The American College of Cardiology (ACC) hosted its annual meeting, ACC.25, at the McCormick Place Convention Center in Chicago, IL, from March 29 – 31, 2025. This prestigious event brought together cardiovascular professionals, researchers, and healthcare providers from around the world to engage, collaborate, and explore the latest scientific advancements in cardiovascular medicine. ACC.25 offered a unique platform for attendees to stay at the forefront of the rapidly evolving field of cardiology, with a specific focus on transforming cardiovascular care. This year, the conference highlights innovative breakthroughs in diagnosis, treatment strategies, and cutting-edge technologies designed to improve patient outcomes.
Today, we will delve into some of the research posters presented at ACC.25, which offer insights into the ongoing efforts to improve care for patients with coronary artery disease (CAD). These posters represent some of the most cutting-edge advancements in cardiology and reflect how scientific innovation and technological progress are shaping the future of cardiovascular care. Let’s explore the highlights and examine the impactful studies that are redefining our understanding of coronary artery disease and its treatment.
- This study aimed to investigate whether an invasive approach improves outcomes in patients with chronic coronary disease (CCD) who have a history of coronary heart disease (CHD). The ISCHEMIA trials randomized 5,956 patients with CCD into invasive or conservative treatment strategies. CHD history was defined by prior myocardial infarction, percutaneous coronary intervention, or coronary artery bypass grafting. The primary outcome was a composite of cardiovascular (CV) death or myocardial infarction (MI).
- Of the participants, 30% had a history of CHD. After 4 years, those with CHD history had a higher rate of CV events than those without. Invasive management led to a 4.7% reduction in CV death or MI in patients with a history of CHD (15.9% vs. 20.6%), whereas no significant benefit was observed for those without CHD history. The invasive strategy significantly reduced CV death or MI for CHD patients (adjusted HR 0.77). Thus, patients with CCD and a history of CHD experienced higher CV event rates and benefitted from invasive management over conservative therapy.
Effects of Edoxaban on Platelet Reactivity in Patients with Coronary Artery Disease
- This study explored whether edoxaban, an oral anticoagulant, could reduce platelet reactivity (PR) when used in combination with aspirin or clopidogrel in patients with chronic coronary artery disease (CAD). In a prospective, open-label study, 61 CAD patients on daily aspirin were treated with combinations of aspirin and edoxaban, clopidogrel alone, clopidogrel with edoxaban, and edoxaban alone for 10 days each. Platelet reactivity was measured using the Multiplate-TRAP, ADP, and Aspirin tests.
- The study found no significant difference in platelet reactivity between the groups when comparing aspirin monotherapy to the combined treatment with edoxaban. This suggests that adding edoxaban to aspirin did not influence platelet function in CAD patients, indicating that platelet reactivity remains unaffected by the addition of this factor Xa inhibitor in combination therapy for these patients.
Sex Differences Among Patients with Coronary Artery Disease: A 20-Year Retrospective Study
- This retrospective study examined sex differences in demographics, comorbidities, disease severity, and outcomes in patients with coronary artery disease (CAD) over 20 years (2000-2019). A cohort of 40,722 patients undergoing coronary angiography was analyzed, focusing on those with severe CAD. Differences in treatments, disease progression, and major adverse cardiovascular events (MACE) at 1, 3, and 20 years were compared by sex.
- Females were older and had more comorbidities, while males had more severe CAD and higher rates of prior MI and hyperlipidemia. Women experienced higher MACE rates at 1 and 3 years, particularly driven by death, but these disparities narrowed by 2015-2019, possibly due to improved recognition and treatment of CAD in females. This study calls for further attention to the unique cardiovascular needs of women to ensure equitable outcomes.
- This study aimed to assess the role of genetic factors in coronary artery disease (CAD) risk among patients with hypercholesterolemia (HCL). By analyzing data from the UK Biobank, the researchers compared CAD risk between patients with monogenic mutations (in genes like LDLR, APOB, or PCSK9) and those with high polygenic risk scores (PGS). Patients were classified based on whether they were carriers of genetic mutations or had a high PGS (≥1.5x risk).
- The study found that HCL significantly increases CAD risk, with 0.72% of HCL patients being carriers of monogenic mutations and 17.61% having high PGS. Polygenic risk scores were a stronger predictor of CAD risk than monogenic mutations. Patients with high PGS or both high PGS and monogenic mutations had significantly increased CAD risk, suggesting that polygenic scores should be prioritized for identifying high-risk HCL patients who may benefit from early intervention and intensive treatment.
The Time-Varying Prognostic Value of Stenosis and Plaque Burden in Coronary Artery Disease
- This study aimed to assess the prognostic significance of coronary stenosis and plaque burden over time in predicting cardiovascular events. Data from 2,819 patients who underwent coronary computed tomography angiography (CCTA) were analyzed. The main outcome was a composite of all-cause mortality and non-fatal myocardial infarction (MI). Both diameter stenosis (DS%) and plaque burden (PAV) were considered in Cox models that adjusted for cardiovascular risk factors.
- The study found that diameter stenosis (DS%) was a significant predictor of short-term cardiovascular events (within 1 year), while plaque burden (PAV) was a stronger predictor for long-term events (beyond 1 year). These findings highlight that DS% is more relevant for early events, while plaque burden is crucial for predicting long-term outcomes in patients with coronary artery disease.
- This study aimed to use artificial intelligence (AI) to assess myocardial deformation in patients with angina but no significant coronary artery obstruction, known as ANOCA. Using a registry of 176 patients with ANOCA, echocardiographic data were analyzed for left ventricular (LV) deformation, including global longitudinal strain (GLS), LV dimensions, and diastolic function parameters. AI-based automated analysis was compared to expert manual reviews of echocardiograms.
- The results indicated significant subclinical abnormalities in both systolic and diastolic function in patients with ANOCA, with nearly half of the patients showing abnormal global longitudinal strain (GLS). AI-based analysis was able to identify these abnormalities, which could be useful for early detection and potential prognosis in ANOCA patients. The study suggests that AI-assisted myocardial deformation assessment could help identify hidden dysfunctions in these patients, warranting further investigation into their clinical implications.
- This meta-analysis explored the relationship between the gut microbiome and coronary artery disease (CAD), focusing on the phylum Firmicutes, which is involved in cholesterol metabolism and inflammation. The analysis pooled data from six Mendelian randomization studies and used inverse variance weighted analysis to examine the association between specific gut microbes and CAD.
- The study found a complex dual relationship between Firmicutes and CAD. Higher levels of Firmicutes were associated with a lower CAD risk (protective effect), while also showing a correlation with a higher risk of CAD. These findings suggest that Firmicutes play both a protective and causative role in CAD, emphasizing the need for further research into how specific microbial species at the taxonomic level influence cardiovascular diseases and their potential therapeutic implications.
The #ACC25 is set to be an enriching and informative event. We recommend clicking here to explore the comprehensive list of topics and sessions that will be covered at this significant event. Don’t miss the opportunity to expand your expertise.
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