New in Clinical Documents ACC Releases Updated Core Cardiovascular Training Statement The latest iteration of the Core Cardiovascular Training Statement (COCATS 4), issued March 13 by the ACC, updates the training recommendations for cardiovascular fellows. This is the first time that the full core competencies expected of clinical cardiologists have been defined. With a focus on outcomes assessment, COCATS 4 utilizes defined evaluation tools to assess communication, professionalism, practicebased training and systems-based practice - competencies beyond knowledge and skills. The six competency domains were developed by the Accreditation Council for Graduate Medical Education and endorsed by the American Board of Internal Medicine and the American Board of Medical Specialties. The competencies are aimed at formalizing the processes that define cardiovascular fellow programs, which in turn will better prepare these specialists to meet the future needs of patients and society. While the document does address the knowledge and skills all cardiologists should possess, it also aligns additional competencies with the career focus of each fellow. According to Eric S. Williams, MD, MACC, co-chair of the document, as well as a member of the COCATS 4 steering committee, "recommendations in the statement are aimed at training program directors, faculty and trainees in our cardiovascular disease fellowship programs. But as the competencies defined in COCATS 4 are also aligned with those of Lifelong Learning for practicing cardiologists, the impact extends across the spectrum of our profession and is part of the foundational structure of the educational activities of the ACC." Valentin Fuster, MD, PhD, MACC, editor-in-chief of the Journal of the American College of Cardiology, also a member of the steering committee, added that "in specific terms, the COCATS 4 document emphasizes training in ambulatory, consultative and longitudinal cardiovascular care. Furthermore, it more generally emphasizes comprehensively training our cardiology fellows to be the best, most well-rounded doctors, which is critical to the future of their careers, clinical cardiac care, the health of our patients and the advancement of our field of cardiovascular medicine." New Training Guidelines For Pediatric Cardiology Fellowship Programs Released New training guidelines for pediatric cardiology fellowship programs were released March 13 by the ACC, the American Academy of Pediatrics, the American Heart Association and the Society of Pediatric Cardiology Training Program Directors. In addition to now fulfilling the Accreditation Council for Graduate Medical Education's new criteria for training programs, the revised training guidelines make updates to task forces and include recommendations for advanced training within sections. The new task force on pulmonary hypertension, advanced heart failure and transplantation joins the previously established task force chapters on general pediatric cardiology, noninvasive imaging, cardiac catheterization, electrophysiology, critical care, adult congenital heart disease and research. The report identifies the core competencies required of all pediatric cardiology fellows to complete training. New Statement on the Treatment of HTN in Patients With CAD Patients with hypertension and vascular diseases should aim for a blood pressure target of less than 140/90 mm Hg to prevent myocardial infarction (MI) and stroke, according to a new scientific statement released March 31 by the ACC, American Heart Association and American Society of Hypertension, and simultaneously published in the Journal of the American College of Cardiology. The statement, which is an update to the 2007 "Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease," addresses the prevention of cardiovascular events and sets blood pressure goals for patients with hypertension and coronary artery disease (CAD). It notes that for those patients who have already experienced a stroke, MI or transient ischemic attack, or those who have other cardiovascular conditions, a blood pressure target of less than 130/80 mm Hg may be more appropriate. The statement further explains that blood pressure lowering can and should be done safely. Most patients will not encounter problems with standard medications, such as a beta-blocker by itself or in combination with another drug. However, clinicians should exercise caution in treating patients with coronary artery blockages and hypertension, lowering blood pressure slowly over time. The statement advises that these patients not lower their diastolic blood pressure to less than 60 mm Hg, especially if the patient is more than 60 years old. Based on evidence from clinical trials and research, the statement makes specific anti-hypertensive medication recommendations for patients with various types of cardiovascular disease. New Statement Recommends tPVR as Less Invasive Option For RVOT Dysfunction in CHD Patients Pulmonary valve replacement may be necessary in patients who have had certain types of congenital heart disease (CHD) repaired with reconstruction of