TCTMD’s Top 10 Most Popular Stories for April 2026

April offered a steady stream of American College of Cardiology conference news and other research on hot topics ranging from left atrial appendage closure to mechanical circulatory support in STEMI and high-risk PCI, spironolactone in heart failure, intravascular imaging, treatment of chronic total occlusions, and the impact of achieving very low LDL cholesterol levels.

Speaking of lipids, the US dyslipidemia guidelines—emphasizing lower targets earlier in life—have already begun to make their mark. Also noteworthy was an article in memory of master operator Matteo Montorfano.

By far, though, our most-read article is a tribute to cardiology legend Eugene Braunwald, who died on April 22.

1. Eugene Braunwald, ‘Icon’ of Modern Cardiology, Dies at 96

With a career in medicine spanning eight decades, Braunwald will be remembered for his impact on every corner of the field.

2. ACC 2026 CHAMPION-AF: A Win for Watchman FLX, but With Caveats

Physicians wrestled with endpoint composition, low event rates, a possible difference in ischemic strokes, and more.

3. ACC 2026 Impella Support in High-Risk PCI Doesn’t Help, Might Harm: CHIP-BCIS3

The results challenge the rapid growth of Impella support during high-risk PCI. Investigators say a reckoning is needed.

4. ACC 2026 SPIRIT-HF: Spironolactone’s Benefit Still Uncertain in HF With Preserved, Mildly Reduced EF

The trial enrolled just half of its planned patients, leaving spironolactone’s role in HFpEF and HFmrEF still up in the air.

5. ACC 2026 Two Neutral IVUS Trials in Complex PCI—and One Positive—Spark Debate 

The controversial findings had interventional cardiologists looking for answers, with operator experience coming into focus.

6. Matteo Montorfano, Master Operator, Dies at 60

Known for his skills as a clinician and educator, Montorfano contributed much to the interventional cardiology community.

7. ACC 2026 ORBITA-CTO: PCI Reduces Angina Symptoms in Sham-Controlled Trial

In carefully selected patients with CTOs, symptom-driven PCI does provide a benefit when done by experienced operators.

8. Lower LDL Levels, Starting Earlier in Life: New ACC/AHA Dyslipidemia Guidelines

LDL targets return with stronger recommendations around CAC and Lp(a) screening and a focus on lifetime risk.

9. ACC 2026 Mechanical Circulatory Support Doesn’t Reduce Infarct Size in STEMI

In the STEMI Door-to-Unload trial, use of Impella missed the mark in patients with anterior MI without cardiogenic shock.

10. ACC 2026 Very Low LDL Levels Best in Secondary Prevention: Ez-PAVE

The trial findings complement the updated US dyslipidemia guidelines that promote early and intensive LDL-lowering.

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This is just a sampling of what TCTMD has on offer. Check out the journalists’ own favorites on Heart Sounds, and join Yael Maxwell as she gets to know the people behind the science on her newly debuted podcast, Hearts & Minds.

Conference season continues, with recent articles coming from Heart Rhythm 2026 and the Society for Cardiovascular Angiography and Interventions’ annual meeting. Up next in May, the TCTMD news team will be covering the European Stroke Organisation Conference, the European Society of Cardiology’s Heart Failure Congress, and EuroPCR—all in addition to recently published practice-changing results.

As always, feel free to reach out with any ideas, questions, or feedback.