ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research

The menopause transition marks a pivotal period of cardiometabolic change that significantly elevates cardiovascular (CV) risk in women. Despite its clinical importance, this phase remains underrecognized in CV risk assessment, contributing to a profound knowledge gap. Enhancing clinician education and fostering multidisciplinary collaboration are essential to delivering individualized care that addresses both symptom burden and long-term CV outcomes. By prioritizing this life stage, we can improve prevention strategies and reduce the overall burden of cardiovascular disease in women.  In this interview, Drs. Alison L. Bailey and Lily Dastmalchi discuss “Improving Cardiovascular Clinical Competencies for Menopausal Transition”.    Subscribe on Apple Podcasts | Subscribe to ACCEL 

The 2025 ACC/AHA Acute Coronary Syndrome guideline is the first major update since 2013, incorporating a decade of new evidence and clinical insights. The writing committee stayed on track and on time, reaching consensus on key recommendations, including checklist-based Class I and II interventions before discharge. They thoughtfully addressed legacy practices and controversial studies to ensure clarity and relevance. While some emerging data didn’t meet the threshold for formal inclusion, areas like discharge antiplatelet therapy, coronary imaging, and mechanical support devices were flagged as important for clinicians to monitor. The result is a practical, evidence-based tool to guide bedside decision-making.    In this interview, Drs. Roxana Mehran and Sunil V. Rao take listeners “Behind the 2025 Acute Coronary Syndrome Guidelines.”   Subscribe on Apple Podcasts | Subscribe to ACCEL 

The 2025 ACC/AHA Acute Coronary Syndrome (ACS) Guideline clarifies diagnostic distinctions using electrocardiogram changes, troponin levels, and imaging tools such as coronary CT angiography and echocardiography in the emergency setting. Updates in lipid-lowering strategies and antiplatelet therapy reflect a more personalized approach to risk reduction and long-term care. These recommendations aim to streamline acute decision-making and improve outcomes across the ACS spectrum.    In this interview, Drs. Sidney C. Smith Jr. and Michelle L. O'Donoghue discuss “Top Takeaways From the 2025 ACC/AHA Acute Coronary Syndrome Guideline.”    Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL 

Chronic Total Occlusion Percutaneous Coronary Intervention (CTO PCI) is a procedure used to open coronary arteries that have been completely blocked for an extended period. It offers benefits like reduced angina and improved quality of life but carries risks such as vessel injury, heart attack, and procedural failure. Before considering CTO PCI, physicians typically optimize patients on anti-anginal medications—such as beta-blockers, nitrates, and calcium channel blockers—to manage symptoms and evaluate the need for intervention.  In this interview, Drs. Anthony N. DeMaria and Lindsey Cilia examine “Risk versus Benefit in Chronic Total Occlusion Revascularization.”  Subscribe on Apple Podcasts | Subscribe to ACCEL 

While blood thinners like warfarin and direct oral anticoagulants (DOACs) remain the standard for stroke prophylaxis, left atrial appendage occlusion (LAAO) devices offer a non-pharmacologic alternative for patients at high bleeding risk. Recent trials have shown that LAAO can be as effective as anticoagulants in preventing stroke and may be a viable option, especially for patients who cannot tolerate long-term anticoagulation.    In this interview, Drs. Anthony N. DeMaria and Dhanunjaya Lakkireddy explore the evolving landscape of stroke prevention in patients with atrial fibrillation, focusing on the comparison between traditional blood thinners and LAAO.    Subscribe on Apple Podcasts | Subscribe to ACCEL 

Persistent symptoms after an acute pulmonary embolism (PE) may indicate post-pulmonary embolism syndrome (PPES), a condition affecting up to 50% of patients. The most important consideration in managing PPES is to carefully evaluate and differentiate it from other potential causes of ongoing shortness of breath, particularly chronic thromboembolic pulmonary hypertension (CTEPH), which requires targeted treatment. How can clinicians best differentiate between PPES and other causes of persistent symptoms following an acute PE?    In this interview, Drs. Dipti Itchhaporia and Paul R. Forfia discuss “Why Are They Still Dyspneic? Post PE Syndrome Workup and Management.”    Subscribe on Apple Podcasts| Subscribe to ACCEL 

