Life-Saving Procedures and Doing What’s Right

Yesterday the New York Times (NYT) published an article, ”Medicare Payments Surge for Stents to Unblock Blood Vessels in Limbs.” The article draws attention to the high volume of such procedures performed by a few individuals and should not be construed as implying a systemic problem among the broader community of interventional cardiologists.

The ACC has had clinical guidelines for peripheral artery disease (PAD) since 2006; an update was issued in 2011. The current guideline specifically recommends revascularization with a stent when the patient is at risk for losing a limb or after an exercise program and/or medication have failed to address lifestyle-limiting symptoms.  Smoking cessation and attention to other risk factors for heart disease and stroke are also emphasized. Continue reading

Thriving in a Time of Change

This post was authored by C. Michael Valentine, MD, FACC, co-director of the Cardiovascular Summit.

It is not the strongest or the most intelligent who will survive but those who can best manage change. – Charles Darwin

Health care has undergone a radical transformation in the last decade.  Monumental shifts – from private practice to physician employment and volume to value – have uprooted a health care system that was relatively stable for decades. Continue reading

New NCDR-Derived Risk Model For AKI Patients Undergoing PCI

This post was authored by Thomas T. Tsai, MD, MSc, FACC, member of the NCDR Science and Quality Oversight Committee and steering committee chair of the PVI Registry.

A paper detailing the development of a new risk model of acute kidney injury (AKI) in patients undergoing percutaneous coronary intervention (PCI) was recently published in the Journal of the American Heart Association. The study, conducted by myself and several colleagues, applied data from the ACC’s NCDR CathPCI Registry to develop this viable tool, which will potentially aid clinicians in counseling patients undergoing PCI regarding the risk of acute kidney injury, identify patients for preventative strategies, and support local quality improvement efforts. Continue reading

Fostering a Culture of Innovation

This post was authored by Shal Jacobovitz, chief executive officer of the ACC.

Innovation is what moves us forward and keeps us relevant in a changing world. At the ACC, innovation is what has made the College what it is today – a vibrant, professional home for cardiovascular professionals around the world. Over the last 65 years, the College has been credited for its state-of-the-art educational programs and products, as well as its development of clinical guidelines, quality improvement programs and suite of clinical data registries, all of which help members stay on top of the latest research and ensure patients are receiving the best, most appropriate care. Continue reading

The Inner Workings of the NFL Combine

This post was authored by Dermot M. Phelan, MD, PhD, member of the ACC’s Sports and Exercise Cardiology Section and director of the Sports Cardiology Center at the Cleveland Clinic.

After a calamitous opener at Ohio Stadium, the Buckeye Nation (including this adopted son of Ohio) rejoiced last Monday night after Ohio State secured the National Championship through the calculations of Urban Meyer, the powerful arm of Cardale Jones and the dancing feet of Ezekiel Elliott. Throughout the country, college athletes went to bed overjoyed, devastated or indifferent but with one eye firmly fixed on Lucas Oil Stadium in Indianapolis. Here, the National Football League (NFL) Scouting Combine will take place within a short few weeks. By invite only, college athletes will have the opportunity to showcase their skills, strength and pace in the hopes of improving their draft status, salary and career prospects. Over the years, this has become a media extravaganza. Who can resist the spectacle of the 40-yard dash and the 225-lbs bench press (14 players have done more than 40 reps!)? Continue reading

Advocacy: An Individual Right and a Professional Responsibility

This post was authored by Richard Chazal, MD, FACC, vice president of the ACC.

While the ACC has long been known for dissemination of education to cardiovascular specialists, quality improvement and advocacy have also become crucial cornerstones of the College’s mission over the last several decades. In fact, these objectives are literally written in stone in our Heart House lobby in Washington, DC.

