New ACC Task Force Focused on Diversity Diversity and inclusion are increasingly recognized as requirements for optimal organizational performance. In medicine, diversity provides opportunities to better serve specific patient populations, promote health equity, bring different views to debates and problem solving, better engage communities, and provide a broad spectrum of mentors and researchers. In a recent leadership page, published in the Journal of the American College of Cardiology, ACC President Mary Norine Walsh, MD, FACC, and former ACC presidents Pamela S. Douglas MD, MACC, and Kim Allan Williams Sr., MD, MACC, expand on the importance of diversity, especially in the field of cardiology where diversity is far less than other medical specialties. To mitigate this trend, the ACC earlier this year formed a Task Force on Diversity, chaired by both Williams and Douglas, charged with ensuring cardiovascular medicine in general, as well as the ACC itself, attracts and provides rewarding careers for the full range of talented individuals in medicine; benefits from diversity of backgrounds, experiences and perspectives in leadership, cardiovascular health care delivery, education and science; and that the diverse needs of cardiovascular patients are met by cardiovascular clinicians sensitive to and respectful of their gender, cultural, racial and ethnic diversity. The group has since identified three broad objectives that were presented in an interim report to the ACC’s Board of Trustees at its recent meeting in August. The objectives: 1) Enhance the culture within the cardiology profession and the perceptions of the field to be more inclusive, professional, equitable and welcoming; 2) Realize and sustain the value of diversity over the long-term by implementing structures and continuous improvement programs within the ACC for accountable execution; 3) Engage and leverage all available talent by providing value to under-represented groups in cardiology across the ‘career life-span’, from ensuring a deep pipeline, to recruitment, retention and leadership development. These objectives will be further refined in the coming months. “With the extraordinary work of the Task Force, the ACC can envision a future College and specialty of cardiology that is more diverse and inclusive thus more able to serve our mission,” write Walsh, Douglas and Williams. In Memoriam: Robert Jesse, MD, FACC Robert (Bob) Jesse, MD, FACC, passed away on Sept. 2. Dr. Jesse, an ACC Fellow, was a member of the ACC Accreditation Management Board, a liaison to the NCDR Management Board and former governor of the ACC’s Virginia Chapter (2006-2009). He was also a founding member of the Society of Chest Pain Centers (now ACC Accreditation Services). Jesse was active with the U.S. Department of Veterans Affairs, having served from 2010-2014 as the Principal Deputy Under Secretary for Health; as the Acting Under Secretary for Health in 2014; and since 2014 as the Chief Academic Affiliations Officer, Veterans Health Administration. Abe Joseph, VP of ACC Accreditation Services, called Jesse “one of the most brilliant cardiologists and a very respected intellect on the Board.” In 2011, he was honored with the Ray Bahr award. Jesse resided in Richmond, VA, with his wife, Janice Jesse, MD. DeMaria Recognized With ESC Gold Medal Anthony DeMaria, MD, MACC, was awarded the European Society of Cardiology’s Gold Medal during the ESC Congress 2017 in Barcelona. The prestigious award recognizes individuals for their outstanding achievements and contributions to the field of cardiology. DeMaria, the youngest-ever ACC president (1988) and past editor-in-chief of the Journal of the American College of Cardiology (2002-2014), was recognized for his contributions and leadership in echocardiography. William Wijns, MD, of the National University of Ireland, Galway, the other recipient of an ESC Gold Medal, was recognized for his contributions to the field of percutaneous coronary intervention (PCI). Internal Medicine Organizations to Explore New Options for Physicians Maintaining Board Certification The ACC, American College of Physicians (ACP) and American Society of Clinical Oncology (ASCO) are working with the American Board of Internal Medicine (ABIM) to explore development of collaborative pathways through which physicians can maintain board certification. This collaborative work is in its early stages, and each organization has committed to looking at the creation of a Maintenance of Certification (MOC) process in their specialty that offers board certified physicians flexibility in how they can demonstrate to their peers and the public that they meet standards and are keeping their medical knowledge current. For cardiology, the ACC would provide clinicians with learning material and assessments modeled after its lifelong learning self-assessment program (ACCSAP). “The ACC is pleased to join ASCO and ACP on exploring these additional pathways for cardiologists, oncologists and internists to maintain their certification,” said ACC President Mary