Dr. Aaron Kugelmass, ACC09 Program Chair

The 58^th annual American College of Cardiology (ACC) Scientific Sessions will open this weekend at the Orange County Convention Center in Orlando, Fla., and ACC09 Program Chair Aaron Kugelmass, MD, told Cardiovascular Business that the meeting is tackling a myriad of cardiovascular specialties and the management of these at-risk patients through four days of lectures, presentations, panel discussions and late breaking clinical trials.

Kugelmass, who is director of the cardiac catheterization laboratory and associate division chief of cardiology at Henry Ford Hospital in Detroit, highlighted several trials that could affect the treatment and management of patients, suffering from various cardiovascular ailments in the hospital setting:

• PROTECT-AF, a multi-center, prospective, randomized study of approximately 1,500 patients with atrial fibrillation, comparing the Watchman device (from Atritech) to long-term warfarin therapy, which "depending on outcomes, may result in a new procedure for treating patients with atrial fibrillation," he said.
• STITCH, a multi-center, prospective randomized trial that compares coronary artery bypass surgery (CABG) with CABG and ventricular reduction surgery for the treatment of ischemic heart failure in 2,048 patients to assess the efficiency of surgical ventricular restoration. Kugelmass noted that this trial could potentially impact operating room procedures.
• EARLY ACS, a randomized, double-blinded trial, whereby 9,500 patients who experience acute coronary syndrome (ACS), are treated with standard of care plus eptifibatide (Integrilin from Schering-Plough and Milennium Pharmaceuticals), compared to standard of care plus placebo to evaluate a reduction in death, MI and cardiac surgery. The outcomes of the trial "could impact patient care from the emergency department and throughout their hospital stay," he noted.
• A trial comparing optimal medical therapy alone with a combination treatment with implantable cardioverter-defibrillators (ICD), seeks to assess the proper time in the patient-care cycle to implant the ICD after a patient experiences an MI. "This trial has the potential to impact a hospital's budget, timing and pathway, as well as increase the patient's length of stay and change DRGs," Kugelmass commented.
• ACCF & United HealthCare SPECT Pilot Study, in which the payor has partnered with the ACC to develop a Cardiac Imaging Appropriateness study to capture and analyze physician practice patterns related to SPECT MPI imaging to inform future education and reimbursement efforts.
• REVERSE EU Cohort, which examines the role of cardiac resynchronization therapy (CRT) in asymptomatic and mildly symptomatic heart failure patients, which "could lead to an expansion of application for CRT," he said.

"Due to the robust number of submissions, we broke the late breaking clinical trials down thematically-representing most, if not all, of the cardiovascular specialties. In addition, the i2 Summit, which is taking place simultaneously at the Orange County Convention Center, will have a more clearly defined focus on acute MI and interventional themes," Kugelmass explained. "At ACC09, we have sessions ranging from heart failure to imaging and prevention to risk factors and preventive care to arrhythmias, as well as a spotlight on new technologies."

Due the political and economic changes over the past year, ACC President Douglas Weaver, MD, will focus his presidential address on healthcare reform. Also, the Simon Dack Lecture will be presented by healthcare economist Uwe Reinhardt, PhD, and Len Nichols, PhD, another healthcare economist, will present the Bishop Lecture.

"Generally, healthcare reform needs ensure the society gets the maximum benefit from the resources it puts into healthcare-in particular, improved access for all members of society is driving healthcare reform. The ACC is attempting to assist with this improved access through its many registries and outcomes measurements-ACCNCDR, CARE Registries, registries for defibrillators," he said. "The college is committed to tracking and defining outcomes, and optimizing pathways for patient care, which is a natural extension to general healthcare reform-all of which is reflected through our content at this year's meeting."