TCTMD’s Top 10 Most Popular Stories for March 2026

Mere days after the American College of Cardiology 2026 Scientific Session in New Orleans, TCTMD’s news coverage from the meeting dominates our most-read stories for March. Top of the list is the much anticipated CHAMPION-AF trial of left atrial appendage closure, with STEMI-DTU, Ez-PAVE, CHIP-BCIS3, and others following close behind. Beyond the ACC, however, this month also offered up the new US dyslipidemia guidelines, a study of the interplay between Lp(a) and CAC as risk predictors, and the COBRRA trial in venous thromboembolism.

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

Physicians looking for clarity on left atrial appendage occlusion wrestled with endpoint composition, low event rates, a possible difference in ischemic strokes, and more.

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

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

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

In the STEMI Door-to-Unload trial, use of Impella (Abiomed/Johnson & Johnson MedTech) missed the mark in patients with anterior MI without cardiogenic shock.

4. 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.

5. 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.

6. Lp(a) and CAC Levels Independently Predict Long-term ASCVD Risk

The 15-year data help support the idea that each test can aid in putting the other’s results in perspective, but questions remain.

7. 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.

8. ACC 2026 HI-PEITHO: Catheter-Directed Therapy Bests Anticoagulation in Intermediate-Risk PE

The intervention group had a 61% lower risk of decompensation and other hard outcomes at 7 days.

9. Apixaban Bests Rivaroxaban for Bleeding in VTE: COBRRA

In an editorial, one expert said the choice of DOAC in VTE is “no longer a toss-up,” with apixaban the clear winner.

10. 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.

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Thank you to all who generously shared your input, data, and enthusiasm with us at this year’s ACC Scientific Session. It was great to see you! Next up, Todd Neale is headed to the Heart Rhythm meeting in Chicago, IL, and Laura McKeown to the Society for Cardiovascular Angiography and Interventions conference in Montreal, Canada.

You can read all the incoming news online, of course, and hear our own top picks on the monthly Heart Sounds podcast with the TCTMD team. If you haven’t already, do check out TCTMD journalist Yael Maxwell’s new podcast, Hearts & Minds.