Published by American College of Cardiology
The American College of Cardiology offers select interviews and summaries of cardiology's most interesting research areas from ACCEL's renowned library, hosted by ACCEL Editor-in-Chief Alison L. Bailey, MD, FACC, FAACPVR.
Listen on Apple Podcasts10 min
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. Together, these innovations strengthen echocardiography's foundational role in heart disease management by improving accuracy, consistency, and overall patient outcomes. In this interview, Steven E. Nissen MD, MACC David H. Wiener, MD, FACC discuss practice-changing advancements in echocardiography.
11 min
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 diet quality, and reduce hospitalizations and costs. Together, prescribing food as part of care highlights a scalable strategy to improve individual health and drive meaningful public health impact. In this interview, Matthew W. Martinez MD, FACC and Laurence S. Sperling, MD, FACC discuss " Prescribing Meals, Not Just M eds: The C ase F or M edically T ailored M eals ".
9 min
The detection of subclinical, or "silent," atrial fibrillation (AF ib ) 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 AF ib burden—such as duration identified on device interrogation—at which anticoagulation should be considered. Additionally, clinicians should consider when consumer wearable rhythm monitoring is appropriate , such as in patients with symptoms or elevated stroke risk. Best practices are needed to guide counseling and management of patients with subclinical AF ib , including when to initiate stroke and systemic embolism prevention strategies. In this interview, W. Douglas Weaver MD, MACC and Deepak Bhakta, MD, MBA, FACC discuss m anag ing s ubclinical AFib d etected by d evices, a mbulatory m onitors and w earables .
10 min
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 CV death, myocardial infarction, and stroke. A current analysis expands these findings by examining a wider spectrum of adverse events to further characterize the comparative cardiorenal effects of tirzepatide. In this interview, Matthew Martinez, MD, FACC and Steven E. Niss en , MD, MACC examine the SURPASS-CVOT Randomized Clinical Trial .
13 min
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 treatment approach that combines pharmacotherapy with lifestyle modifications, which together are associated with improved patient outcomes. The trial aims to inform more effective, evidence-based care for individuals experiencing persistent autonomic dysfunction following COVID-19. In this interview, Thomas F. Deering, MD, FACC and Pam Taub, MD, FACC discuss t he Recover-Autonomic Trial .
6 min
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 availability, and well-established safety profile, making it highly accessible in diverse care settings. By initiating anticoagulation early, this approach aims to support reperfusion without introducing additional harm. Given these benefits, it has strong potential for translation into routine clinical practice, particularly in systems focused on rapid, prehospital STEMI care. In this interview, Kim Allan Williams Sr., MD, MACC and Misa Fister, MD, PhD examine ' Prehospital Heparin Administration In Patients With STEMI Undergoing Primary PCI '.
13 min
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. A growing body of randomized clinical trials demonstrates that treating ID, particularly with intravenous iron, improves symptoms, exercise capacity, and quality of life, with emerging evidence for reductions in HF hospitalizations. In this interview, Clyde W. Yancy MD, MACC and Robert J. Mentz, MD, FACC examine d efinitions and t reatment of ID in H F.
11 min
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 balance the potential cardiovascular risks of intense exercise with its well-established benefits for health, performance, and quality of life. In this interview, Alison L. Bailey, MD, FACC and Aaron Baggish , MD , FACC examine the latest sports cardiology guidelines .
12 min
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 pulmonary vascular disease was most biologically relevant. Given that CpcPH ‑ HFpEF —including valvular ‑ associated HFpEF—is underdiagnosed, associated with worse prognosis, and has no approved therapies, these findings suggest potential broader applicability pending further study. In this interview, Clyde W. Yancy MD, MACC and Mardi Gomberg-Maitland, MD, MSc, FACC discuss the CADENCE Trial (Efficacy And Safety Of Sotatercept In Combined Post- a nd Pre-capillary Pulmonary Hypertension Associated With Heart Failure With Preserved Ejection Fraction).
12 min
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 angina symptoms compared with placebo. These findings provide strong evidence that CTO PCI can effectively reduce anginal pain and improve quality of life for patients with chronic total occlusions. In this interview, Allen J. Taylor, MD, FACC and John Davies, MBBS, PhD evaluate the ORBITA-CTO Trial.