the right ventricular outfl ow tract (RVOT), according to an expert consensus statement released March 24 by the ACC, Society for Cardiovascular Angiography and Interventions (SCAI), American Association for Thoracic Surgery (AATS) and The Society of Thoracic Surgeons (STS). The statement, "SCAI/ AATS/ACC/ STS Operator and Institutional Requirements for Transcatheter Valve Repair and Replacement, Part III: Pulmonic Valve," provides recommendations to guide transcatheter pulmonic valve replacement (tPVR) for children and adults with CHD. New Statement on Use of Percutaneous MCS Devices For HF Released A new expert consensus statement provides new guidance for physicians in matching new percutaneous mechanical circulatory system (MCS) devices to patients for the treatment of heart failure. The statement, released by the ACC, the Society for Cardiovascular Angiography and Interventions, the Heart Failure Society of America and The Society of Thoracic Surgeons, was simultaneously published in the Journal of the American College of Cardiology. According to the statement, percutaneous MCS provides superior hemodynamic support compared to medical therapy. MCS can also be beneficial to high-risk percutaneous coronary intervention patients and certain patients with acute decompensated heart failure with worsening symptoms. Patients in cardiogenic shock may also benefit from early MCS placement when initial interventions do not stabilize the patient. Finally, MCS can also be used in patients who failed to wean off cardio-pulmonary bypass. The statement reports that, "there are insufficient data to support or refute the notion that routine use of MCS as an adjunct to primary revascularization in the setting of large acute myocardial infarction is useful in reducing reperfusion injury or infarct size." 2014 Million Hearts Hypertension Control Champions In February, the U.S. Health and Human Services' Million Hearts Initiative recognized Arsalan Tariq Shirwany, MBBS, FACC; Daniel E. Otten, MD, FACC; Holger P. Salazar, MD, FACC; and Jennifer S. Morrow, MD, FACC - all from the Stern Cardiovascular Foundation in Germantown, TN - as Hypertension Control Champions for their success in helping patients control high blood pressure. According to Million Hearts, the 30 Hypertension Control Champions for 2014 include private and tribal clinical practices and health services, ranging from solo practitioners to large systems and representing both urban and rural areas. Each Champion was able to achieve hypertension control rates of 70 percent or more. Get the Updated JACC Journals App The latest research and clinical practice updates in cardiology are at your fingertips with the JACC Journals app. The app allows user to browse all of the JACC Journals, jump to featured articles, interact with multimedia content, personalize their experience with a reading list function, save articles for offl ine reading, share articles via social media (use #JACC to join the conversation), email useful content, and much more. Download the app in the Apple iTunes and Google Play stores. Also check out a complete list of ACC's mobile resources at ACC.org/Apps. Stronger Hearts Helpline The National Forum for Heart Disease and Stroke Prevention launched the Stronger Hearts™ Helpline in February for residents of San Bernardino County, CA, with heart failure. The helpline is a 24/7 free, bilingual call center that includes referrals to medical professionals, clinics and services like nutrition advice, educational information about heart failure and treatment, and transportation to doctor's appointments and clinics. The Stronger Hearts Helpline was created with the help of the steering committee, including Clyde Yancy, MD, MACC; Inderjit Anand, MD, FACC; Keith Ferdinand, MD, FACC; Gregg C. Fonarow, MD, FACC; Steven Manoukian, MD, FACC; Frank W. Smart, MD, FACC; and Paul Underwood, MD, FACC. This initiative adds to the county's existing 2-1-1 helpline, which is a resource for health and community information. San Bernardino County currently has the secondhighest rate of heart failure treatment in California. Residents can access the hotline by dialing 2-1-1 or 888-435-7565. Notable News Michael K. Schroyer, RN, MSN, MBA, AACC Appointed to Hospital Outpatient Payment Panel Michael K. Schroyer, RN, MSN, MBA, AACC, has been appointed to the U. S. Department of Health and Human Services (HHS)/ Centers for Medicare and Medicaid Services (CMS) Advisory Panel on Hospital Outpatient Payment for a four-year term, which began in January 2015. The panel advises HHS and CMS on the clinical integrity of the ambulatory payment classification groups and weights, and the supervision of hospital outpatient services. Schroyer currently serves as the chief operating officer and chief nursing officer of St. Vincent Heart Center of Indiana. Brian Keeffe, MD, FACC Receives Microsoft's Health Innovation Award Brian Keeffe, MD, FACC, has been named as a recipient of one of Microsoft Corp.'s 2015 Health Innovation Awards. The awards recognize the innovative use in the clinical setting of Microsoft devices and services which