WHAT’S NEW IN CLINICAL DOCUMENTS AUC For Diagnostic Imaging of Patients With Chest Pain Released New recommendations on the appropriate use of diagnostic imaging for patients with chest pain were released Jan. 22 by the ACC, the American College of Radiology and 10 other specialty societies including the Society of Cardiovascular Patient Care, and published in the Journal of the American College of Cardiology. Led by Frank J. Rybicki, MD, PhD; James E. Udelson, MD, FACC; and W. Frank Peacock, MD, co-chairs of the Emergency Department Patients With Chest Pain Writing Panel, two panels of cardiology and radiology specialists reviewed evidencebased medicine, existing guidelines and practice experience to address appropriate use criteria in 20 fundamental clinical scenarios for emergency imaging in patients who present to the emergency department with chest pain. Each recommendation assesses when imaging is useful in a given scenario, as well as what information is provided by the specified imaging procedure. Expert Consensus on LAA Institutional and Operator Requirements Released Recommendations to institutions and interested physicians for the establishment and maintenance of left atrial appendage (LAA) occlusion programs performing LAA closure (LAAC) procedures were released Dec. 10 by the ACC, the Society for Cardiovascular Angiography and Interventions (SCAI), and the Heart Rhythm Society (HRS). The expert consensus paper, “SCAI/ACC/HRS Institutional and Operator Requirements for Left Atrial Appendage Occlusion,” was published in the Journal of the American College of Cardiology. The document recommends that physicians performing LAAC procedures have significant knowledge of atrial fibrillation, including medical management, rate and rhythm control, tools for assessing stroke risk, management Of oral anticoagulant therapy, knowledge of available medications, an understanding of bleeding risks, and knowledge of risks associated with LAAC. Focused Update of ACC/AHA Lipid Performance Measures Stress Shared Decision-Making Updated performance measures for lipid management in secondary prevention were released Dec. 14 by the ACC and American Heart Association (AHA), and were published in the Journal of the American College of Cardiology. The updated measures place a greater emphasis on shared decision-making, and are based on the secondary prevention recommendations of the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. “These measures respect the wishes of patients regarding the use of statins and do not penalize physicians who may have a patient decline to take medications for personal reasons,” says Joseph P. Drozda Jr., MD, FACC, chair of the writing committee. “Integrating patient values, preferences and personal context with evidence-based medicine and guidelines is novel and changes the focus from recommending and prescribing statins based on evidence to promoting choice by an informed patient.” ACC/AHA Releases Statement on Aortic Dilatation in Patients With Bicuspid Aortic Valves A statement of clarification has been issued by the ACC and the American Heart Association (AHA), with endorsement from other societies, regarding differences between two guidelines that address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement. The statement was released Dec. 4 and published in the Journal of the American College of Cardiology. It clarifies differences in the 2010 ACCF/AHA/AATS/ACR/ASA/SCA/ SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients with Thoracic Aortic Disease and the 2014 AHA/ACC Guideline for the Management of Patients with Valvular Heart Disease, which differ in regard to the recommended threshold of aortic root or ascending aortic dilatation that would justify surgical intervention in patients with bicuspid aortic valves. New Recommendations May Allow Some Athletes With CVD to Compete Athletes with irregular heart beat caused by Long QT syndrome and those with an implanted medical device may safely play competitive sports, according to new recommendations from the ACC and American Heart Association (AHA) published Nov. 2 in the Journal of the American College of Cardiology. The recommendations apply only to athletes diagnosed with cardiovascular disease who participate in competitive sports directed by a coach, such as football, basketball, baseball and others. They do not apply to those who occasionally play sports for fun or exercise. Previous recommendations stated that the risk of sudden cardiac death was too high in athletes with Long QT syndrome or with heartbeat disorders treated by an implanted device, but new research indicates that the risk is lower than previously thought. These athletes may now be able to compete with the approval of their health care provider. ACC Sports Council Encourages Exercise For Heart Health Even small amounts of physical activity are associated with a lower risk of cardiovascular disease, but more exercise may lead to an even greater reduction in the risk of death from cardiovascular disease, according to a clinical perspective from the ACC Sports and Exercise Cardiology Leadership Council published Jan. 18 in the Journal of the American College of Cardiology. According to the Council, most people in developed countries should not be concerned by potential harm from exercise but rather by too little exercise. “The public media has embraced the idea that exercise may harm