Palliative care supports heart failure patients by guiding complex medical decisions, managing symptoms, and enhancing quality of life. Despite being a guideline-recommended therapy, it remains underused—referrals are 45% lower for heart failure patients than for cancer patients with similar prognoses. Collaboration between cardiology and palliative care teams ensures that patients and caregivers receive goal-aligned care and the best possible quality of life.   In this interview, Dr. Mary Norine Walsh and Ms. Jill A. Patton explore how palliative care can help patients across the span of their illness.   Related References:   1.  Chuzi S, Saylor MA, Allen LA, et al. Integration of Palliative Care into Heart Failure Care: Consensus-Based Recommendations from the Heart Failure Society of America. J Card Fail. 2025;31(3):559-573. doi:10.1016/j.cardfail.2024.10.435  2. Gelfman LP, Blum M, Ogunniyi MO, McIlvennan CK, Kavalieratos D, Allen LA. Palliative Care Across the Spectrum of Heart Failure. JACC Heart Fail. 2024;12(6):973-989. doi:10.1016/j.jchf.2024.01.010   Subscribe on Apple Podcasts | Subscribe to ACCEL 

Recent clinical trials demonstrate that intensive blood pressure lowering—targeting systolic levels below 120 mm Hg—can significantly reduce cardiovascular events and mortality, even among older adults, individuals with diabetes, and those with chronic kidney disease. This challenges the long-standing belief that looser blood pressure targets are safer for older patients, showing instead that with proper monitoring, tighter control offers substantial net benefits for most high-risk groups.   In this interview, Dr. Alison L. Bailey and Dr. Keith C. Ferdinand explore the evolving landscape of hypertension management, highlighting new evidence supporting the benefits of tight blood pressure control across diverse populations.    Suggested Materials:   1. Liu J, Li Y, Ge J, et al. Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial. Lancet. 2024;404(10449):245-255. doi:10.1016/S0140-6736(24)01028-6  2. Bi Y, Li M, Liu Y, et al. Intensive Blood-Pressure Control in Patients with Type 2 Diabetes. N Engl J Med. 2025;392(12):1155-1167. doi:10.1056/NEJMoa2412006  3. Reddy TK, Nasser SA, Pulapaka AV, Gistand CM, Ferdinand KC. Tackling the Disproportionate Burden of Resistant Hypertension in US Black Adults. Curr Cardiol Rep. 2024;26(11):1163-1171. doi:10.1007/s11886-024-02115-5   Subscribe on Apple Podcasts | Subscribe to ACCEL 

Rapid emergency medical services transport to a percutaneous coronary intervention (PCI)-capable hospital is critical for timely intervention and management of life-threatening arrhythmias in ST-elevation myocardial infarction patients. Upon emergency room arrival, immediate transfer to the cath lab is essential to restore perfusion and improve both short- and long-term cardiovascular outcomes, as recommended by clinical guidelines. Interventional cardiologists must also be adept at managing culprit lesions in multivessel disease (MVD) and addressing complications like the no-reflow phenomenon during PCI.   In this interview, Drs. Dipti Itchhaporia and Nabil Farag discuss “What's the Best Time to Revascularize the Non-culprit Lesions in MVD.”   Suggested Materials:  Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes [published correction appears in Eur Heart J. 2024 Apr 1;45(13):1145. doi: 10.1093/eurheartj/ehad870.]. Eur Heart J. 2023;44(38):3720-3826. doi:10.1093/eurheartj/ehad191  Mehta SR, Wood DA, Meeks B, et al. Design and rationale of the COMPLETE trial: A randomized, comparative effectiveness study of complete versus culprit-only percutaneous coronary intervention to treat multivessel coronary artery disease in patients presenting with ST-segment elevation myocardial infarction. Am Heart J. 2019;215:157-166. doi:10.1016/j.ahj.2019.06.006   Subscribe on Apple Podcasts | Subscribe to ACCEL 