enhance the quality of patient care, improve clinician productivity and electronic medical record optimization, and streamline clinical and business processes. Keeffe is a physician adviser in the development of software maker Allscripts electronic health record for use on mobile devices. LINK TO VIDEO > Spencer B. King III, MD, MACC, Receives Lifetime Achievement Awards In February, Spencer B. King III, MD, MACC, past president of the ACC, received a Lifetime Achievement Award during IndiaLive in Chennai, India. King also received the Master Operator Award during TCTAsia in April, and received the Lifetime Achievement Award during TCTAsia last year. In Memoriam: Kanu Chatterjee, MBBS, FACC Kanu Chatterjee, MBBS, FACC, passed away on March 4. Born and educated in India, Chatterjee received his medical degree from the Royal College of Physicians in London in 1965. He served as the director of inpatient cardiology at Cedars-Sinai Medical Center in Los Angles until 1975, when he moved to the University of California in San Francisco for research. Since 2009, Chatterjee and his wife have lived in Iowa, where he joined the faculty of the University of Iowa, as both teacher and mentor. Chatterjee posthumously received the ACC Presidential Honor for Excellence in Cardiology during the ACC.15 Convocation. He was also the recipient of the Gifted Teacher Award from the ACC, the Lifetime Achievement Award of the Heart Failure Society of America, and the James Herrick Award - the highest honor in clinical cardiology available from the American Heart Association. Chatterjee is remembered for his great impact on modern cardiology, as well as for being an outstanding teacher, friend, colleague and mentor. LINK TO ACC IN TOUCH BLOG POST > Robert Roberts, MD, MACC, Appointed to COR Medical Technologies Senior Editorial Board In March, Robert Roberts, MD, MACC, was appointed to the COR Medical Technologies Senior Editorial Board. In his position on the editorial board, Roberts will assist in the review of current medical research and best practice treatments in order to provide instant decision support from the most current information available to treat cardiovascular conditions. Upon the appointment, he said, "I'm pleased to be part of the COR Senior Editorial Board. I look forward to contributing my expertise and providing essential medical information to decision makers in the field." Roberts is the past president, CEO, and chief scientific officer of the University of Ottawa Heart Institute in Canada. He is also the founder and director of the Ruddy Canadian Cardiovascular Genetics Centre at the Ottawa Heart Institute and retains an adjunct professorship of medicine at Baylor College of Medicine in Houston, TX. In addition to many other accolades, Roberts received the ACC's Distinguished Scientist Award in 1998, and earned the Master of the American College of Cardiology designation in 2007. Nominate Your Next ACC Leaders Submit recommendations for the slate of ACC Officers and Trustees by July 31. Recommendations are invited for the positions of Vice President, President-Elect and Trustees. The Vice President will serve a one-year term and traditionally advances to the office of President-Elect. Each Trustee will serve a five-year term. Officers and Trustees can serve in both organizations for the duration of their terms. The elections will take place at the Annual Business Meeting in April 2016 in Chicago. To learn more about nomination guidelines and see who is on the Nominating Committee, visit ACC.org. A portrait of Alfred A. Bove, MD, PhD, MACC, past president of the ACC, has been dedicated to the Temple University School of Medicine in Philadelphia, PA. The portrait is in honor of Bove’s more than 50 years of service to the medical school, where he is now an emeritus professor. The portrait will hang, along with other distinguished colleagues, in the portrait hall at the medical school. ACC in Touch Follow @ACCinTouch on Twitter for updates on the latest cardiovascular news, including guidelines, hot clinical trials, and studies from the JACC Journals. Interested in guidelines, new studies from the Journal of the American College of Cardiology and updates from the ACC? ‘Like’ the ACC on Facebook to gain access to news, promotions, meeting coverage and more. Recent posts on the ACC in Touch Blog include a blog by Robert Shor, MD, FACC, chair of the Board of Governors, who explores the opportunities that membership to ACC Chapters offers. Others topics include a post honoring the 2015 ACC/ Merck Fellows; a post authored by Christina Salazar, MD, FACC, member of the ACC’s Sports and Exercise Cardiology Section Leadership Council on an Early Career Member perspective of the ACC.15 Sports and Exercise Intensive; and a post authored by Craig J. Beavers, PharmD, AACC, BCPS-AQ Cardiology, CACP, co-chair of the ACC’s Clinical Pharmacist Workgroup, on the role of pharmacists in the care of patients with myocardial infarction. Check out the ACC in Touch Blog for more insights on the latest in cardiology at blog.acc.org.
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