ACC Updates Choosing Wisely Recommendations Applying Clinical Research to Clinical Practice he ACC’s Research to Practice (R2P) initiative identifies impactful cardiovascular research and analyzes its implications for contemporary clinical practice using the College’s NCDR clinical registries. The goal for these analyses is to assist front-line cardiovascular clinicians in applying clinical research insights to their individual patients. Furthermore, these analyses can identify relevant questions in contemporary practice that are unanswered by current clinical T he ACC has released an updated list of “Five Things Physicians and Patients Should Question” in cardiology as part of the Choosing Wisely campaign, led by the ABIM Foundation. The update includes a new recommendation not to “perform routine electrocar-diography (ECG) screening as part of pre-operative or pre-procedural evaluations for asymptomatic patients with low perioperative risk of death or myocardial infarction.” T research data, and thus inform clinical researchers of important questions for future investigation. The R2P initiative was founded in 2015 by Thomas M. Maddox MD, MSc, FACC, with support from NCDR leaders John S. Rumsfeld MD, PhD, FACC, and Frederick A. Masoudi MD, MSPH, FACC. Under the oversight of the R2P committee, chaired by Robert W. Yeh MD, FACC, eight recent cardiovascular clinical studies or evidence covering the spectrum of cardiovascular disease were identified and analyzed using their relevant NCDR clinical registry. Scan the QR code to read more about the R2P initiative in the March issue of Cardiology. PEOPLE ARE COUNTING ON THIS MIDDLE-AGED FATHER OF 3... EFFIENT ® (PRASUGREL) CAN HELP The recommendation states: “Despite potential value in having a pre-operative ECG to identify unsuspected cardiac abnormalities or as a comparison after a perioperative event, the likelihood of benefit for patients at low risk of major cardio-vascular events is very small.” The recommendation notes the absence of scientific studies establishing the value of a pre-operative ECG in low-risk patients and cautions that unnecessary ECGs can lead to needless consults, delays and changes to operative plans, which may counterbalance any potential patient benefits. The new recommendation now brings the total number of ACC recommendations back to five. Following new data showing potential improvements for some patients as a result of complete revascularization, the College in 2014 withdrew the recommen-dation that heart attack patients should have only their culprit artery unblocked and should question whether complete revascularization of all non-culprit lesions should be performed. PROTECT HIM AFTER STEMI-PCI Scan the QR Code to view the ACC’s full list. Learn more at EffientHCP.com ® Effient and the Effient logo are registered trademarks of Eli Lilly and Company. ©Daiichi Sankyo, Inc. and Lilly USA, LLC 09/2016. All Rights Reserved. PGHCPISI03Oct2011 PP-PG-US-1039.