Day 1 at #ACC13 A chest pain sandwich

It seemed quite appropriate for the meeting to kick off where it often all begins; with a troponin assay.

The opening session: High Sensitivity Troponin Assays Are Coming: How to Exploit the Benefits and Avoid the Pain was addressed by a ‘Who’s Who’ of work in this field including Fred Apple, Alan Wu, Alan Jaffe, David Morrow and James Januzzi. Along with that, pretty much everyone else who might have been included on the program was in the room anyway along with a strong contingent of interested representatives of the diagnostics industry. This was meeting session #601 but it was really Troponin 101, covering through from analytical issues, normal ranges, deltas and clinical use in the setting of acute and chronic disease states. It was great to see some of our work (ADAPT) alongside that of Christian Mueller’s group cited by David Morrow as the studies showing the direction this is all heading.

At the other end of the day I went along to session #625 CT Angiography in clinical use. This too was chaired by two of the luminaries in this field, particularly when concerned with the use of CT coronary angiography (CTCA) in the context of acute chest pain assessment; Udo Hoffmann from Boston and James Goldstein form Michigan. Again there wasn’t so much new here, but an excellent review of the state of the art. CTCA has a good case for being the investigation of choice to exclude coronary disease in patients at low to intermediate risk presenting acutely with chest but the burning question I hoped would have been answered is just how low is too low to need a complex test such as this? It seems that still no-one is either willing or able to answer this one just yet. It strikes me that this is one just crying out to be studied further…

So a good first day for those interested in chest pain and still time to meet up with many colleagues and friends. I haven’t been to the ACC meeting for many years and I’d really forgotten how good it can be.

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