print].    Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL   

Disparities in health care disproportionally impact under-resourced and minority communities resulting in excess mortality and morbidity. Decreasing and eliminating these disparities will improve health statistics for all. The American College of Cardiology's (ACC) Health Equity Task Force is demonstrating its commitment to health equity through championing the improvement of patients’ lived experiences, population health, and clinician well-being while reducing health care costs—the Quadruple Aim of Health Equity.   In this interview, Drs. Richard Chazal and Paul Douglass discuss Achieving Equitable Cardiovascular Care for All: ACC Board of Trustees Health Equity Task Force Action Plan.     Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL 

Medical therapy is critical in preventing the worst complications of peripheral artery disease (PAD), among them heart attack, stroke, bleeding risk, and leg disease, which could lead to acute limb ischemia and amputation. Blood thinning medications (antithrombotic therapy) have shown rapid evolution and broad benefits and novel approved strategies that improve outcomes are available. It is imperative that clinicians select appropriate patients for use and consider the complex situations for management.  In this interview, Drs. Cindy Grines and Marc Bonaca discuss Antithrombotic Strategies for Patients with Peripheral Artery Disease: JACC Scientific Statement.  Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL 

Discover how AI is reshaping cardiovascular care, enhancing diagnostics and treatment strategies. Experts discuss the rapid rise of AI technologies in medicine and the challenges of their integration. Learn about innovative tools like AI ECG that aim to bridge healthcare disparities, especially in underserved areas. The conversation also covers the transformative impact of these advancements on patient outcomes, emphasizing the importance of trust and regulatory frameworks for successful AI deployment in clinical settings.

Can algorithms improve the management of patients with myocardial injury? Is there a tool to aid diagnosing patients faster and more accurately leading to appropriate treatment sooner to optimize results? This study highlights the challenges and opportunities associated with the integration of artificial intelligence (AI) into health care to improve outcomes.    In this interview, Drs. Allen Taylor and Derek Chew discuss the findings of the RAPIDxAI trial: re-engineering the clinical approach to suspected cardiac chest pain assessment in the emergency department by expediting evidence to practice using AI.   Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL 

Recent trials have clarified that the timing of antihypertensive medication—whether morning or evening—has no significant impact on major cardiovascular events. Drs. DeMaria and Garrison discuss the unique challenges faced by general and frail populations in clinical trials. They emphasize the importance of medication adherence over timing and how individual patient preferences should shape dosing schedules. Additionally, the role of circadian rhythms in blood pressure management is explored, indicating that personalizing treatment may yield better outcomes.

The BedMed and BedMed-Frail trials assisted in providing clarity as to the daily timing of prescribed blood pressure medication. The two trials, one conducted in a general primary-care population and the other among nursing-home residents, determined no difference in major cardiovascular events or safety between blood pressure (BP) medication distribution in the evening or morning.    In this interview, Drs. Anthony DeMaria and Scott Garrison review the BedMed and BedMed-Frail trials findings which proved the emphasis to patients is taking BP medication when they are least likely to forget, irrelevant of time of day.   References:  Pigazzani F, Dyar KA, Morant SV, et al. Effect of timed dosing of usual antihypertensives according to patient chronotype on cardiovascular outcomes: the Chronotype sub-study cohort of the Treatment in Morning versus Evening (TIME) study. EClinicalMedicine 2024;72:102633.   Mackenzie IS, Rogers A, Poulter NR, et al. Cardiovascular outcomes in adults with hypertension with evening versus morning dosing of usual antihypertensives in the UK (TIME study): a prospective, randomised, open-label, blinded-endpoint clinical trial. Lancet 2022;400:1417-25.   Hermida RC, Crespo JJ, Dominguez-Sardina M, et al. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. Eur Heart J 2020;41:4565-76.   Hermida RC, Ayala DE, Fernandez JR, et al. Administration-time differences in effects of hypertension medications on ambulatory blood pressure regulation. Chronobiol Int 2013;30:280-314.   Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL 

The goal of the TIGHT K trial was to evaluate if prescribing relaxed control of potassium levels and only giving supplements in the rare event that levels became pathologically low was equally as effective in preventing atrial fibrillation (AFib) after cardiac surgery as tightly controlling levels.     In this interview, Drs. Steven Nissen and Benjamin O’Brien discuss the TIGHT K trial results which proved that practitioners can safely cease the widespread practice of maintaining high-normal potassium levels after isolated coronary artery bypass grafting surgery. Additional benefits include improved tpatient experience and reduced patient cost.  References:  O’Brien B, Campbell NG, Allen E, et al; TIGHT K Investigators. Potassium supplementation and prevention of atrial fibrillation after cardiac surgery: the TIGHT K randomized clinical trial. JAMA 2024;332:979-88.  Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL 

The goal of the SENIOR RITA trial was to evaluate routine invasive therapy compared with conservative therapy among older patients with non–ST-elevation myocardial infarction. Additionally, the trial assessed whether optimal medical therapy or coronary angiography and stents are beneficial in older adults with heart attacks.  In this interview, Drs. Nanette Kass Wenger and Vijay Kunadian discuss the SENIOR RITA trial results and the importance of individualizing routine invasive therapy in individuals ≥75 years of age.    References:  Kunadian V, Mossop H, Shields C, et al., for the British Heart Foundation SENIOR-RITA Trial Team and Investigators. Invasive Treatment Strategy for Older Patients With Myocardial Infarction. N Engl J Med 2024;Sep 1:[Epub ahead of print].  Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL