Highlights From the 2019 SCCT Scientific Sessions

The Society for Cardiovascular Computed Tomography (SCCT) 2019 Scientific Sessions recently took place in Baltimore, MD, and numerous ACC members were in attendance. This action-packed weekend highlighted many new and important topics in the world of cardiovascular CT, ranging from novel applications of cardiac CT to developments in the world of preventative cardiology. Top thought leaders in the field, including ACC members, were present to share their insights.

Prevention Symposium
Before the awards ceremony kickoff, the SCCT held the "Cardiovascular Disease Prevention Symposium" in partnership with the International Atherosclerosis Society. This symposium was chaired by upcoming SCCT President Ron Blankstein, MD, FACC, with key contributions from many innovators in the field. Roger S. Blumenthal, MD, FACC, shared his insights as a co-chair of the 2019 ACC/AHA guidelines on the primary prevention of cardiovascular disease. Khuram Nassir, MD, MPH, provided an excellent overview of PCSK9 inhibitor utilization in the modern era, including a discussion of cost-benefit analysis and issues with access to this important medication class. Along with Blankstein, they discussed the evolving role of coronary artery calcification (CAC) scoring for risk stratification in primary prevention. Using the hashtag #PowerOfZero, social media showed its power for disseminating messages such as the prognostic value zero CAC as a negative risk predictor for cardiovascular event. Deepak L. Bhatt, MD, MPH, FACC, later provided a summary of his 2018 REDUCE-IT study, which demonstrated the benefits of high dose Icosapent ethyl in patients with elevated triglycerides for secondary and high risk primary prevention. Kavitha Chinnaiyan, MD, FACC, gave an excellent talk on perhaps an important but often overlooked topic: physician burnout. In her talk, she spoke of the importance of physician self-care in an increasingly taxing health care environment. Finally, the session ended with keynote speaker Philip Greenland, MD, FACC, about his top 10 predictions for the future of cardiovascular disease prevention.

The SCCT 2019 conference kicked off with the opening ceremony led by outgoing SCCT president Suhny Abbara, MD. Blumenthal received the Arthur Agatston award for his contributions in the field of cardiovascular prevention. Stephan Achenbach, MD, FACC, received the inaugural Achenbach pioneer award for his landmark contributions in cardiovascular CT. Journal of Cardiovascular Commuted Tomography Editor-in-Chief James K. Min, MD, FACC (Figure 1), gave an excellent synopsis on the top eight papers published in the field of cardiac CT this past year. Prominent in this talk was the increasing role of plaque characteristics in prognosticating risk (PARADIGM, PACIFIC and ICONIC trials). Discussion also included the five-year follow-up findings from the SCOT-HEART trial, which demonstrated a reduction in cardiovascular events and increased rates of primary prevention with the use of cardiac CT in patients presenting with chest pain.

Figure 1

Figure 1
Figure 1: Top 8 papers of the year according to James K. Min, MD, FACC, Editor-in-Chief of the Journal of Cardiovascular Computed Tomography.
Cardiology Magazine Image
Erin D. Michos, MD, FACC

Cardiology Magazine Image
Malissa J. Wood, MD, FACC

Women and Cardiovascular Disease
Leslee J. Shaw, PhD, FACC, and Erin D. Michos, MD, FACC, chaired a session on the important topic of cardiovascular disease in women. Leading off was a talk by Martha Gulati, MD, MS, FACC, on the current issues surrounding the care of women with cardiovascular disease. In this talk, she discussed the gender differences in women presenting with acute coronary syndrome and the inequalities in care received, including delayed coronary angiography and disparities in optimal medical therapy. Shaw pointed out key differences in atherosclerosis in women compared with men, including the increased prevalence of high-risk plaques. Malissa J. Wood, MD, FACC, capped off the session with an overview of the pathogenesis and management of spontaneous coronary artery dissection (SCAD). When asked about the role of cardiac CT in SCAD, she stated, "In our practice, cardiac CTA has provided a much-needed noninvasive modality with which to evaluate resolution of coronary artery dissection. Additionally, given the high likelihood of persistent symptoms and return visits to the ER in this population, we are able to integrate cardiac CTA images with prior cardiac catheterization images to determine that there has been no significant worsening of prior lesions or new SCAD. Invasive coronary angiography remains the gold standard, however, for initial diagnosis of SCAD. As CT technology improves, we will hopefully have a non-invasive alternative, allowing for timely diagnosis of SCAD."

Overall, this session was an excellent overview of the current state and potential areas for improvement in the care of women with cardiovascular disease.

Social Media (#SoMe)
Social media is becoming an increasingly popular tool for disseminating knowledge, networking and promoting academic discussion within cardiology. It is therefore no surprise that the power of social media (#SoMe) was on full display at #SCCT2019. In one such session, "Social Medial: A Prism For Cardiac CT and Medicine," multiple discussants talked about the meaningful role of social media in cardiac CT. Purva Parwani, MD, FACC, talked about social media as a valuable tool for advancement for Fellows in Training (FIT) and early career faculty. Michos spoke about her experience embracing the Twitter community and how it helped provide a support network for her early in her career. She also strongly encouraged early career physicians to adopt social media. She stated, "The use of Twitter can present new opportunities for networking by connecting cardiovascular researchers, clinicians, policymakers, the public and other stakeholders on a global scale. The instantaneous availability of work to a targeted audience can transcend current limitations in knowledge translation. Alternative bibliometrics known as Altmetric scores track the attention a publication receives from on-line sources and can even boost traditional citation counts. As social media influence continues to expand, it becomes increasingly important for cardiovascular researchers to employ social media strategies to increase the impact of their work." Joining the conference from Mexico City, radiologist Aloha Meave, MD, also discussed the opportunities social media provided for international networking and collaboration. Finally, in her talk "How to suck at Twitter," Gulati gave an excellent overview of rules and pitfalls for doctors on social media.

Other Notable Activities
The joint session with the Heart Rhythm Society discussed CT guided rhythm management. The session reviewed the role of CT in imaging integration with EP hardware, ruling our left atrial appendage thrombus, the use of late enhancement CT imaging to detect myocardial scar, and the growing role of CT in diagnosis and management of arrhythmogenic right ventricular dysplasia. Pierre Qian, MD, discussed the use of radiation therapy for ventricular tachycardia ablation using CT guidance, a novel and promising approach for treating a life-threatening disease.

Other scientific sessions covered topics including the use of cardiac CT in structural heart disease, role of CT-FFR in the evaluation of coronary artery disease and use of cardiac CT in congenital heart disease. There were also numerous opportunities for early career faculty and FIT, including a session on carving a niche in CT for early career faculty and FITs led by Andrew D. Choi, MD, FACC.

Overall, this conference provided ample learning opportunities for both cardiologists and radiologist at all stages of their careers.

This article was authored by Jeremy Slivnick, MD, and Thura T. Harfi, MD, MPH, from the Ohio State University Medical Center in Columbus, OH.