What’s Going to Be Hot at ACC 2026

The American College of Cardiology (ACC) 2026 Scientific Session is once again heading to New Orleans, the legendary Louisiana city on the banks of the Mississippi River.

The 3-day meeting is packed with roughly 300 sessions involving more than 1,300 faculty members, including 200 or so from outside the United States. Its organizers had their hands full this past year, with more than 10,000 abstracts from 82 countries submitted for presentation. In the end, 4,730 abstracts will be presented in one form or another during the meeting.

ACC 2026 officially kicks off on Saturday, March 28, 2026, with the Opening Showcase in the Main Tent. The session includes the ACC Presidential Address by Christopher Kramer, MD (University of Virginia School of Medicine, Charlottesville), followed by an overview of the meeting by Chair Kathryn Berlacher, MD (University of Pittsburgh Medical Center, PA).

Berlacher, who spoke with the media ahead of the conference, said it’s a “massive meeting,” noting there are 11 distinct clinical pathways, each focused on a different specialty: cardiac arrhythmias, heart failure (HF), imaging, prevention, and coronary, peripheral, and structural interventions, among others. There are 20 sessions related to clinical guidelines, including the newly released recommendations for the treatment of dyslipidemia.

“Practice-changing science is really the heart of the ACC annual scientific sessions,” Vice Chair Julie Damp, MD (Vanderbilt University Medical Center, Nashville, TN), told the media. “We consistently get feedback that this is why people come to the meeting. It’s what people want to hear about and take away from the meeting.”

Back again is a “crowdsourced” session, with the topic selected by meeting attendees. The focus of this town hall discussion is concierge medicine, an approach to care delivery in which patients pay an annual or monthly fee for enhanced access to their primary care doctors, often without third-party reimbursement.

“It’s a completely different practice strategy and it’s been growing quite a bit in the US, mainly in primary care models, but we’re starting to see it expand into cardiology,” said Damp. “There’s quite a lot of interest in what that looks like, how it works, and the pros and cons.” The session will also provide attendees with information about the policies and economics behind the model, she added.  

There is also a focus on artificial intelligence (AI), including sessions on the real-world implementation of AI that will be capped off with a keynote lecture from Mintu Turakhia, MD (Stanford Medicine, CA), chief medical and scientific officer of iRhythm, exploring how to scale AI into cardiology practices. On Sunday, Rohan Khera, MD (Yale School of Medicine, New Haven, CT), is delivering a lecture on some of the bottlenecks that occur when translating AI research into clinical care. There will also be discussions on financial and governance structures necessary to support the adoption of AI.

For those in New Orleans early, there are several preconference sessions on Friday, March 27, including immersive programs on the cardiovascular care of patients with cancer, sports cardiology, and critical care cardiology.

Late-Breaking Clinical Trials

This year, there are seven late-breaking clinical trial (LBCT) sessions with 27 presentations. There are also five featured research sessions and three that fall under the umbrella of “Investigative Horizons.” All told, 175 studies from 26 countries were submitted for consideration.

In LBCT I, the HI-PEITHO trial is comparing ultrasound-facilitated catheter-directed thrombolysis to anticoagulation alone for acute intermediate-to-high-risk pulmonary embolism. Next up is CHAMPION-AF, an eagerly anticipated trial in light of last year’s “not noninferior” CLOSURE-AF study of left atrial appendage occlusion (LAAO). With CHAMPION-AF, investigators are also comparing LAAO to oral anticoagulation in patients with atrial fibrillation. The third study is STEMI Door-to-Unload, an investigation of primary left ventricular unloading in STEMI patients without cardiogenic shock.

“We have been using devices that unload the strain on the left ventricle for some time,” said Berlacher. “Typically, we have done that in patients with shock, but [STEMI Door-to-Unload] is looking at using the Impella device to unload the LV regardless of shock, just in the setting of STEMI, and is being compared to PCI alone.”  

LBCT II includes two hypertension studies: KARDINAL, a phase II study of the antisense oligonucleotide tonlamarsen (Ionis Pharmaceuticals) for treating uncontrolled hypertension, and GoFreshRx, which is looking into whether the delivery of DASH diet-patterned groceries can reduce blood pressure in hypertensive adults with challenging access to healthy food. Also slated for presentation are two lipid trials, more data from VESALIUS-CV, and Ez-PAVE investigating the safety and benefits of taking LDL cholesterol down to less than 55 mg/dL. 

The analysis of VESALIUS-CV, which takes a look at the benefits of evolocumab (Repatha; Amgen) in the subgroup of patients without significant atherosclerosis, has “the potential to really change our understanding of how we use PCSK9 inhibition,” said Damp. “It may inform our ability to do better risk management long term for a broader group of our patients.”