Cardiogenic shock remains a critical, time-sensitive emergency with a high mortality rate. However, recent advances—particularly multidisciplinary, team-based strategies—have shown promise in improving patient outcomes.  With the release of the 2025 ACC Concise Clinical Guidance on Cardiogenic Shock, clinicians now have access to a streamlined, evidence-informed roadmap for early recognition, rapid stabilization, and escalation of care.    In this episode, Drs. Glenn A. Hirsch and Shashank S. Sinha explore the latest strategies in cardiogenic shock management in 2025, emphasizing the how the new guidance integrates clinical decision-making tools and highlighting the role of shock teams and regional partnerships in optimizing care delivery.   SUGGESTED MATERIALS:    Sinha SS, Geller BJ, Katz JN, et al; American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology; Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation; Council on Cardiovascular and Stroke Nursing; and Council on Kidney in Cardiovascular Disease. Evolution of Critical Care Cardiology: An Update on Structure, Care Delivery, Training, and Research Paradigms: A Scientific Statement From the American Heart Association. Circulation. 2025 Feb 13. doi: 10.1161/CIR.0000000000001300. Epub ahead of print. PMID: 39945062.   Hall EJ, Agarwal S, Cullum CM, Sinha SS, Ely EW, Farr MA. Survivorship After Cardiogenic Shock. Circulation. 2025 Jan 21;151(3):257-271. doi: 10.1161/CIRCULATIONAHA.124.068203. Epub 2025 Jan 21. PMID: 39836757.   Ton VK, Li S, John K, et al. Serial Shock Severity Assessment Within 72 Hours After Diagnosis: A Cardiogenic Shock Working Group Report. J Am Coll Cardiol. 2024 Aug 1:S0735-1097(24)07740-4. doi: 10.1016/j.jacc.2024.04.069. Epub ahead of print. PMID: 39217545.     Subscribe on Apple Podcasts | Subscribe to ACCEL  

Heart failure arises when the heart is unable to pump or fill with blood effectively. In the cardiac catheterization lab, we have the unique ability to directly measure the physiological abnormalities underlying this condition, making it the gold standard for diagnosing heart failure. While not every patient requires heart catheterization, it is often essential for those with heart failure with preserved ejection fraction (HFpEF). This is because noninvasive tests, which are commonly used, frequently fall short—providing false reassurance and leading to missed diagnoses. As a result, HFpEF remains underrecognized. And ultimately, a condition that goes unrecognized cannot be properly treated.    In this interview, Drs. Matthew Martinez and Barry Borlaug discuss “Hemodynamic Assessment for Diagnosis and Treatment Selection in HFpEF.”    Subscribe on Apple Podcasts | Subscribe to ACCEL 

The SOUL trial demonstrated that in patients with type 2 diabetes (T2DM) and established atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD), or both, treatment with oral semaglutide significantly reduced the risk of major adverse cardiovascular events (MACE) compared to placebo—without an increase in serious adverse events. These findings position oral semaglutide as a compelling option with cardiovascular benefits consistent with those seen in injectable GLP-1 receptor agonists.   In this episode, Drs. Deepak L. Bhatt and Darren K. McGuire explore how the SOUL trial further strengthens the favorable risk-benefit profile of oral semaglutide for patients with T2DM and coexisting ASCVD and/or CKD, highlighting its potential to reshape cardiovascular risk management in this high-risk population.   SUGGESTED MATERIALS  McGuire DK, Marx N, Mulvagh SL, et al.; SOUL Study Group. Oral Semaglutide and Cardiovascular Outcomes in High-Risk Type 2 Diabetes. N Engl J Med. 2025 Mar 29. doi: 10.1056/NEJMoa2501006. Epub ahead of print.   Subscribe on Apple Podcasts | Subscribe to ACCEL 

