Dr Purvi Parwani (Loma Linda University Health, US) recaps the standout science from Day 2 of ACC 2026, a day defined by a central theme: challenging long-held assumptions in cardiology. Her summary focuses on what these updates mean for day-to-day clinical practice, from prevention strategies to interventional decision-making.

Prevention and Risk Reduction
VESALIUS-CV: Showed a 25% reduction in major cardiovascular outcomes among high-risk patients without established ASCVD. This finding underscores the expanding frontier of primary prevention and the power of earlier intervention.
KARDINAL: Offered new insights into resistant hypertension, emphasizing patient phenotyping to guide therapy optimization and avoid a one-size-fits-all approach.
SPIRIT-HF: Highlighted ongoing challenges in HFpEF management, particularly around tolerability and adherence, calling for greater personalization in treatment plans.

Interventional Insights
CHIP-BCIS3: Questioned the need for routine LV unloading before elective PCI in complex high-risk cases, suggesting a more selective, physiology-driven approach.
ORBITA-CTO: Demonstrated symptom and quality-of-life improvements with PCI compared to placebo in chronic total occlusion, affirming the role of patient-centered outcomes in revascularization decisions.

Recorded on-site at ACC.26, New Orleans.

Editor: Mirjam Boros
Videographers: Dan Brent, David Ben-Harosh