Apple Heart Study Ate Up Day 1 of ACC

Tricia Ward

Disclosures

March 26, 2019

The Apple Heart Study was the sole presentation in the opening Late-Breaking Clinical Trial (LBCT) session at the 68th annual American College of Cardiology (ACC) meeting in New Orleans.

The 3-day meeting had only one LBCT session that day, showcasing the app-based study that used a smart watch to identify atrial fibrillation. A spokesperson for ACC said via email that there has always been one LBCT session on Saturday and two on each Sunday and Monday. "The difference this year was that there was only one presentation in LBCT I versus the usual two or three."

On Sunday, there were two LBCT sessions, each featuring five trials; and on the final day, as attendees descended upon Ernest N. Morial Convention Center in a sea of roller boards primed to catch flights home, there were also two LBCT sessions with a total of 10 trials.

So, did the Apple Heart Study warrant its own session? Ajay Kirtane, MD (Columbia University), who is involved in program development for meetings run by the Cardiovascular Research Foundation, including TCT, said via email that "in general, more good science, especially at the start of a meeting, always transcends the excitement of a single study," adding that "because the Apple Watch Study wasn't a home run...Saturday felt a little anemic, which is really tough with a compressed-format meeting."

The Apple Heart Study may have had the physical stage all to itself, but an embargo break on Saturday triggered early online release of data from two late-breakers on transcatheter aortic valve replacement (TAVR) in low-surgical-risk patients with aortic stenosis (PARTNER-3 and Evolut) that were slated for the Sunday morning LBCT session.

Figure. #ACC19 and Apple mentions (red) and TAVR/Evolut/PARTNER (orange) among cardiologists on Twitter, March 14-20, 2019. Source: Symplur/Medscape

A snapshot of CardioTwitter shows that the Apple Heart Study dominated on Saturday, and while there was some discussion of the TAVR trials after the embargo break, the topic didn't peak until the live presentations on Sunday as mentions of Apple waned (Figure).

The embargo-break spoilers did not dampen attendees' enthusiasm for the PARTNER-3 or Evolut studies. Their respective investigators, Martin B. Leon, MD, and Michael Reardon, MD, received a standing ovation , and panelists proclaimed this a historic day in cardiology.

CardioTwitter seemed more impressed by the Apple Heart Study's potential implications for clinical research than what it may mean for the diagnosis and management of atrial fibrillation.

So Many Trials, and More

The Apple Heart Study was presented in the LBCT session sponsored by the Journal of the American College of Cardiology. ACC confirmed that neither the journals nor any of the trial sponsors have a say in the sessions in which they are included: "It's decided by a committee of our physician leadership." Journal sponsorship does not mean that the presentations will be published in that journal (or at all).

Of course, the scientific sessions include much more than late-breaking clinical trials; there were more than 1500 presentations and nearly 3000 posters at ACC, not to mention the updated ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. Rightly or wrongly, the late-breakers tend to dominate the conversation and media coverage.

In 2018 the American Heart Association condensed a former 5-day conference to a tighter 3-day format. Meeting co-chair, Eric Peterson, MD, explained at the time that physicians are simply unable and/or unwilling to be away for more than 3 days. The AHA kicked off with not one but three LBCT sessions on its opening Saturday, featuring 13 presentations.

In response to a photo showing a dearth of attendees on day 3 of AHA 2018, Kirtane tweeted that the best attendance is on a Saturday or Sunday and that Friday tends to trump Monday if an additional day is needed.

Robert Harrington, MD (Stanford University), who is also on the planning committee for AHA 2019, tweeted, "[N]o matter how long or short the mtg, attendees want to leave early. Raises existential question: if the mtg was one day, would people come and immediately leave?"


 

The LBCT schedule for the AHA Scientific Sessions 2019 was not available at press time.

Additional reporting by Liz Neporent.

Follow Tricia Ward on Twitter: @_triciaward

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