The SMART-CHOICE 3 trial demonstrated that clopidogrel monotherapy is more effective than aspirin monotherapy in reducing the risk of major adverse cardiac and cerebrovascular events in high-risk patients who completed standard dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI). Despite concerns that more potent antiplatelet agents may increase bleeding risk, the study found that clopidogrel significantly reduced ischemic events—including myocardial infarction and all-cause death—without increasing bleeding risk, making it a highly favorable option for long-term maintenance therapy.   In this episode, Drs. Allen J. Taylor and Joo-Yong Hahn discuss the clinical implications of these findings and offer insights into selecting the optimal single antiplatelet regimen after PCI.    SUGGESTED MATERIALS  Choi H, Park H, Lee JY, et al. Efficacy and safety of clopidogrel versus aspirin monotherapy in patients at high risk of subsequent cardiovascular event after percutaneous coronary intervention (SMART-CHOICE 3): a randomised, open-label, multicentre trial. Lancet. 2025;405(10486):1252-63. doi: 10.1016/S0140-6736(25)00449-0.  Koo BK, Kang J, Park KW, et al.; HOST-EXAM investigators. Aspirin versus clopidogrel for chronic maintenance monotherapy after percutaneous coronary intervention (HOST-EXAM): an investigator-initiated, prospective, randomised, open-label, multicentre trial. Lancet. 2021;397(10293):2487-2496. doi: 10.1016/S0140-6736(21)01063-1.   Subscribe on Apple Podcasts | Subscribe to ACCEL 

The DapaTAVI trial, conducted across 39 centers in Spain, is the first study to evaluate the use of sodium-glucose co-transporter-2 (SGLT-2) inhibitors, specifically dapagliflozin, in patients with heart failure undergoing transcatheter aortic valve implantation (TAVI). The trial found that patients who received dapagliflozin (10 mg daily) within 14 days of hospital discharge after TAVI experienced a 28% relative risk reduction in the composite outcome of all-cause mortality or worsening heart failure at one year, compared to those receiving standard care    In this episode, Drs. Allen J. Taylor and Sergio Raposeiras Roubin discuss the safety and clinical benefits of initiating dapagliflozin—or other SGLT-2 inhibitors—in patients undergoing TAVI who are at risk for heart failure, emphasizing its potential to improve outcomes in this high-risk population.    SUGGESTED MATERIALS  Raposeiras-Roubin S, Amat-Santos IJ, Rossello X, et al.; the DapaTAVI Investigators. Dapagliflozin in patients undergoing transcatheter aortic-valve implantation. N Engl J Med 2025;392:1396-14. Doi: 10.1056/NEJMoa2500366      Subscribe on Apple Podcasts | Subscribe to ACCEL 

The PRAGUE-25 study evaluated the effectiveness of two treatment strategies in patients with both atrial fibrillation (AF) and obesity: catheter ablation versus lifestyle modification (including weight loss and increased physical activity) combined with antiarrhythmic drug therapy. While motivated patients who adhered to lifestyle changes experienced a reduction in AF episodes, the study found that catheter ablation was significantly more effective in achieving and maintaining sinus rhythm.    In this episode, Drs. Joseph Marine and Pavel Osmancik discuss the trial’s findings, highlighting that catheter ablation outperformed lifestyle modification and medication in restoring and sustaining normal heart rhythm.    SUGGESTED MATERIALS  Osmancik P, Havránek Š, Bulková V, et al. Catheter ablation versus antiarrhythmic drugs with risk factor modification for treatment of atrial fibrillation: a protocol of a randomised controlled trial (PRAGUE-25 trial). BMJ Open. 2022 Jun 15;12(6):e056522. doi: 10.1136/bmjopen-2021-056522.  Pathak RK, Middeldorp ME, Meredith M, Mehta AB, Mahajan R, Wong CX, Twomey D, Elliott AD, Kalman JM, Abhayaratna WP, Lau DH, Sanders P. Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: A Long-Term Follow-Up Study (LEGACY). J Am Coll Cardiol. 2015 May 26;65(20):2159-69. doi: 10.1016/j.jacc.2015.03.002.       Subscribe on Apple Podcasts | Subscribe to ACCEL 

A Global Cardiovascular Risk Consortium study of nearly 2 million people worldwide found that avoiding five modifiable risk factors—hypertension, hyperlipidemia, abnormal weight, diabetes, and smoking—by age 50 added over a decade of life expectancy for both sexes. Midlife control of systolic blood pressure and smoking yielded the greatest global gains.  In this interview, Drs. Roger S. Blumenthal and Christina Magnussen discuss how this landmark study moves beyond a predominantly North American and European focus, translating abstract risk factors into tangible years of healthy life for patients.    SUGGESTED MATERIALS  The Global Cardiovascular Risk Consortium. Global effect of cardiovascular risk factors on lifetime estimates. NEJM. Published online March 30, 2025. Doi: 10.1056/NEJMoa2415879     Subscribe on Apple Podcasts | Subscribe to ACCEL 