On Sunday, March 29, there are three late-breaking sessions. LBCT III is focused on interventional trials, including a provocative placebo-controlled trial of PCI in patients with chronic total occlusions (ORBITA-CTO). Another study, CHIP-BCIS3, is investigating PCI in high-risk cases with percutaneous LV unloading. The two other trials address the role of different physiology-guided approaches in PCI (ALL-RISE and FAST III).

LBCT IV, focused on heart failure, spotlights SPIRIT-HF investigating the mineralocorticoid receptor antagonist spironolactone in the treatment of patients who have HF with preserved or mildly reduced ejection fraction (HFpEF and HFmrEF, respectively). Results from SCOUT-HCM, a study testing mavacamten (Camzyos; Bristol Myers Squibb) in adolescent patients with obstructive hypertrophic cardiomyopathy, will also be presented. Another study is digging into the role of lung impedance-guided therapy in HFpEF patients, while the last is CADENCE, which is looking at the efficacy and safety of sotatercept (Winrevair; Merck Sharp & Dohme) in adults with pre- and postcapillary pulmonary hypertension due to HFpEF.    

The last of these on Sunday, LBCT V, is tackling structural interventions, including the SURVIV trial looking at redo surgery against a transcatheter valve-in-valve procedure for mitral bioprosthetic dysfunction. The ProtectH2H trial will compare two different embolic protection devices in patients undergoing TAVI, while PRO-TAVI is pitting a strategy of routine PCI against a deferred approach in patients undergoing TAVI. The final trial in the session will include further data from the Tri.fr study of tricuspid transcatheter edge-to-edge repair.

On the meeting’s last day are LBCT VI and VII. In the Monday morning session, there is a CT angiography substudy of ESSENCE-TIMI 73b with olezarsen (Tryngolza; Ionis Pharmaceuticals), a study of digoxin in rheumatic heart disease (Dig-RHD), and the THRIVE pilot study of a “food is medicine” intervention on blood pressure in Black and Hispanic adults. The last study, SMART-DECISION, is looking into outcomes in stabilized acute MI patients who stop beta-blocker therapy.

“SMART-DECISION is definitely getting a lot of discussion in the cardiovascular world,” said Berlacher. “We have been using beta-blockers in the post-MI population for many years now, and it has always been thought that it’s a lifelong therapy, but there are data coming out looking at actually stopping beta-blockers in patients after a certain period of time.” Getting a patient off a medication when it’s no longer providing a benefit is “always great,” she said.

Finally, LBCT VII is again focused on more interventional trials, including several looking at intravascular guidance in complex, high-risk procedures (IVUS-CHIP), bifurcation lesions (DKCRUSH-VIII), and unprotected left main PCI (OPTIMAL). Phase III results from the SirPAD trial, which looked at the role of sirolimus-coated balloons in infra-inguinal PAD cases, is also on the docket.   

Featured Science and More

In addition to the LBCTs, there 19 presentations spread across five Featured Clinical Research sessions. These include studies in patients with myocardial infarction with no obstructive coronary arteries (MINOCA), imaging studies with coronary artery calcium (CAC) scoring in diverse global cohorts, long-term follow-up on antiplatelet strategies in PCI-treated patients, and more data from the TRISCEND II randomized trial, among others.

Lastly, on Monday, March 30, the three Investigative Horizons sessions are focused on novel tools, including AI-based analysis of retinal images to assess atherosclerotic CVD risk and gene therapy to treat patients with Friedreich ataxia cardiomyopathy. There are also presentations on an AI-based model to evaluate surgical techniques of cardiac surgeons, AI-based screening with ECGs for structural heart disease from PREVUE-VALVE, and long-term results with acoramidis (Attruby; BridgeBio Pharma) in patients with transthyretin amyloid cardiomyopathy.

As always, ACC 2026 will host several keynote presentations. Cathleen Biga, MSN, RN (Cardiovascular Management, IL), immediate past president of ACC, is slated to deliver the James T. Dove lecture and Carole Warnes, MD (Mayo Clinic, Rochester, MN), is set to give the Dan G. McNamara address. The Eugene Braunwald lecture will be given by Paul Friedman, MD (Mayo Clinic; Rochester, MN), who will focus on the future of AI in cardiovascular medicine.

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The full TCTMD team will be in attendance at this year’s meeting, so feel free to reach out if you have a great idea for a story or come by the press room if you just want to say hello. You might even find some of us in the French Quarter after each day is done.