16 min
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 mm Hg, a clinically meaningful improvement. The program showed high acceptability and sustainability potential, with participants asking, "When does Phase 2 start?" By integrating produce prescriptions, personalized dietitian coaching, weekly adaptive messaging, and community resource navigation, THRIVE improved dietary quality, nutrition security, and blood pressure outcomes. In this episode, Alison L. Bailey, MD, FACC and Bunmi Ogungbe , BSN, MPH, PhD discus s "THRIVE Food is Medicine Pilot Trial: Addressing Hypertension through Produce Prescriptions ".
10 min
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 universal CRP screening. Despite advances such as interleukin ‑ 6–targeted therapies, implementation remains limited, as clinicians are unlikely to treat what they do not routinely measure. Addressing current gaps in inflammatory risk assessment presents both a challenge and an opportunity to better personalize CVD prevention and treatment strategies. In this interview, W. Douglas Weaver MD, MACC and Paul M. Ridker, MD, MPH, FACC discuss Inflammation in CVD: A 2025 ACC Scientific Statement .
11 min
Should statin therapy be routinely initiated in middle ‑ aged adults with at least one a therosclerotic 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 adults with low 10–30 ‑ year risk, the role of additional risk stratification tools—such as hsCRP and coronary artery calcium scoring—becomes critical in guiding individualized decisions about when to begin lipid-lowering pharmacotherapy. In this interview, William E. Boden MD, FACC and Roger S. Blumenthal, MD, FACC discuss ' Lower LDL-C for Longer? Defining the Optimal Timing and Intensity of Rx '.
12 min
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, harmonization with the ESC/EAS guidelines reinforces a unified approach to prevention. Overall, the message is to keep prevention simple — start with accurate risk assessment and prioritize blood pressure and lipid management, beginning with optimization of diet and physical activity. In this interview, Kim All a n Williams, Sr., MD, MACC and Roger S. Blumenthal, MD, FACC discuss key takeaways from the 2026 Dyslipidemia Guideline .
10 min
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 insight into more integrated approaches to care and consider why this clinically important connection has only recently gained broader attention. In this interview, Richard A. Chazal MD, MACC and Vishal N. Rao, MD, MPH examine the interconnectedness of cardiovascular (CV) and hepatic risk.
14 min
Cardiovascular-Kidney-Metabolic (CKM) syndrome encompasses a spectrum of interconnected car d iovascular, kidney, and metabolic conditions that progress through defined stages. A five-stage CKM treatment framework emphasizes t imely identification of risk factors, structured and personalized risk discussions, and early, interdisciplinary intervention. By targeting obesity, diabetes, and chronic kidney disease, this approach supports comprehensive risk reduction and improved long-term cardiometabolic outcomes . I n this interview, Alison L. Bailey , MD, FACC and Chiadi E . Ndumele , MD, PhD discuss Addressing Cardiovascular-Kidney-Metabolic S yndrome Health.
11 min
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 for sotat ercept when used early in the disease course. Pooled analyses across trials further suggest that sotatercept may have a meaningful impact on mortality in patients with PAH. In this interview, Mary Norine Walsh MD, MACC and Vallerie V. McLaughlin, MD, FACC discuss the phase 3 HYPERION trial .
11 min
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 caffeinated coffee—and that it may even help lower their risk of future episodes. In this interview, Matthew W. Martinez MD, FACC and Gregory M. Marcus, MD, FACC discuss the ' D oes Eliminating Coffee Avoid Fibrillation ( DECAF) ' Trial .
13 min
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, enhanced risk ‑ stratification approaches, and clearer direction for individualized patient care. Looking ahead, the guideline underscores a forward ‑ thinking approach that integrates emerging research to support more proactive hypertension management. In this interview, Clyde W. Yancy MD, MACC and Daniel W. Jones, MD discuss the 2025 AHA/ACC High Blood Pressure Guideline .
12 min
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 blood pressure, glucose, and inflammation—can simultaneously lower the risk of heart disease and slow kidney decline. Newer treatments now allow clinicians to address both organs together, improving long ‑ term health outcomes. I n this interview, Allen J. Taylor, MD, FACC and Janani Rangaswami, MD examine " Cardiovascular - Kidney Therapies in CKD " .