The ZENITH trial evaluated sotatercept, an activin signaling inhibitor, in patients with advanced pulmonary arterial hypertension (PAH) at high risk of death. Sotatercept met its primary endpoint—time to first morbidity or mortality event—prompting an independent data monitoring committee to recommend early trial termination and offer the drug to all participants.    In this interview, Drs. Allen J. Taylor and Marc Humbert discuss how ZENITH highlights sotatercept’s clinical benefit even in the sickest PAH patients, offering renewed hope for a disease long seen as unrelenting.   SUGGESTED MATERIALS  1. Humbert M, McLaughlin VV, Badesch DB, et al., for the ZENITH Trial Investigators. Sotatercept in Patients With Pulmonary Arterial Hypertension at High Risk for Death. N Engl J Med 2025;Mar 31:[Epub ahead of print].  2. Hoeper MM, Badesch DB, Ghofrani HA, et al.; STELLAR Trial Investigators. Phase 3 trial of sotatercept for treatment of pulmonary arterial hypertension. N Engl J Med 2023;388:1478-90.   3. Humbert M, McLaughlin V, Gibbs JSR, et al.; PULSAR Trial Investigators. Sotatercept for the treatment of pulmonary arterial hypertension. N Engl J Med 2021;384:1204-15.   Subscribe on Apple Podcasts | Subscribe to ACCEL 

The “Cardiac Arrest During Long-Distance Running Races: 2010–2023” study analyzed the incidence and outcomes of sudden cardiac arrests (SCAs) occurring during marathons and half-marathons in the United States. Known as the RACER2 study, it serves as a follow-up to the original RACER1 study, which covered the years 2000–2009.   In this episode, Drs. Jonathan H. Kim and Aaron L. Baggish discussed the study findings, emphasizing the importance of continued vigilance and preparedness to further reduce the risk of fatal outcomes during endurance events.   SUGGESTED MATERIALS    1. Kim JH, Rim AJ, Miller JT, et al. Cardiac Arrest During Long-Distance Running Races. JAMA. Published online March 30, 2025. doi:10.1001/jama.2025.3026.  2. Kim JH, Malhotra R, Chiampas G, d'Hemecourt P, Troyanos C, Cianca J, Smith RN, Wang TJ, Roberts WO, Thompson PD, Baggish AL; Race Associated Cardiac Arrest Event Registry (RACER) Study Group. Cardiac arrest during long-distance running races. N Engl J Med. 2012;366:130-40.     Subscribe on Apple Podcasts | Subscribe to ACCEL 

Funded by the Congressionally Directed Medical Research Programs (CDMRP) of the Department of Defense, the WARRIOR (Women's IschemiA TRial to Reduce events In non-ObstRuctive CAD) Trial addresses the urgent need for evidence-based care in a growing population of patients—particularly women—experiencing ischemia without obstructive coronary artery disease (INOCA).    This clinical strategy trial compares optimal medical therapy with usual care in women with angina but no significant coronary blockages. In this episode, Drs. Nanette Kass Wenger and Noel Bairey Merz discuss the trial’s design, enrollment progress, follow-up strategies, and the primary and secondary outcomes that could reshape cardiovascular care for women.  Subscribe on Apple Podcasts || Subscribe to ACCEL 

Patients with peripheral artery disease (PAD) often experience significant walking difficulties, and there are limited therapies available to improve their mobility. Investigation made through the STRIDE (Effects of Semaglutide on Functional Capacity in Patients With Type 2 Diabetes and Peripheral Arterial Disease) trial focused on semaglutide, a drug known for promoting weight loss, reducing inflammation, and lowering the risk of heart attack or stroke, to determine if it could enhance the functional abilities of PAD patients.   In this interview, Drs. Alison Bailey and Marc Bonaca discuss how the STRIDE trial data supports the use of semaglutide for individuals with PAD and type 2 diabetes, highlighting its cardiometabolic, cardiovascular, and kidney benefits, as well as its ability to improve function, symptoms, and overall quality of life.   Subscribe on Apple Podcasts | Subscribe to ACCEL