ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research

Prehospital heparin administration in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) offers a practical strategy to facilitate early restoration of blood flow in the infarct-related artery before hospital arrival. A key advantage of heparin over other agents studied for this purpose is its low cost, widespread availability, and well-established safety profile, making it highly accessible in diverse care settings. By initiating anticoagulation early, this approach aims to support reperfusion without introducing additional harm. Given these benefits, it has strong potential for translation into routine clinical practice, particularly in systems focused on rapid, prehospital STEMI care. 

 
In this interview, Kim Allan Williams Sr., MD, MACC and Misa Fister, MD, PhD examine 'Prehospital Heparin Administration In Patients With STEMI Undergoing Primary PCI'.

Iron deficiency (ID) is highly prevalent in patients with heart failure (HF) and is independently associated with poorer functional status, higher hospitalization rates, and increased mortality. ID in HF is typically defined by abnormal iron indices—most commonly low ferritin and/or low transferrin saturation—and is distinct from anemia, as it may be present even when hemoglobin levels are normal. A growing body of randomized clinical trials demonstrates that treating ID, particularly with intravenous iron, improves symptoms, exercise capacity, and quality of life, with emerging evidence for reductions in HF hospitalizations. 

In this interview, Clyde W. Yancy MD, MACC and Robert J. Mentz, MD, FACC examine definitions and treatment of ID in HF.

There is increasing emphasis on shared decision-making when evaluating sports participation for competitive athletes with cardiovascular disease, reflecting a shift toward more individualized care. This approach recognizes that participation decisions should integrate clinical risk assessment with the athlete's values, goals, and informed preferences. Current guidelines aim to thoughtfully balance the potential cardiovascular risks of intense exercise with its well-established benefits for health, performance, and quality of life. 

 In this interview, Alison L. Bailey, MD, FACC and Aaron Baggish, MD, FACC examine the latest sports cardiology guidelines.

In the CADENCE proof-of-concept study, sotatercept demonstrated meaningful improvements in pulmonary vascular and cardiac hemodynamics in patients with combined pre‑ and post‑capillary pulmonary hypertension due to HFpEF (CpcPH‑HFpEF). Investigators selected a pulmonary vascular resistance threshold of ≥4 Wood units to enrich patients with a significant pre‑capillary component, where targeting pulmonary vascular disease was most biologically relevant. Given that CpcPH‑HFpEF—including valvular‑associated HFpEF—is underdiagnosed, associated with worse prognosis, and has no approved therapies, these findings suggest potential broader applicability pending further study. 

In this interview, Clyde W. Yancy MD, MACC and Mardi Gomberg-Maitland, MD, MSc, FACC discuss the CADENCE Trial (Efficacy And Safety Of Sotatercept In Combined Post-and Pre-capillary Pulmonary Hypertension Associated With Heart Failure With Preserved Ejection Fraction).

The ORBITA-CTO trial was a multicenter, randomized, double-blinded study that enrolled 50 patients with symptomatic single-vessel chronic total occlusion (CTO) and no bystander coronary disease. Participants were assigned to either CTO percutaneous coronary intervention (PCI) or a placebo procedure. The results demonstrated that PCI with angioplasty and stenting led to greater improvement in angina symptoms compared with placebo. These findings provide strong evidence that CTO PCI can effectively reduce anginal pain and improve quality of life for patients with chronic total occlusions.  

In this interview, Allen J. Taylor, MD, FACC and John Davies, MBBS, PhD evaluate the ORBITA-CTO Trial.