In a recent Journal of the American College of Cardiology (JACC) editorial, strong opinion was voiced about physician responsibility and the use of advocacy. What is the proper role to be played by physicians and by the ACC in regard to these efforts? How best do we maintain the primacy of care for patients, but also respect the needs of members? And what of our obligations beyond those to the individual patient: obligations to society or our obligations to improve systems of care? Continue reading

The New Online Professional Home For the Entire CV Care Team Has Arrived

This post was authored by Kim Eagle, MD, MACC, editor-in-chief of

As the editor-in-chief for the new, I am pleased to announce today’s launch of the ACC’s new and improved website. Nearly two years ago, the ACC embarked on the redesign of, with the goal of leveraging new technologies to ensure cardiovascular professionals and their patients have the tools and resources to communicate easily and effectively in today’s increasingly digital world. What you see today is the culmination of this journey. I congratulate the ACC staff and the many member leaders who played a role in this impressive undertaking.

The return to the original web address symbolizes an overall streamlined approach to the College’s new online home. Centering on the key attributes of anytime and anywhere, focused and personalized, and trusted and in-depth, the new website furthers the ACC’s key missions of science, quality patient care, lifelong learning and member education. Key highlights include mobile optimization, personalization options, streamlined navigation and improved search performance – all of which make the website easier to use whether in the office, at home or on the go. Continue reading

The ABIM MOC Debate Continues

Last week two perspectives were published in the New England Journal of Medicine discussing the ongoing controversy of the American Board of Internal Medicine’s (ABIM’s) Maintenance of Certification (MOC) process. (For those who need a refresher, you can view all of the previous blog posts on MOC here.)

The first perspective, by Mira B. Irons, MD, and Lois M. Nora, MD, JD, MBA, representatives of the American Board of Medical Specialties (ABMS), details the background of MOC and how the recently approved 2015 ABMS standards for MOC were developed. They note that the standards were modified after a comprehensive two-year review. They emphasize that “high standards of specialty certification are important to health care, and we hope our medical-community partners will work with us to continue to evolve our certification systems to ensure that the standards they set continue to be highly valued in the future.” Continue reading

PINNACLE Registry Wraps Up Successful Year of Research

This post was authored by William J. Oetgen, MD, MBA, FACC, executive vice president of Science, Education, & Quality of the ACC.

I recently had the opportunity, along with other members of the ACC staff, to serve on the research team for a project that analyzed data from the PINNACLE Registry India database. The database now includes well over 100,000 patient records collected from Indian hospital outpatient clinics. Using this database, Yashashwi  Pokharel, MD, MSCR, and a team of his colleagues recently submitted an abstract entitled “Guideline Recommended Medication Use Among Systolic Heart Failure (HF) Patients in India: Insights from the American College of Cardiology Practice Innovation and Clinical Excellence (PINNACLE) India Registry,” to the 66th Annual Conference of the Cardiological Society of India. The abstract was selected for a prestigious oral presentation at the conference this past December, which was delivered by Prafulla Kerkar, MD, FACC, the Mumbai-based chair of the PINNACLE India research group. Not only does this study inform us on guideline-recommended medication use among patients in India, but it also marks the first time data from ACC’s outpatient registry in India have been presented at a conference outside of the U.S. Continue reading

A Good Reminder Not to Lose Sight of Patient Value When Looking at Costs of Care

This post was authored by William A. Zoghbi, MD, MACC, past president of the ACC, in response to the New York Times article on echocardiography charges.

The New York Times this week ran a feature article in its “Health” section on the variations in charges associated with echocardiography (The Odd Math of Medical Tests: One Scan, Two Prices, Both High). In addition to raising concerns about charges, the piece suggested not only an increase in the use of echocardiography, but also inappropriate use of the technology by physicians.

Discussions about variations in cost are important across the health care spectrum – charges for all health services, not just echocardiography, vary significantly from one institution to another in the US. However, as Dr. David Wiener of the American Society of Echocardiography (ASE) noted in the article, it’s important that these discussions take into account the multiple factors responsible for the variation, including our decentralized health care system, state regulations and the need to subsidize poorly reimbursed services. Furthermore, the actual charges have little to do with actual payment for services by private or governmental payers, as charges have become an index of overall health care costs and inflation for each institution over the years, and do not mirror actual payments – a mere fraction. Unfortunately, the uninsured in the US are burdened with negotiating these high charges to a more acceptable and realistic level, highlighting the need for reform and transparency in prices of rendered services.   Continue reading