the heart and disseminated this message, thereby diverting attention away from the benefits of exercise as a potent intervention for the primary and secondary prevention of heart disease,” says Michael Scott Emery, MD, FACC, co-chair of the ACC Sports and Exercise Cardiology Council. “The available evidence should prompt clinicians to recommend strongly low and moderate exercise training for the majority of our patients. Equally important are initiatives to promote population health at large through physical activity across the life span, as it modulates behavior from childhood into adult life.” Global Health Experiences Important to Development of New Cardiologists As the global burden of cardiovascular disease continues to increase worldwide, nurturing the development of early career cardiologists interested in global health is essential to create a cadre of providers with the skill set to prevent and treat cardiovascular diseases in international settings, according to a review topic by ACC’s Early Career International Working Group, published Jan. 4 in the Journal of the American College of Cardiology. Although interest in global health has grown among cardiology trainees and early career cardiologists over the past decade, opportunities for international clinical and research experiences abroad have not increased at the same rate. In the review, Marwah Abdalla, MD, MPH, et al., describe the ACC International Cardiovascular Exchange Database, a new resource for cardiologists interested in pursuing short-term clinical exchange opportunities abroad, and report some of the benefits and challenges of global health cardiovascular training. UPDATES FROM THE JACC JOURNALS Interested in engaging more with clinical electrophysiology? Take a deep dive into each issue of JACC: Clinical Electrophysiology with audio commentary from Editor-in-Chief David Wilber, MD, FACC. For the latest developments and state-of-the-art clinical research in basic, translational science, read JACC: Basic to Translational Science, ACC’s first open-access journal, launching Feb. 29. ACC members can access full journal content through the JACC Journals App. Subscribe to JACC: Cardiovascular Interventions – now publishing twice per month – for the latest interventional cardiovascular medicine, including coronary and non-coronary cardiac, peripheral and cerebrovascular interventions. New Updates For ACC’s Clinical Mobile App Collection The ACC has recently expanded the mobile clinical content and decision support tools for clinicians with important additions to its Clinical Mobile App Collection. The new STS/ACC TAVR In-Hospital Mortality Risk App assists clinicians in determining the predicted in-hospital mortality risk of a patient who is considering transcatheter aortic valve replacement. The updated Anticoag- Evaluator App helps clinicians make well-informed decisions on antithrombotic therapy for non-valvular atrial fibrillation patients. In addition to an upgraded look, the app features up-to-date therapy options, renal-specific dosing advice, and expanded web access. Content additions have also been made to the Guideline Clinical App, including the Executive Summary, Key Points to Remember and 19 related tools for the new 2015 Supraventricular Tachycardia Guideline. Find out more and download the apps at ACC.org/Apps. FH Patient Wins ‘I am CardioSmart’ Contest Diagnosed at age two with homozygous familial hypercholesterolemia (FH), Christian Jacobs has spent his entire life beating the odds on his heart health. Now at 24, he’s raising awareness about his condition and challenging the notion that heart disease only affects older people. Because of his inspiring work, he has been named the winner of the annual “I am CardioSmart” contest, which recognizes people living well with heart disease. “It has been my goal to help raise awareness of FH so that others have the fighting chance I’ve had,” says Jacobs. “I want people to realize that some people are born with this genetic condition that increases their risk for early heart disease. There are effective treatments available, and you have the chance to fight it like I have.” Jacobs will be recognized during the CardioSmart Patient Engagement Reception held during ACC.16 in Chicago. To learn more about Jacobs and for additional "I am CardioSmart" patient stories, visit CardioSmart.org. Statin Intolerance App – Named One of the Best 2015 Medical Apps ACC’s Statin Intolerance App, which guides clinicians through the process of managing and treating patients who report muscle symptoms while on statin therapy, was recently recognized by iMedicalApps as one of the top medical apps released in 2015. Clinicians can use the app to evaluate possible intolerance to a patient’s current statin prescription, follow steps to manage and treat a patient who reports muscle symptoms on a statin, and compare statin characteristics and drug interactions to inform management of LDL-related risk. This is the second year in a row that one of ACC’s clinical apps has been recognized. The ASCVD Risk Evaluator App was named one of the best medical apps of 2014. Rumsfeld Named ACC Chief Innovation Officer The ACC has named John S. Rumsfeld, MD, PhD, FACC, as chief innovation officer. Rumsfeld, who has been a member of ACC’s Board of Trustees and chief science officer for the NCDR programs, will be responsible for developing and implementing an innovation