Mexico City was home base for more than 700 participants from across the Americas who took part in ACC’s 2nd Latin America Conference in June. The conference, part of three ACC regional meetings in 2017, brought together cardiovascular professionals for region-specific, targeted education, new science and opportunities for mentoring and networking.

Preconference activities included the ACC In-Training Exam, as well as a two-hour session focused on the “The Power of Data” in patient care, teaching and research. “The Power of Data session provided a unique opportunity for early career cardiologists, regardless of their interests in conducting research,” said Frederick A. Masoudi, MD, FACC, chair of ACC’s NCDR Management Board. “Participants learned how to get the tools to interpret data, ranging from the data they have to interpret as clinicians in caring for patients to those that are collected for the purposes of advancing science.”

The Latin America Conference, led by Erick Alexanderson, MD, FACC, chair of ACC’s Assembly of International Governors, and Hector I. Michelena, MD, FACC, provided attendees with the chance to hear from leaders across Latin America on topics ranging from solutions to everyday problems, to the best ways to apply clinical guidelines in areas like syncope, heart failure (HF) and hypertension at the point of care, to how to manage acute coronary syndromes. Participants could also test their knowledge in a special “Skills Center” featuring Hearts Songs, ECG Drill & Practice and simulation exercises.

"The Power of Data session provided a unique opportunity for early career cardiologists, regardless of their interests in conducting research." — Frederick A. Masoudi, MD, FACC

Plenary sessions featuring keynote speakers like Spencer B. King III, MD, MACC; Jagat Narula, DM, MD, PhD, MACC; Noel Bairey Merz, MD, FACC; and ACC Vice President C. Michael Valentine, MD, FACC, addressed issues surrounding women and cardiovascular disease, unanswered questions in coronary artery disease, and the importance of leadership. During his session on coronary artery disease and whether it can be eliminated in our lifetime, Narula presented data from a recent study published in the Journal of the American College of Cardiology looking at the global burden of disease and cardiovascular mortality from 1990-2015. Data showed an estimated 422.7 million prevalent cases of cardiovascular disease worldwide in 2015.

In multiple sessions zeroing in on obstacles and treatment methods specific to cardiovascular disease in women, Bairey Merz led discussions around the insufficient emphasis placed on cardiovascular disease in women by both women themselves and their physicians. “Guidelines don’t tell you to stratify by sex, they say just treat,” she said. Additional topics covered during these sessions included the management of anticoagulation and valvular heart disease in pregnancy, insights into the future of ischemic heart disease in women, and holistic approaches to employ when managing women with heart disease.

In a highly popular session, Valentine, Masoudi and King talked about leadership from the perspective of an incoming ACC president, an editor and a researcher. “Leadership development needs to be part of medical school to help prepare students,” noted Valentine. While King, when asked how best to lead, urged attendees to “start early… pick the right team.” In addition to educational sessions, new science was also presented. Among the highlighted poster abstracts:

• Research suggesting that previous exposure to Dengue may enhance the Zika virus infection and may increase the risk of developing HF. Researchers suggest that increased awareness of cardiac complications with Zika are needed.
• A study finding that supplementation of L-arginine during acute infection in patients with Chagas disease improved repolarization disturbances and axis deviation. “L-arginine could be useful in adjuvant therapy for Chagasic patients,” according to the study author.
• A study looking to determine the frequency of T cells, B cells, NK cells and mucosal-associated invariant T (MAIT) cells in the blood of STEMI patients, found no differences at 24 hours and 30 days after PCI in MAIT and T cell patients. Researchers noted the role of MAIT cells in AMI could “surely be a new line of research, where we can change the natural history of AMI with new therapeutic targets at the immunological level.”
• Research showing that the burden of chronic HF (CHF) on informal caregivers across Argentina, Brazil, Colombia and Mexico is high, with emotional, mental, physical and financial impacts. Of note, caregivers reported spending an average of 43.4 hours a week caring for a CHF patient and 46 percent of caregivers reported an impact on their own health.
• A study evaluating mortality risk using the Barcelona Bio-HF calculator in patients with CHF found a statistically significant relation between the risk model with NT-proBNP and mortality, suggesting the need for better clinical management of CHF patients in Latin America.
• Research showing that cardiac autonomic dysfunction was an independent predictor of inappropriate left ventricular mass in patients with chronic essential hypertension undergoing medical treatment. “This study highlights the importance of [heart rate recovery] as a predictor of mortality in patients with chronic hypertension and opens up different targets to modulate autonomic function to reduce cardiovascular outcomes,” researchers said.
• Data suggesting that use of dual antiplatelet therapy (DAPT) scoring is valid in AMI patients. Additionally, researchers note, a cut-off value of 2 is useful in predicting who will benefit from prolonged DAPT.
• A study showing that establishment of a PCI program for STEMI in the Dominican Republic is feasible and comparable with international standards — research that could be used to justify a national STEMI system of care in the country.
• Research showing the use of three-dimensional echocardiography left ventricular ejection fraction (3DE LVEF), compared with two-dimensional echocardiography, has the potential to change the decision to implant ICDs in “a sizeable number” of patients. Further, 3DE LVEF was identified as an independent risk factor for appropriate ICD therapy, note study authors.
• Research showing real-world patient characteristics and treatment patterns in CHF patients from across Argentina, Brazil, Colombia and Mexico that could help with treatment and preventing hospitalizations.

Two additional regional conferences — one in the Middle East and one for the Asia Pacific region — are taking place this fall. Registration for the Middle East Conference taking place in collaboration with the 8th Emirates Cardiac Society Congress in Dubai this October is now open. For more highlights from the Latin American Conference search #ACCLatinAmericaConf on Twitter.

ACC Latin America Conference 2017 Best Poster Winners, Hugo Rodriguez-Zanella, MD, Daniel Veron-Esquivel, MD, and Cesar Herrara, MD, who presented on behalf of Samuel Zorrilla, MD. Scenes from ACC Latin America Conference. Scenes from ACC Latin America Conference. Scenes from ACC Latin America Conference. Scenes from ACC Latin America Conference. Scenes from ACC Latin America Conference. Scenes from ACC Latin America Conference. Scenes from ACC Latin America Conference.

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Clinical Topics: Acute Coronary Syndromes, Anticoagulation Management, Noninvasive Imaging, Prevention, Valvular Heart Disease, Atherosclerotic Disease (CAD/PAD), ACS and Cardiac Biomarkers, Anticoagulation Management and ACS, Echocardiography/Ultrasound, Hypertension

Keywords: ACC Publications, Cardiology Magazine, Coronary Artery Disease, Risk Factors, Research Personnel, Heart Rate, Latin America, Acute Coronary Syndrome, Point-of-Care Systems, Leadership, Cost of Illness, Stroke Volume, Natriuretic Peptide, Brain, Myocardial Ischemia, Hypertension, Peptide Fragments, Syncope, Echocardiography, Heart Valve Diseases, Echocardiography, Three-Dimensional, Electrocardiography

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