ACC Education Sessions Preview: Coronary Interventions

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In many hospitals, the cath lab is the hub around which the practice of cardiology revolves. With our increasingly aging population and epidemic rise in diabetes and obesity, interventional cardiologists are performing more and more coronary interventions. To ensure efficacy and efficiency in the cath lab, physicians must focus on a broad range of areas, including devices, drugs, patient selection and protocols. All of these topics must be considered because a chain is only as strong as its weakest link.

Drug-eluting stents (DES) have proved their worth compared to bare-metal stents in terms of improved restenosis rates. Questions still exist, however, regarding stent thrombosis. In addition, newer generation DES, coupled with new drugs and drug regimens, have made significant progress in reducing adverse events during and after PCI. But cardiologists want to know which DES and which drug regimen are best for their patients? The amount of research being conducted around improving the safety and efficacy of PCI is staggering. Even more impressive, however, is the careful consideration that interventionalists give to the emerging data.

ACC.10, which kicks off Saturday in Atlanta, in conjunction with the i2 Summit, is chock full of educational sessions and late-breaking trials piloted by experts trying to determine how best to interpret the latest evidence. Attendees will no doubt hear disagreement, but they also will be treated to thoughtful analyses, robust discussions and honest deliberation. The basis of the next-generation of best practices will be defined.

The late-breaking trials alone are worth the price of admission. Most of these trials are comparative studies, pitting one therapy against another. For example, the PLATO trial compared ticagrelor with clopidogrel in patients undergoing CABG. Other trials examine various management strategies for diabetics, intense versus less intense blood pressure control and various atrial fibrillation treatment approaches.

In the past few years, there have been dramatic advances in PCI techniques, devices, and medications, with no sign that these will slow down. Guidelines published by the ACC, in conjunction with other societies, are continually being updated as new approaches supplant the old. Within the last few years, changes to guidelines include:

  • Updated recommendations on using anti-clotting medications, such as clopidogrel, low molecular-weight heparin and bivalirudin, before, during and after PCI;
  • A recommendation that embolic protective devices be used during PCI or peripheral arterial interventions; and
  • A recommendation for early follow-up of patients who have PCI of the left main coronary artery.

Interventional cardiologists can expect to find many sessions at ACC.10 that will help them improve their daily practice. What's good for the patient is also good for the practice. With decreasing reimbursement and payment increasingly tied to performance, incorporating the latest cutting-edge research into one's practice will go a long way toward ensuring patient safety and practice efficiency.

For educational session and late-breaking trial locations as well as other details, consult the session program onsite or visit To download a PDF of conference sessions, click here. Click here to download the program to a mobile device or click here from within your mobile browser to download directly. You also can download the final program to your eBook reader here.

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