Deepak Bhatt discusses some of the most impactful trials at ACC 2026
To unpack the large number of late-breaking trials at the American College of Cardiology 2026 meeting, Cardiovascular Business spoke in the above video interview with Deepak L. Bhatt, MD, MPH, MBA, FACC, FAHA, FESC, MSCAI, director of the Mount Sinai Fuster Heart Hospital, who highlighted several studies he felt had the most scientific impact. This included a mix of drug, device and strategy trials pointing to advances in cardiometabolic therapies, lipid management and the evolving role of interventional devices.
Among pharmacotherapy studies, Bhatt emphasized new analyses from the SURPASS-CVOT trial comparing tirzepatide with dulaglutide in patients with cardiovascular risk. While the trial met its primary endpoint of non-inferiority for major adverse cardiovascular events, it did not achieve statistical superiority. However, Bhatt noted a particularly compelling signal in reduced all-cause mortality with tirzepatide.
He added that the mortality benefit—driven in part by reductions in non-cardiovascular deaths—aligns with trends seen in other GLP-1–based therapies. Additional data from the trial also showed benefits in kidney outcomes, underscoring the growing role of cardiologists in prescribing metabolic drugs such as GLP-1 receptor agonists and SGLT2 inhibitors.
In lipid management, Bhatt pointed to subgroup data from the VESALIUS-CV trial supporting the expansion of PCSK9 inhibition into primary prevention populations.
“The data looked terrific,” he said, noting that ongoing dedicated trials will further clarify the role of these agents beyond secondary prevention.
On the interventional side, Bhatt discussed mixed results for the microaxial flow Impella pump. The STEMI-DTU trial evaluating left ventricular unloading prior to primary PCI in STEMI patients failed to show statistically beneficial reduction in infarct size, reinforcing current practice to avoid delaying revascularization. He acknowledged there is still a lot of ongoing interest in the concept of 30 minutes of perfusion support first period to PCI to reduce infarct size, of which were was a signal, but that would need to be refined in a new trial.
“I think the trial was negative and you shouldn’t do it,” he said.
He contrasted that with positive findings from the 2024 late-breaking DanGer Shock trial, where the device reduced mortality in patients with STEMI and cardiogenic shock, albeit with notable complication rates. Other studies in complex PCI populations, however, did not demonstrate benefit, highlighting the need for careful patient selection and more refined device designs.
Bhatt also addressed trials of left atrial appendage occlusion (LAAO), which generated significant debate. While the CHAMPION-AF trial showed non-inferiority compared with anticoagulation but with wide margins and numerically higher event rates, including stroke. As a result, Bhatt cautioned against broader adoption beyond patients who can tolerate direct oral anticoagulants.
"I think with left atrial appendage occlusion, the complication rates, especially outside of expert centers, aren't trivial. There's always this potential for patients to prefer a device-based therapy if they think it's a one and done, as opposed to lifelong taking a medicine," Bhatt explained. "Patient preferences should be weighed in, but on the other hand, doctors and particular proceduralists shouldn't just jump on it without saying, 'Hey, I actually think the data might support a medical approach.'"
Overall, Bhatt characterized ACC.26 as “a phenomenal” meeting, with a wide range of data that will inform clinical decision-making while reinforcing the importance of balancing innovation with evidence-based care and patient-centered discussions.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]