strategy for the College. “ACC’s focus on innovation sets us apart as an association,” said ACC Chief Executive Officer Shal Jacobovitz. “Dr. Rumsfeld has played a visionary role in developing the Veterans Administration’s health records and quality management system and in the management of the College’s NCDR, ensuring the registries continue to be relevant and successful in today’s health care environment. We look forward to him bringing this vision and passion to bear on broader ACC efforts to transform care and improve heart health.” ACC Appoints New Annual Scientific Session Vice Chair The ACC has announced the appointment of Andrew M. Kates, MD, FACC, to the position of vice chair of the ACC Annual Scientific Session. Kates will serve as vice chair during ACC.17 and ACC.18, and will assume the chair position for ACC.19 and ACC.20.The position was developed to ensure consistent leadership and allow for continual improvement of ACC's flagship Annual Scientific Session. "Dr. Kates is an exceptional choice for this critical role at the College," says ACC President Kim Allan Williams Sr., MD, FACC. “His long history of working to expand and improve educational opportunities for the cardiovascular community shows a commitment to innovation and excellence that will not only keep the meeting’s mission on course, but also guide it to new heights in the future.” Valentín Fuster, MD, PhD, MACC, Receives Two Prestigious Global Awards Editor-in-Chief of the Journal of the American College of Cardiology, Valentín Fuster, MD, PhD, MACC, has received two prestigious awards: the “Severo Ochoa Award for Biomedical Research” from the Ferrer Research Foundation for his contributions in his career to the understanding and approaches to the atherolclerosis process; and “The Cross of the Civil Order of Health” award from the Spanish Government for his dedication to the development of promoting health programs across the country and elsewhere. The Cross is the highest distinction granted in Spain and is granted to those deemed exceptional in the field of health services. Daniel I. Simon, MD, FACC, New President of University Hospitals Case Medical Center Daniel I. Simon, MD, FACC, has been appointed as the new president of the University Hospitals (UH) Case Medical Center, effective Jan. 1. Prior to assuming this position, Simon served as president of the UH Harrington Heart & Vascular Institute, chief of the division of cardiovascular medicine at the UH Case Medical Center, and professor of medicine at Case Western Reserve University School of Medicine. ACC Launches LAAO Registry to Track Use, Results of New Stroke Prevention Technology in Afib Patients The ACC has launched a new LAAO Registry to capture data on a new class of medical devices used in left atrial appendage occlusion procedures, which will help assess real-world procedural indications and outcomes as well as shortand long-term safety of procedures and devices for closing the left atrial appendage. The registry will serve not only as the formal U.S. Food and Drug Administration-mandated postapproval study for the WATCHMAN device, but it is also expected to serve as a long-term clinical registry for all patients undergoing occlusion of the left atrial appendage, regardless of the device used. ACC Earns ACEhp’s 2016 Award For Outstanding Live CE Activity The ACC has received the Alliance for Continuing Education in the Health Professions’ (ACEhp) 2016 Award for “Outstanding Live Continuing Education Activity” for the Prevention Intensive at ACC.14. This novel educational program offered to ACC Annual Scientific Session attendees was a four-hour deep-dive session into the world of cardiovascular prevention. The “intensive” format was the brainchild of Jeffrey Kuvin, MD, FACC, who is the incoming chair of ACC.17 and ACC.18, and who currently serves as chair of the ACC Lifelong Learning Oversight Committee. Several ACC education staff members who helped design the Prevention Intensive recently accepted the award at the ACEhp Annual Meeting in Washington, DC. The "intensive" format has become a standard feature at the ACC Annual Scientific Session as a place where novel or provocative cardiovascular topics of relevance are covered. ACC IN TOUCH Follow @ACCCardioEd on Twitter for breaking news from ACC’s Annual Scientific Session. Stay up-to-date on the latest news about #ACC16, including featured science and more. In honor of the 65th Annual Scientific Session, share your “throwbacks” each Thursday with the hashtag #TBT and make sure to tag @ACCCardioEd. Interested in receiving immediate updates from the ACC? ‘Like’ ACC’s Facebook page to gain access to news, meeting coverage, special promotions, and more. Recent posts on the ACC in Touch Blog include a blog by Paul Casale, MD, MPH, FACC, on the journey to value-based payment. Others topics include a post authored by Monika Sanghavi, MD, on her perspective as a new mom and new faculty cardiologist, and a post authored Ada Stefanescu, MD, on the responsibility and power of advocacy. Check out the ACC in Touch Blog for more insights on the latest in cardiology. Correction The Fall 2015 issue of Cardiology (page 26) inaccurately stated Pamela Bowe Morris, MD, FACC’s current position with the Medical University of South Carolina. She is an associate professor of medicine. Cardiology regrets the error.
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