Norine Walsh, MD, FACC. Helping our collective members in the provision of professional and compassionate care, while also keeping up with current knowledge, is a shared goal. We appreciate ABIM’s willingness to continue to listen to and engage with stakeholders in order to achieve this goal in a more effective manner.” These collaborations are the result of an ongoing dialogue within the internal medicine community in an effort to improve MOC. Updates about the new pathway options will be shared as they become available. For more on MOC, visit ACC.org/MOC. New Appropriate Use Criteria Focus on Valvular Heart Disease New appropriate use criteria (AUC) released by the ACC and several other partnering societies focus on the evaluation and use of multimodality imaging in the diagnosis and management of valvular heart disease (VHD). The criteria are divided into three primary sections: 1) initial evaluation for VHD; 2) prior testing; and 3) transcatheter intervention for VHD. They address a broad spectrum of clinical scenarios, some of which were included in former AUC documents and others, such as structural valve interventions, that the writing group notes “were not in the armamentarium of clinicians when prior single-modality documents were published.” An independent rating panel scored the scenarios, assessing whether the use of an imaging test for each indication fell into one of the following categories: Appropriate, May Be Appropriate or Rarely Appropriate. “As imaging technologies and clinical applications continue to advance, the health care community must understand how best to incorporate these technologies into daily clinical care and how to choose between new and established imaging technologies,” said John U. Doherty, MD, FACC, professor of medicine at Thomas Jefferson University and chair of the writing committee. The ACC/AATS/AHA/ASE/ ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease was published in the Journal of the American College of Cardiology. This document is the first of two companion AUC documents, with the second companion document addressing multimodality imaging in structural heart disease currently being developed. Scan the QR code for more information on the 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease ACC, angelMD Launch Innovative Partnership The ACC and angelMD recently announced a new partnership to promote engagement of cardiovascular clinicians in health care innovation and entrepreneurship. The partnership is designed to help increase the exchange of knowledge in cultivating, advising, evaluating and investing in the most relevant technology solutions within cardiovascular health. “One of the ACC’s core values is promoting the growth and application of knowledge about cardiovascular health,” said ACC President Mary Norine Walsh, MD, FACC. “This partnership ensures that our members have the opportunity to learn about and understand the latest health care innovations while gaining first-hand knowledge of the health care startup community.” “angelMD is pleased to collaborate with the ACC and help connect ACC members with opportunities to learn, advise and invest in dynamic startups currently advancing cardiology and patient care,” said Tobin Arthur, angelMD co-founder and CEO. Stay tuned for more information on this exciting venture as it moves forward. Updated ACC Recommendations for Non-Statin Therapies As a result of recent evidence regarding proprotein convertase subtilisin/kexin 9 (PCSK9) inhibitors and ezetimibe in some patients, the ACC has released the 2017 Focused Update of the 2016 ACC Expert Consensus Decision Pathway on the Role of Non-Statin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk. Since the publication of the 2016 expect consensus decision pathway, additional evidence and perspectives have emerged from randomized clinical trials and other sources, particularly considering the longerterm efficacy and safety of PCSK9 inhibitors in secondary prevention of atherosclerotic cardiovascular disease (ASCVD), as well as evidence on the types of patients most likely to benefit from the use of ezetimibe in addition to statin therapy after acute coronary syndrome. Due to these findings, revised recommendations are provided for patients with clinical ASCVD with or without comorbidities on statin therapy for secondary prevention, indicating more clearly when ezetimibe or a PCSK9 inhibitor may be considered. The writing committee judged that the new data did not warrant changes to the decision pathways and algorithms regarding the use of ezetimibe or PCSK9 inhibitors in primary prevention patients LDL-C <190 mg/dl with or without diabetes or patients without ASCVD and LDL-C <190 mg/dl not due to secondary causes. Also provided in the focused update is new information on diagnostic categories of heterozygous and homozygous familial hypercholesterolemia, based on clinical criteria with and without genetic testing. Scan the QR code for “10 Things to Remember” about the Focused Update.
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