ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research

The VESALIUS-CV trial demonstrated that the PCSK9 inhibitor evolocumab significantly reduced the risk of a first major cardiovascular event in patients with diabetes who had no known significant atherosclerosis. These findings challenge current clinical practice, where PCSK9 inhibitors are typically reserved for secondary prevention in patients with prior heart attack or stroke. Importantly, the results support earlier, more proactive lipid-lowering intervention, showing benefit even before overt atherosclerotic disease is evident. This paradigm shift underscores the opportunity to intensify preventive strategies and reduce cardiovascular risk earlier in high-risk populations. 

 
In this interview, Nanette Kass Wenger MD, MACC and Nicholas Marston, MD discuss the VESALIUS-CV Trial.

Randomized trials in stable ischemic heart disease (SIHD) show revascularization does not reduce death or myocardial infarction versus guideline-directed medical therapy, with benefit limited to symptom relief. This likely reflects lesion–ischemia mismatch, unclear ischemia origin, effective modern medical therapy, and trial design constraints. As a result, a prognostic advantage is difficult to demonstrate in broad SIHD populations. Exceptions where revascularization may improve outcomes include severe left main disease, significant left ventricle dysfunction, large ischemic burden, and refractory angina. 

 
In this interview, Allen J. Taylor MD, FACC and Sanjay Kaul, MBBS examine 'Why Can't We Prove Revascularization Is Better Than Medical Therapy for SIHD?'

ecent advancements in echocardiography since ACC.25 highlight a shift toward greater precision, efficiency, and consistency in cardiac imaging. Standardized echo reporting is now recognized as a key marker of quality care, improving communication and supporting more reliable clinical decisions, while artificial intelligence enhances imaging through automated measurements and diagnostic support. Together, these innovations strengthen echocardiography's foundational role in heart disease management by improving accuracy, consistency, and overall patient outcomes. 

 In this interview, Steven E. Nissen MD, MACC David H. Wiener, MD, FACC discuss practice-changing advancements in echocardiography.

The "Food is Medicine" approach is central to cardiovascular disease (CVD) prevention because diet directly shapes key risk factors, making nutrition a powerful, modifiable intervention. Medically tailored meals (MTMs) are fully prepared, condition-specific meals prescribed to meet the clinical needs of patients with chronic disease. Evidence shows that MTMs can improve health outcomes, enhance diet quality, and reduce hospitalizations and costs. Together, prescribing food as part of care highlights a scalable strategy to improve individual health and drive meaningful public health impact. 

 
In this interview, Matthew W. Martinez MD, FACC and Laurence S. Sperling, MD, FACC discuss "Prescribing Meals, Not Just Meds: The Case For Medically Tailored Meals".

The detection of subclinical, or "silent," atrial fibrillation (AFib) has increased substantially with the widespread use of implantable devices (e.g., pacemakers, defibrillators) and consumer wearables such as smartwatches. A key clinical question is the threshold of cumulative AFib burden—such as duration identified on device interrogation—at which anticoagulation should be considered. Additionally, clinicians should consider when consumer wearable rhythm monitoring is appropriate, such as in patients with symptoms or elevated stroke risk. Best practices are needed to guide counseling and management of patients with subclinical AFib, including when to initiate stroke and systemic embolism prevention strategies. 

In this interview, W. Douglas Weaver MD, MACC and Deepak Bhakta, MD, MBA, FACC discuss managing subclinical AFib detected by devices, ambulatory monitors and wearables.